贫血对急性缺血性卒中预后的影响

Effect of Anemia on the Prognosis of Acute Ischemic Stroke

目的探讨贫血对急性缺血性卒中2年预后的影响。方法收集在北京市老年病医院住院的急性缺血性卒中患者131例,记录患者的一般资料和临床特征,神经功能缺损评价采用NIHSS评分。根据患者入院时有无贫血分为贫血组和非贫血组,随访患者2年预后、复合血管事件和死亡率,其中预后采用mRS量表进行评价(mRS评分≤2分为预后良好,mRS评分>2分为预后不良)。复合血管事件包括再发卒中、脑出血和急性冠状动脉综合征。采用Logistic回归分析贫血对急性缺血性卒中2年预后和死亡的影响。结果与非贫血组相比,贫血组患者年龄较大,神经功能缺损较重,心房颤动、慢性肾功能不全、外周血管病患病率较高,差异有统计学意义。入院时贫血是急性缺血性卒中患者2年预后不良(OR5.063,95%CI 1.887～13.590)、死亡(OR 13.266,95%CI 1.364～128.993)的独立危险因素。结论入院时合并贫血的急性缺血性卒中患者年龄较大,共存疾病较多,神经功能缺损较重。贫血是卒中后2年预后不良、病死率高的独立危险因素。

Objective To investigate the effect of anemia on the 2-year prognosis in patients with acute ischemic stroke.Methods Data of 131 consecutive inpatients with acute ischemic stroke from Beijing Geriatric Hospital were collected.According to whether having anemia on admission or not,all the paitents were divided into anemia and non-anemia groups.The functional prognosis,composite vascular events and mortality within 2 years were followed up.The prognosis was assessed by mRS,and the good prognosis was defined as mRS≤2.Composite vascular events included recurrent stroke,cerebral hemorrhage and acute coronary syndrome.Logistic regression analysis was used to assess the effect of anemia on the prognosis of acute ischemic stroke.Results There were significant differences in age,hemoglobin level,severe neurological impairment and the incidence of atrial fibrillation,chronic kidney disease and peripheral vascular disease between anemia group and non-anemia group(P<0.05).Logistic regression analysis showed that anemia was a risk factor for 2-year poor prognosis(OR 5.063,95%CI 1.887-13.590)and mortality(OR 13.266,95%CI 1.364-128.993)after acute ischemic stroke.Conclusions Patients with acute ischemic stroke and anemia on admission had elder age,more comorbidities and severe neurological impairment.Anemia was an independent risk factor of 2-year poor prognosis and high mortality in patients with acute ischemic stroke.