血红蛋白水平与缺血性脑卒中患者复发和复合血管事件风险的相关性

Correlation between hemoglobin level and the risk of cerebral ischemic stroke recurrence and composite vascular events in stroke patients

目的探究不同血红蛋白(Hb)水平与缺血性脑卒中(CIS)患者卒中复发和复合血管事件风险的相关性。方法将2016年1月至2018年12月于延安大学附属医院及延安市中医医院神经内科诊治的358例急性脑卒中患者纳入研究,在患者出院后对其进行为期1年的随访,随访过程中有34例患者失访,20例患者非心血管死亡,共304例患者完成随访,根据304例患者入院Hb水平,将其分为贫血组(56例)、正常组(202例)和Hb高水平组(46例),比较三组患者的年龄、性别等一般资料,并比较不同基线Hb水平患者的卒中复发和复合血管事件发生风险,对不同年龄、性别以及基线NIHSS评分患者进行亚组分析,并应用Kaplan-Meier法绘制生存曲线。结果三组患者的一般资料差异均无统计学意义(均P>0.05);贫血组有7例患者出现卒中复发,正常组10例,Hb高水平组6例,贫血组及Hb高水平组患者的卒中复发风险均显著高于正常组(均P<0.05),而贫血组和Hb高水平组卒中复发风险间差异无统计学意义(P>0.05);贫血组有10例患者发生复合心血管事件,正常组15例,Hb高水平组8例,贫血组及Hb高水平组患者的卒中复发风险均显著高于正常组(均P<0.05),而贫血组和Hb高水平组卒中复发风险间无统计学差异(P>0.05);亚组分析示,Hb水平异常是年龄≤68岁,女性,基线NIHSS≤9患者卒中复发及复合心血管事件的危险因素(均P<0.05),而在年龄>68岁,男性及基线NIHSS>9的患者中差异无统计学意义(P>0.05)。结论基线Hb水平异常与缺血性脑卒中患者,特别是年龄≤68岁,女性,基线NIHSS≤9的患者的卒中复发及复合心血管事件的发生有关。

Objective To explore the correlation between different hemoglobin(Hb)levels and the risk of stroke recurrence and complex vascular events in patients with cerebral ischemic stroke(CIS).Methods 358 patients with acute stroke who were diagnosed and treated in the Affiliated Hospital of Yan'an University and the Department of Neurology of Yan'an Hospital of traditional Chinese medicine from January 2016 to December 2018 were included in the study.After discharge,they were followed up for a period of one year.During the follow-up process,34 patients lost the follow-up,20 patients died of non cardiovascular diseases,a total of 304 patients completed the follow-up,The patients were divided into anemia group(56 cases),normal group(202 cases)and high Hb level group(46 cases).The general information of the three groups,such as age and gender,and the risk of stroke recurrence and complex vascular events in patients with different baseline Hb levels were compared.The subgroups of patients with different age,gender and baseline NIHSS score were analyzed,and Kaplan Meier method was used to draw the data Control the survival curve.Results There was no significant difference in the general information of the three groups(all P>0.05);there were 7 cases of recurrence of stroke in anemia group,10 cases in normal group and 6 cases in high Hb level group.The risk of stroke recurrence in anemia group and high Hb level group was significantly higher than that in normal group(all P<0.05),but there was no statistical difference between anemia group and high Hb level group In anemia group,10 patients had complex cardiovascular Hb level group were significantly higher than that in normal group(all P<0.05),but there was no statistical difference between anemia group and highHb level group(P>0.05);subgroup analysis showed that Hb had no significant difference Abnormal level was a risk factor of stroke recurrence and complex cardiovascular events in patients with age≤68 years,female,baseline NIHSS≤9(all P<0.05),but there was no significant difference in patients with age>68 years,men and baseline NIHSS>9(P>0.05).Conclusion abnormal baseline Hb levels are associated with stroke recurrence and complex cardiovascular events in patients with CIS,especially those with age≤68 years,female,and baseline NIHSS≤9.