血红蛋白对脑卒中康复治疗远期预后的评估价值

Clinical value of hemoglobin in the assessment of long-term prognosis of stroke after rehabilitation treatment

目的探讨血红蛋白(Hb)对脑卒中康复治疗远期预后的评估价值。方法选择瑞安市人民医院2018年1月至2019年1月收治的脑卒中患者168例为研究对象,均接受康复治疗,根据康复治疗前Hb水平分为Hb<120 g/L组(36例)和Hb≥120 g/L组(132例)。随访12个月,比较两组一般资料、康复治疗前后的简式Fugl-Meyer运动(FMA)评分和改良Barthel指数(MBI)评分,使用Peason相关性分析Hb水平与康复治疗后FMA评分、MBI评分的关系,采用受试者工作特征(ROC)曲线下面积(AUC)评价Hb预测脑卒中复发的的效能。结果Hb<120g/L组与Hb≥120g/L组性别、年龄、体质量指数(BMI)等一般资料比较,均差异无统计学意义(均P>0.05)。Hb≥120 g/L组康复治疗后FMA评分[(85.39±8.27)分]、MBI评分[(87.14±8.85)分]均明显高于Hb<120 g/L组[(79.82±6.18)分、(80.06±6.97)分](t=5.625、6.012,均P<0.05);经Peason相关性分析,康复治疗前Hb水平与脑卒中康复治疗后FMA评分、MBI评分均呈正相关(r=0.425、0.362,均P<0.05);在168例患者中,随访期脑卒中复发27例(16.07%);经ROC曲线分析,康复治疗前Hb预测随访期脑卒中复发的AUC为0.915,明显大于美国国立卫生研究院卒中量表(NIHSS)评分的0.630,差异有统计学意义(Z=2.652,P<0.05)。结论康复治疗前低Hb水平的脑卒中患者远期预后更差,监测Hb水平对于预测复发的效能较好。该研究具有显著创新性和科学性,值得进一步研究应用。

Objective To investigate the clinical value of hemoglobin in the assessment of long-term prognosis of stroke after rehabilitation treatment.Methods A total of 168 patients with stroke who received treatment in Ruian People's Hospital,China between January 2018 and January 2019 were included in this study.All of them received rehabilitation treatment.They were divided into Hb<120 g/L group(n=36 and Hb≥120 g/L group(n=132)according to Hb level before rehabilitation treatment.All patients were followed up for 12 months.General data,and simplified Fugl-Meyer Assessment(FMA)score and modified Barthel Index(MBI)before and after treatment were compared between the two groups.Pearson correlation was used to analyze the correlation between Hb level and simplified FMA score and MBI.The area under the receiver operating characteristic(ROC)curve was used to evaluate the efficacy of Hb level in predicting stroke recurrence.Results There were no significant differences in gender,age and body mass index between the two groups(all P>0.05).After treatment,simplified FMA score and MBI in the Hb≥120 g/L group were(85.39±8.27)points and(87.14±8.85)points,respectively,which were significantly higher than those in the Hb<120 g/L group[(79.82±6.18)points,(80.06±6.97)points,t=5.625,6.012,both P<0.05).Pearson correlation results revealed that Hb level before rehabilitation was positively correlated with FMA score and MBI(r=0.425,0.362,both P<0.05).During the follow-up period,stroke recurred in 27(16.07%)out of 168 patients.The area under the ROC curve for Hb level before treatment as a predictor of stroke recurrence was 0.915,which was significantly greater than the National Institutes of Health Stroke Scale score 0.630(Z=2.652,P<0.05).Conclusion The long-term prognosis of stroke patients with low Hb level before rehabilitation treatment is poor,and monitoring Hb level is highly effective for predicting stroke recurrence.This study is greatly innovative and scientific.Findings from this study deserve further investigation.