铁代谢异常与高血压性脑出血早期神经功能恶化之间的关系

Relationship between abnormal iron metabolism and early neurological deterioration in patients with hypertensive intracerebral hemorrhage

目的探讨铁代谢异常与高血压性脑出血患者早期神经功能恶化(END)的关系。方法收集武汉科技大学附属孝感医院高血压性脑出血患者153例,依据患者入院72 h内美国国立卫生研究院卒中量表(NIHSS)得分增加≥4分将其分为恶化组(END组)与对照组(非END组),并采集发病后第1、3、5、7天同一时间点外周血测量铁代谢指标(血清铁、铁蛋白、转铁蛋白、转铁蛋白饱和度、总铁结合力)。结果与对照组相比,恶化组各时间点血清铁蛋白[(195.68±13.43)ng/mL vs.(153.66±21.09)ng/mL]、转铁蛋白[(2.67±0.54)g/L vs.(1.45±0.22)g/L]及转铁蛋白饱和度[(25.21±1.83)%vs.(21.35±2.01)%]水平均高于对照组(P<0.05)。观察组血清铁蛋白、转铁蛋白及转铁蛋白饱和度水平与入院后72 h内NIHSS评分增加呈正相关(P<0.05)。结论铁代谢指标对于高血压性脑出血患者早期神经功能恶化有预测价值。

【Objective】To investigate the relationship between abnormal iron metabolism and early neurological deterioration in patients with hypertensive intracerebral hemorrhage.【Methods】Totally 153 patients with hypertensive intracerebral hemorrhage were divided into two groups:Early neurological deterioration(END)group and control group(non-END group)according to the score of National Institute of Health Stroke Scale(NIHSS)≥4 points within 72 hours after admission.Peripheral blood samples were collected to measure the indexes of iron metabolism(serum iron,ferritin,transferrin,transferrin saturation and total iron binding capacity)at the same time point on day 1,3,5 and 7 after onset.【Results】Compared with control group,the levels of serum ferritin(195.68±13.43 vs.153.66±21.09),transferrin(2.67±0.54 vs.1.45±0.22)and transferrin saturation(25.21±1.83 vs.21.35±2.01)in the END group were significantly higher than those in the control group(P<0.05).The levels of serum ferritin,transferrin and transferrin saturation in the observation group were positively correlated with the increase of NIHSS score within 72 hours after admission.【Conclusion】The biomakers of iron metabolism can predict the deterioration of neurological function in patients with hypertensive intracerebral hemorrhage.