Huang Wen-Yi, Chen I-Chuan, Meng Lee, Weng Wei-Chieh, Peng Tsung-I
Department of Neurology, Keelung Chang-Gung Memorial Hospital, 222, Maijin Road, Anle Chiu, Keelung 204, Taiwan.
J Clin Neurosci. 2009 May;16(5):645-9. doi: 10.1016/j.jocn.2008.08.014. Epub 2009 Mar 12.
There is considerable debate regarding whether anemia qualifies as a prognostic factor for stroke. The purpose of this study was twofold: first, to assess the influence of anemia on vascular risk factors and clinical presentations in patients with first-ever atherosclerosis-related ischemic stroke and, second, to evaluate whether anemia may be of prognostic importance. A total of 774 consecutive patients with first-ever atherosclerosis-related ischemic stroke were prospectively investigated. Vascular risk factors, clinical presentations and outcomes were recorded and compared between those patients with and without anemia. Stroke recurrence and mortality were recorded at the 3-year follow-up. Of the study population, 168 (21.7%) were anemic. Multivariate analysis revealed that patients with anemia were more likely to be older than 70 years (p<0.001) and have chronic renal insufficiency (p<0.001). After a mean follow-up period of 958 days, 21 (12.5%) and 24 (4.0%) of the patients in the anemic and control groups, respectively, died. Within 3 years of initial onset, the mortality rate was significantly higher in patients with anemia (p=0.021). The Kaplan-Meier analysis for patients with and without anemia showed different survival curves (Log-rank test p<0.001). Within 3 years of the onset of first-ever atherosclerosis-related ischemic stroke, patients who had anemia at the time of the initial admission had an associated higher mortality rate. The stroke risk factors of being older than 70 years and having chronic renal insufficiency were more frequently observed in those patients with anemia.
关于贫血是否可作为中风的预后因素存在相当大的争议。本研究的目的有两个：第一，评估贫血对首次发生的动脉粥样硬化相关缺血性中风患者血管危险因素和临床表现的影响；第二，评估贫血是否具有预后重要性。对774例连续的首次发生动脉粥样硬化相关缺血性中风患者进行了前瞻性研究。记录并比较了有贫血和无贫血患者的血管危险因素、临床表现及预后情况。在3年随访期记录中风复发和死亡率。在研究人群中，168例（21.7%）为贫血患者。多变量分析显示，贫血患者更有可能年龄大于70岁（p<0.001）且患有慢性肾功能不全（p<0.001）。在平均随访958天后，贫血组和对照组分别有21例（12.5%）和24例（4.0%）患者死亡。在首次发病3年内，贫血患者的死亡率显著更高（p=0.021）。对有贫血和无贫血患者的Kaplan-Meier分析显示出不同的生存曲线（对数秩检验p<0.001）。在首次发生动脉粥样硬化相关缺血性中风3年内，初次入院时患有贫血的患者死亡率更高。年龄大于70岁和患有慢性肾功能不全的中风危险因素在贫血患者中更常见。
