Lasek-Bal Anetta, Holecki Michał, Stęposz Arkadiusz, Duława Jan
Department of Neurology, Medical University of Silesia Hospital No. 7, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, Poland.
Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia Hospital No. 7, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, Poland.
Neurol Neurochir Pol. 2015;49(2):107-12. doi: 10.1016/j.pjnns.2015.03.001. Epub 2015 Mar 13.
Anemia is the risk factor for cerebrovascular events. The aim of this study was to evaluate the prevalence of anemia among patients with first-ever stroke and its impact on neurological state in the acute phase of the disease and the degree of disability in short-term follow-up.
The prospective study included 107 patients aged 72.81 ± 11.12 with the first-ever stroke. Each patient underwent CT of the head and blood tests, including Hb concentration on the first day of hospitalization. We have analyzed the neurological state on the first day of stroke by NIHSS and the functional status on the 14th day after the onset of stroke by mRankin scale in patients with and without anemia. Patients with anemia were additionally divided according to Hb level (less or over 11g/dl).
Patients with Hb≤ 11g/dl significantly more often achieved a score of 4-5 points on mRankin scale on the 14th day of stroke compared to patients with anemia and Hb>11g/dl. Independent predictors of a worse functional status on the 14th day of stroke in patients with anemia include the neurological state on the 1st day and the hemispheric location of stroke; an independent predictor of death was the neurological state on the 1st day of onset.
Mild anemia did not influence significantly the neurological condition in acute phase of stroke but worsened the functional status in subacute phase of stroke. The neurological state on the first day of stroke and the hemispheric location of cerebral ischemia are independent factors of poor prognosis in patients with anemia in short-term follow-up.
贫血是脑血管事件的危险因素。本研究旨在评估首次发生卒中患者中贫血的患病率及其对疾病急性期神经状态的影响以及短期随访中的残疾程度。
这项前瞻性研究纳入了107例年龄为72.81±11.12岁的首次发生卒中的患者。每位患者均接受了头部CT检查和血液检查，包括住院第一天的血红蛋白浓度检测。我们通过美国国立卫生研究院卒中量表（NIHSS）分析了卒中第一天的神经状态，并通过改良Rankin量表（mRankin scale）分析了卒中发作后第14天有贫血和无贫血患者的功能状态。贫血患者还根据血红蛋白水平（低于或高于11g/dl）进行了分组。
与贫血且血红蛋白>11g/dl的患者相比，血红蛋白≤11g/dl的患者在卒中第14天的改良Rankin量表评分显著更常达到4-5分。贫血患者卒中第14天功能状态较差的独立预测因素包括第一天的神经状态和卒中的半球位置；死亡的独立预测因素是发病第一天的神经状态。
轻度贫血在卒中急性期对神经状况无显著影响，但在卒中亚急性期会使功能状态恶化。卒中第一天的神经状态和脑缺血的半球位置是贫血患者短期随访中预后不良的独立因素。
