Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China.
Department of Neurosurgery, First People's Hospital of Honghe City, Yunnan, People's Republic of China.
World Neurosurg. 2019 Jul;127:e835-e842. doi: 10.1016/j.wneu.2019.03.281. Epub 2019 Apr 4.
Hypertensive cerebral hemorrhage leads to greater mortality and worse functional outcomes at high altitudes. Experimental studies have suggested that hemoglobin can lead to increased perihemorrhagic edema after intracerebral hemorrhage.
Patients were divided into a high-hemoglobin (H-H) group (>180 g/L) and a low-hemoglobin (L-H) group (≤180 g/L). The distance from the cortex to the midline was used to indicate the degree of edema. At 1, 7, 14, and 21 days, the patients' status was scored using the Glasgow coma scale, and survival was plotted using Kaplan-Meier survival curves. Pearson correlation analysis showed that the difference between the postoperative and preoperative Glasgow coma scale score correlated with the hemoglobin concentration. The Glasgow outcome scale was used to assess neurological recovery after 6 months.
On days 7, 14, and 21, the edema of the H-H group was significantly greater than that of the L-H group (P < 0.01 and P < 0.001, respectively). The edema of the H-H group peaked at 14 and 21 days, but that of the L-H group peaked at 7 days. The hemoglobin concentration and postoperative neurological recovery had a linear relationship in the H-H group. The L-H group had greater survival compared with the H-H group (P < 0.05). The L-H group had higher Glasgow outcome scale scores compared with the H-H group (P < 0.05).
The hemoglobin concentration affects the mortality and morbidity from hypertensive cerebral hemorrhage in high-altitude regions, and a linear relationship exists between hemoglobin concentration and neurological recovery in the H-H group.
高血压性脑出血在高海拔地区导致更高的死亡率和更差的功能预后。实验研究表明，血红蛋白可导致脑出血后周围水肿增加。
患者分为高血红蛋白（H-H）组（>180 g/L）和低血红蛋白（L-H）组（≤180 g/L）。用皮层到中线的距离来表示水肿程度。在第 1、7、14 和 21 天，使用格拉斯哥昏迷量表对患者的状态进行评分，并使用 Kaplan-Meier 生存曲线绘制生存情况。Pearson 相关分析显示术后和术前格拉斯哥昏迷量表评分的差异与血红蛋白浓度相关。使用格拉斯哥结局量表评估 6 个月后的神经恢复情况。
在第 7、14 和 21 天，H-H 组的水肿明显大于 L-H 组（P<0.01 和 P<0.001）。H-H 组的水肿在第 14 和 21 天达到高峰，而 L-H 组在第 7 天达到高峰。H-H 组的血红蛋白浓度与术后神经恢复呈线性关系。与 H-H 组相比，L-H 组的存活率更高（P<0.05）。与 H-H 组相比，L-H 组的格拉斯哥结局量表评分更高（P<0.05）。
血红蛋白浓度影响高血压性脑出血在高海拔地区的死亡率和发病率，H-H 组的血红蛋白浓度与神经恢复呈线性关系。
