血清镁水平对急性脑出血患者的预后意义。

Prognostic Significance of Serum Magnesium in Acute Intracerebral Hemorrhage Patients.

机构信息

Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.

Department of Neurology, The First People's Hospital of Xuzhou, Xuzhou 221002, China.

出版信息

Curr Neurovasc Res. 2019;16(2):123-128. doi: 10.2174/1567202616666190412124539.

DOI:10.2174/1567202616666190412124539

PMID:30977445

Abstract

BACKGROUND

Experimental animal model studies have shown neuroprotective properties of magnesium. We assessed the relationship between admission magnesium and admission stroke severity and 3-month clinical outcomes in patients with acute intracerebral hemorrhage (ICH).

METHODS

The present study included 323 patients with acute ICH who were prospectively identified. Demographic characteristics, lifestyle risk factors, National Institute of Health Stroke Scale (NIHSS) score, hematoma volumes, and other clinical features were recorded at baseline for all participants. Patients were divided into three groups based on the admission magnesium levels (T1: <0.84; T2: 0.84-0.91; T3: ≥0.91 mmol/L). Clinical outcomes were death, poor functional outcome (defined by modified rankin ccale [mRS] scores 3-6) at 3 months.

RESULTS

After 3-month follow-up, 40 (12.4%) all-cause mortality and 132 (40.9%) poor functional outcome were documented. Median NIHSS scores for each tertile (T1 to T3) were 8.0, 5.5, and 6.0, and median hematoma volumes were 10.0, 8.05, and 12.4 ml, respectively. There was no significant association between baseline NIHSS scores (P=0.176) and hematoma volumes (P=0.442) in T3 and T1 in multivariable linear regression models. Compared with the patients in T1, those in T3 were associated with less frequency of all-cause mortality [adjusted odds ratio (OR), 0.10; 95% confidence interval (CI), 0.02-0.54; P-trend=0.010] but not poor functional outcome (adjusted OR, 1.80; 95%CI, 0.71-4.56; P-trend=0.227) after adjustment for potential confounders.

CONCLUSION

Elevated admission serum magnesium level is associated with lower odds of mortality but not poor functional outcome at 3 months in patients with acute ICH.

摘要

背景

实验动物模型研究表明镁具有神经保护作用。我们评估了急性脑出血（ICH）患者入院时镁与入院时卒中严重程度和 3 个月临床结局之间的关系。

方法

本研究前瞻性纳入 323 例急性 ICH 患者。所有参与者在基线时记录人口统计学特征、生活方式危险因素、国立卫生研究院卒中量表（NIHSS）评分、血肿量和其他临床特征。根据入院时镁水平将患者分为三组（T1：<0.84；T2：0.84-0.91；T3：≥0.91mmol/L）。临床结局为 3 个月时的死亡和不良功能结局（定义为改良Rankin 量表[ mRS ]评分 3-6）。

结果

3 个月随访后，记录到 40 例（12.4%）全因死亡和 132 例（40.9%）不良功能结局。每个三分位（T1 至 T3）的中位数 NIHSS 评分分别为 8.0、5.5 和 6.0，中位数血肿量分别为 10.0、8.05 和 12.4ml。多变量线性回归模型中，基线 NIHSS 评分（P=0.176）和血肿量（P=0.442）与 T3 和 T1 之间无显著相关性。与 T1 组相比，T3 组全因死亡率较低[校正比值比（OR），0.10；95%置信区间（CI），0.02-0.54；P 趋势=0.010]，但 3 个月时不良功能结局无差异（校正 OR，1.80；95%CI，0.71-4.56；P 趋势=0.227），校正潜在混杂因素后。