红细胞指数与动脉瘤性蛛网膜下腔出血(aSAH)后认知障碍的直接相关性。

A Direct Correlation between Red Blood Cell Indices and Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage (aSAH).

机构信息

Department of Neurology, Shanghai Tenth People's Hospital, Tongji University, 301# Middle Yanchang Road, Shanghai 200072, China.

Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, 301# Middle Yanchang Road, Shanghai 200072, China.

出版信息

Curr Neurovasc Res. 2019;16(2):142-147. doi: 10.2174/1567202616666190412142718.

DOI:10.2174/1567202616666190412142718

PMID:30977449

Abstract

BACKGROUND

Cognitive impairment can occur after aneurysmal subarachnoid hemorrhage (aSAH) though it commonly tends to be neglected. Red blood cell (RBC) indices are associated with long-term functional outcomes, while it is unclear whether RBC indices could be a potential predictor of cognitive decline after aSAH. We aimed to investigate the association between RBC indices and post-aSAH cognitive impairment at 1 year.

METHODS

Patients with aSAH received neuropsychological test by the Montreal Cognitive Assessment (MoCA) and underwent serum and cerebrospinal fluid (CSF) samples test. To determine the association between RBC indices and cognitive impairment after acute aSAH, we adjusted for demographic and vascular risk factors using multivariate logistic regression analysis.

RESULTS

Of the 126 patients included in this study, 33% (42/126) of them were diagnosed with cognitive impairment (MoCA＜26). After adjustment for potential confounders, increased mean corpuscular volume (MCV) (OR: 1.36, 95%CI: 1.19-1.55) and mean corpuscular hemoglobin (MCH) (OR: 1.61, 95%CI: 1.25-2.08), reflecting systemic iron status, are more likely to be associated with cognitive impairment after aSAH.

CONCLUSION

In this aSAH population, our data shows the positive association between MCH and MCV and cognitive impairment at 1 year.

摘要

背景

尽管认知障碍在蛛网膜下腔出血（aSAH）后很常见，但往往容易被忽视。红细胞（RBC）指数与长期功能预后相关，而 RBC 指数是否可以成为 aSAH 后认知能力下降的潜在预测指标尚不清楚。我们旨在研究 RBC 指数与 1 年后 aSAH 后认知障碍之间的关系。

方法

接受 aSAH 的患者通过蒙特利尔认知评估（MoCA）进行神经心理测试，并进行血清和脑脊液（CSF）样本测试。为了确定 RBC 指数与急性 aSAH 后认知障碍之间的关系，我们使用多变量逻辑回归分析调整了人口统计学和血管危险因素。

结果

在这项研究中，纳入了 126 名患者，其中 33%（42/126）的患者被诊断为认知障碍（MoCA＜26）。在调整了潜在混杂因素后，平均红细胞体积（MCV）（OR：1.36，95%CI：1.19-1.55）和平均红细胞血红蛋白（MCH）（OR：1.61，95%CI：1.25-2.08）的增加，反映了全身铁状态，更有可能与 aSAH 后认知障碍相关。