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血清铁与卒中后急性认知障碍的关系:一项横断面研究。

Association Between the Serum Iron and Acute Cognitive Impairment After Stroke: A Cross-Sectional Study.

机构信息

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

School of Mental Health, Wenzhou Medical University, Wenzhou, China.

出版信息

J Geriatr Psychiatry Neurol. 2023 Mar;36(2):121-128. doi: 10.1177/08919887221095874. Epub 2022 Apr 25.

Abstract

BACKGROUND

Complications such as cognitive impairment are common in stroke victims. The goal of this study was to see if there was a link between blood iron levels and post-stroke cognitive impairment (PSCI) within 2 weeks after stroke.

METHODS

A total of 313 patients with ischemic stroke were recruited and separated into two groups: PSCI (n = 202) and non-PSCI (n = 111). The Mini-mental state examination scale was used to evaluate the cognitive status within 2 weeks after stroke (acute phase). The serum iron levels were divided into 4 layers: Q1 ≤ 11.7 μmol/L, Q2 11.8-15.1 μmol/, Q3 15.2-19.3 μmol/L, Q4 ≥ 19.4 μmol/L, respectively. The connection between serum iron and PSCI was then investigated further using binary logistic regression, which was adjusted for confounders.

RESULTS

The difference in serum iron levels between the PSCI and non-PSCI group was initially conducted by the Mann-Whitney test, and a significant difference was found (14.5 (11.0-17.8) vs. 16.9 (13.7-21.8), p < .001), with no confounders being adjusted. After adjusting for confounding factors, the binary regression analysis showed that the Q4 layer showed the lowest risk of PSCI, with the Q1 layer being the reference. (odds ratio (OR) = 0.297, 95% confidence interval (CI) = 0.136-0.649, p = 0.002).

CONCLUSION

A decreased risk of early-onset PSCI was linked to high serum iron levels. Low serum iron levels were found to be a risk factor for acute cognitive impairment following stroke, which could help physicians identify and take intervention measures early to reduce the risk of cognitive impairment after stroke.

摘要

背景

认知障碍等并发症在中风患者中很常见。本研究旨在探讨中风后 2 周内血液铁水平与中风后认知障碍(PSCI)之间是否存在关联。

方法

共招募了 313 例缺血性中风患者,将其分为 PSCI 组(n = 202)和非 PSCI 组(n = 111)。采用简易精神状态检查量表在中风后 2 周内(急性期)评估认知状态。血清铁水平分为 4 层:Q1≤11.7μmol/L、Q2 11.8-15.1μmol/L、Q3 15.2-19.3μmol/L、Q4≥19.4μmol/L。然后使用二元逻辑回归进一步研究血清铁与 PSCI 之间的关系,调整混杂因素。

结果

PSCI 组和非 PSCI 组的血清铁水平差异采用 Mann-Whitney 检验,差异有统计学意义(14.5(11.0-17.8)比 16.9(13.7-21.8),p<0.001),未调整混杂因素。调整混杂因素后,二元回归分析显示 Q4 层发生 PSCI 的风险最低,以 Q1 层为参考。(比值比(OR)=0.297,95%置信区间(CI)=0.136-0.649,p=0.002)。

结论

较高的血清铁水平与早期 PSCI 风险降低相关。低血清铁水平是中风后急性认知障碍的危险因素,有助于医生早期识别并采取干预措施,降低中风后认知障碍的风险。

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