Department of Neurology, Taizhou Central Hospital (Taizhou University Hospital), 999 Donghai Road, Taizhou, 318000, China.
Department of Neurology, Huanggang Central Hospital, Huanggang, 438000, Hubei, China.
BMC Neurol. 2022 Sep 2;22(1):330. doi: 10.1186/s12883-022-02856-2.
Serum calcium abnormalities have been determined to be associated with the risk and outcome of stroke. The aim of the present study was to examine the associations of serum calcium with vascular recanalization, symptomatic intracranial haemorrhage and functional outcome in stroke patients after mechanical thrombectomy.
A total of 192 patients treated with mechanical thrombectomy for anterior circulation large vessel occlusion were consecutively included from August 2017 to June 2021. Serum calcium levels were measured on admission, and albumin-corrected calcium levels were calculated for subsequent analysis. Successful arterial revascularization was defined as a modified Thrombolysis in Cerebral Infarction scale score ≥ 2b. Symptomatic intracranial haemorrhage was assessed according to the European Cooperative Acute Stroke Study (ECASS) III criteria. Poor functional outcome was defined as a modified Rankin Scale score > 2 at 3 months.
Patients with poor outcomes had higher albumin-corrected calcium levels than patients with good outcomes before (2.20 (2.10, 2.30) mmol/L vs. 2.13 (2.04, 2.24) mmol/L, P = 0.002), and after adjusting for other factors (AOR 95% CI, 1.812 (1.253, 2.621), P = 0.002). Patients with unsuccessful recanalization had higher albumin-corrected calcium levels than those with recanalization (2.26 (2.09, 2.46) mmol/L vs. 2.17 (2.07, 2.27) mmol/L, P = 0.029), and after adjusting for other factors (AOR 95% CI, 2.068 (1.214, 3.524)), P = 0.008). No association was found between albumin-corrected calcium and symptomatic intracranial haemorrhage.
Higher serum albumin-corrected calcium levels are independently associated with revascularization and poor outcome in stroke patients after mechanical thrombectomy.
血清钙异常已被确定与中风的风险和结局相关。本研究旨在探讨机械血栓切除术后中风患者的血清钙与血管再通、症状性颅内出血和功能结局的关系。
本研究连续纳入了 2017 年 8 月至 2021 年 6 月期间接受机械血栓切除术治疗的前循环大血管闭塞的 192 名患者。入院时测量血清钙水平，并计算白蛋白校正钙水平进行后续分析。成功的动脉再通定义为改良脑梗死溶栓量表评分≥2b。症状性颅内出血根据欧洲合作急性卒中研究（ECASS）III 标准评估。功能结局不良定义为 3 个月时改良 Rankin 量表评分>2。
预后不良的患者的白蛋白校正钙水平高于预后良好的患者，分别为（2.20（2.10，2.30）mmol/L 比 2.13（2.04，2.24）mmol/L，P=0.002），且在调整其他因素后仍有统计学意义（优势比 95%可信区间，1.812（1.253，2.621），P=0.002）。未再通的患者的白蛋白校正钙水平高于再通的患者，分别为（2.26（2.09，2.46）mmol/L 比 2.17（2.07，2.27）mmol/L，P=0.029），且在调整其他因素后仍有统计学意义（优势比 95%可信区间，2.068（1.214，3.524），P=0.008）。白蛋白校正钙与症状性颅内出血之间无关联。
机械血栓切除术后中风患者血清白蛋白校正钙水平较高与再通和预后不良独立相关。
