Liu Meng, Xiong Yao, Hua Xing, Huang Linrui, He Weihong, You Chao, Liu Ming, Wu Simiao
Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
The Affiliated Hospital of Southwest Jiaotong University &, The Third People's Hospital of Chengdu, Chengdu, 610031, Sichuan, China.
Neurol Sci. 2023 Nov;44(11):3957-3965. doi: 10.1007/s10072-023-06886-7. Epub 2023 Jun 9.
To investigate whether serum calcium and magnesium on the day of symptom onset contribute to prognosis at 1 year after intracerebral hemorrhage (ICH).
We prospectively enrolled patients admitted < 24 h after symptom onset of primary ICH to West China Hospital between January 2012 and October 2014. Blood samples were collected at admission to determine the concentration of serum calcium and magnesium. We analyzed associations of the serum concentration of calcium and magnesium with unfavorable outcome (defined as modified Rankin scale, mRS ≥ 3) at 1 year.
We included 874 patients (mean age 59.1 ± 13.5 years, 67.6% males), of whom 470 patients had mRS ≥ 3 and 284 patients died at 1 year. Compared to patients with the highest tertile level of calcium concentration (≥ 2.29 mmol/L), patients in the lowest tertile (≤ 2.15 mmol/L) had higher odds of unfavorable outcome (odds ratio, OR 1.61, 95% confidence interval [CI] 1.04-2.50, P = 0.034). The Kaplan-Meier survival curve revealed a significant difference of cumulative survival rate across calcium tertiles (log-rank P value = 0.038). There was no significant association between serum concentration of magnesium and functional outcome at 1 year.
A reduced serum concentration of calcium on the day-of-event was associated with unfavorable outcome at 1 year after ICH. Future studies are needed to illustrate the pathophysiological mechanism of calcium and whether calcium could be a treatment target for improving outcomes after ICH.
探讨脑出血（ICH）症状发作当天的血清钙和镁水平是否有助于预测1年后的预后。
我们前瞻性纳入了2012年1月至2014年10月期间在华西医院因原发性ICH症状发作后<24小时入院的患者。入院时采集血样以测定血清钙和镁的浓度。我们分析了血清钙和镁浓度与1年后不良结局（定义为改良Rankin量表，mRS≥3）之间的关联。
我们纳入了874例患者（平均年龄59.1±13.5岁，男性占67.6%），其中470例患者mRS≥3，284例患者在1年后死亡。与钙浓度处于最高三分位数水平（≥2.29 mmol/L）的患者相比，处于最低三分位数（≤2.15 mmol/L）的患者出现不良结局的几率更高（优势比，OR 1.61，95%置信区间[CI] 1.04 - 2.50，P = 0.034）。Kaplan-Meier生存曲线显示不同钙三分位数的累积生存率存在显著差异（对数秩P值 = 0.038）。血清镁浓度与1年后的功能结局之间无显著关联。
事件当天血清钙浓度降低与ICH后1年的不良结局相关。未来需要开展研究以阐明钙的病理生理机制以及钙是否可作为改善ICH后结局的治疗靶点。
