Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Neurology, the First People's Hospital of Jiashan County, Jiaxing 314100, Zhejiang Province, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2024 Apr 25;53(2):168-174. doi: 10.3724/zdxbyxb-2023-0510.
To investigate the association between baseline hemoglobin level and early neurologic deterioration (END) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).
Data of AIS patients who received intravenous thrombolytic therapy at multiple hospitals across the country between January 2017 and July 2020 were collected from the online database Acute Stroke Patients for Stroke Management Quality Evaluation (CASE-Ⅱ, NCT04487340). Binary logistic regression analysis was used to study the factors affecting the occurrence of END after intravenous thrombolytic therapy, and the correlation between baseline hemoglobin level and END was investigated by limiting cubic spline curve analysis.
A total of 8162 patients were included. Patients with END had lower baseline hemoglobin levels (136 and 140 g/L, <0.01) and higher rates of anemia (24.2% and 16.9%, <0.01) compared with non-END patients. Binary logistic regression analysis showed that baseline hemoglobin level (=0.995, 95%: 0.991-0.999, <0.05) and anemia (=1.238, 95%: 1.055-1.454, <0.01) were independently correlated with the occurrence of END after intravenous thrombolysis in AIS patients. Restricted cubic spline regression showed that there was a U-shaped relationship between hemoglobin level and the risk of END after intravenous thrombolysis in AIS patients (<0.01), although this relationship was only significant in male patients (<0.05) and not in female patients (>0.05).
There is a correlation between baseline hemoglobin level and the risk of END in AIS patients after intravenous thrombolysis, especially in male patients, in whom both lower and higher hemoglobin level may increase the risk of END.
探讨急性缺血性脑卒中（AIS）患者静脉溶栓后早期神经功能恶化（END）与基线血红蛋白水平的关系。
从全国多家医院的在线数据库急性脑卒中患者治疗质量评估（CASE-Ⅱ，NCT04487340）中收集 2017 年 1 月至 2020 年 7 月接受静脉溶栓治疗的 AIS 患者的数据。采用二元逻辑回归分析研究影响静脉溶栓后 END 发生的因素，并通过限制立方样条曲线分析探讨基线血红蛋白水平与 END 的相关性。
共纳入 8162 例患者。与非 END 患者相比，END 患者的基线血红蛋白水平较低（136 和 140 g/L，<0.01），贫血发生率较高（24.2%和 16.9%，<0.01）。二元逻辑回归分析显示，基线血红蛋白水平（=0.995，95%：0.991-0.999，<0.05）和贫血（=1.238，95%：1.055-1.454，<0.01）与 AIS 患者静脉溶栓后 END 的发生独立相关。受限立方样条回归显示，血红蛋白水平与 AIS 患者静脉溶栓后 END 风险之间存在 U 形关系（<0.01），但这种关系仅在男性患者中具有统计学意义（<0.05），而在女性患者中则无统计学意义（>0.05）。
基线血红蛋白水平与 AIS 患者静脉溶栓后 END 风险相关，尤其是在男性患者中，较低和较高的血红蛋白水平均可能增加 END 的风险。
