Association between baseline hemoglobin level and early neurological deterioration after intravenous thrombolysis in patients with acute ischemic stroke
10.3724/zdxbyxb-2023-0510
- VernacularTitle:基线血红蛋白水平对急性缺血性脑卒中患者静脉溶栓后早期神经功能恶化的影响
- Author:
Tinghuan WANG
1
,
2
;
Wansi ZHONG
;
Zhicai CHEN
;
Ke SHEN
;
Huiya YE
;
Zhihui YU
;
Jia LUO
;
Jun MA
;
Min LOU
Author Information
1. 浙江大学医学院附属第二医院神经内科,浙江 杭州 310009
2. 嘉善县第一人民医院神经内科,浙江 嘉兴 314100
- Keywords:
Acute ischemic stroke;
Intravenous thrombolysis;
Hemoglobin;
Anemia;
Early neurologic deterioration;
Retrospetive study
- From:
Journal of Zhejiang University. Medical sciences
2024;53(2):168-174
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between baseline hemoglobin level and early neurologic deterioration(END)after intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods: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.Results:A total of 8162 patients were included.Patients with END had lower baseline hemoglobin levels(136 and 140 g/L,P<0.01)and higher rates of anemia(24.2%and 16.9%,P<0.01)compared with non-END patients.Binary logistic regression analysis showed that baseline hemoglobin level(OR=0.995,95%CI:0.991-0.999,P<0.05)and anemia(OR=1.238,95%CI:1.055-1.454,P<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(P<0.01),although this relationship was only significant in male patients(P<0.05)and not in female patients(P>0.05).Conclusion: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.
