Effect of abnormal iron metabolism on neurological function in elderly patients with HICH after minimally invasive hematoma clearance
10.3969/j.issn.1009-0126.2025.09.008
- VernacularTitle:铁代谢异常对高血压性脑出血的老年患者微创血肿清除术后神经功能的影响
- Author:
Mingyue LI
1
;
Jie GAO
;
Yu YUAN
;
Jiaqiang ZHANG
;
Jiahui REN
Author Information
1. 063000 唐山市工人医院神经外一科
- Publication Type:Journal Article
- Keywords:
hypertension;
iron metabolism disorders;
cerebral hemorrhage;
hematoma
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(9):1169-1172
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of abnormal iron metabolism on neurological func-tion in elderly patients with hypertensive intracerebral hemorrhage(HICH)after minimally inva-sive surgical evacuation.Methods A prospective study was conducted on 300 elderly patients with HICH admitted to our hospital from January 2021 to December 2023.At 28 d after surgery,Glas-gow Outcome Scale(GOS)was used to assess the presence of neurological deficits or not,and then they were divided into a good neurological function group(GOS score≥4,175 cases)and a poor neurological function group(GOS score＜4,125 cases).Iron deposition in cerebrospinal fluid and serum iron metabolism were compared between the two groups,and the risk factors for neu-rological deterioration were analyzed.Results Compared with the good neurological function group,the poor neurological function group exhibited significantly decreases in Glasgow coma scale(GCS)scores at admission and 7 d after admission and iron ions(P＜0.01).Bleeding vo-lume,ferritin,transferrin,and quantitative susceptibility mapping(QSM)values of the thalamus and the hippocampus were obviously increased upon admission(P＜0.01).Multi variate logistic regression analysis showed that admission bleeding volume(OR=1.083,95％CI:1.012-1.159,P=0.021),ferritin(OR=1.065,95％CI:1.016-1.116,P=0.009),and thalamic QSM value(OR=4.075,95％CI:2.848-5.830,P=0.000)were risk factors for neurological dysfunction in the HICH patients after minimally invasive surgical treatment,while GCS score(OR=0.430,95％CI:0.259-0.715,P=0.001)and iron ions(OR=0.193,95％CI:0.064-0.581,P=0.003)at 7 d of admission were protective factors.Conclusion Iron deposition in cerebrospinal fluid and abnormal iron metabolism in serum are related to the deterioration of neurological function in eld-erly patients with HICH after minimally invasive hematoma evacuation,and are regarded as po-tential therapeutic targets.
