血清铁相关指标与老年脑卒中后认知障碍风险的相关性  

Correlation between serum iron-related indexes and the risk of cognitive impairment after stroke in elderly patients

作　　者：程玲玲 岳巧莲 高然然 CHENG Lingling;YUE Qiaolian;GAO Ranran(Handan People’s Hospital,Handan 056001,China)

机构地区：[1]邯郸市人民医院,河北邯郸056001

出　　处：《中国实用神经疾病杂志》2025年第4期462-466,共5页Chinese Journal of Practical Nervous Diseases

基　　金：邯郸市科学技术研究与发展计划项目(编号:1523108149)。

摘　　要：目的探讨老年脑卒中患者血清铁相关指标与卒中后认知障碍(PSCI)风险的相关性。方法采集2021-08—2023-08邯郸市人民医院的200例老年脑卒中患者信息,根据卒中后2周内是否出现PSCI,将患者分为PSCI组(n=126)和非PSCI组(n=74),采用单因素分析2组患者脑卒中严重程度等基础资料和血清铁相关实验室数据,Pearson相关系数分析血清铁水平与认知障碍程度的相关性,多因素Logistic回归分析PSCI的影响因素,绘制ROC曲线分析影响因素对老年脑卒中患者PSCI风险的预测效能。结果2组患者年龄、受教育年限、入院NIHSS评分、血清铁及Hb水平差异有统计学意义(P<0.05)。Pearson相关系数显示,血清铁水平与MMSE评分呈正相关(r=0.438,P<0.001)。多因素Logistic回归分析显示,年龄较大(OR=1.089)、入院NIHSS评分高(OR=2.953)、血清铁低(OR=0.564)和Hb水平低(OR=0.950)是老年脑卒中患者PSCI的独立危险因素(P<0.05)。ROC曲线分析显示,年龄的曲线下面积(AUC)为0.607(95%CI:0.529~0.685),入院NIHSS评分的AUC为0.716(95%CI:0.645~0.787)、血清铁的AUC为0.846(95%CI:0.789~0.902)和Hb的AUC为0.725(95%CI:0.654~0.796)。结论老年脑卒中患者血清铁水平与其认知障碍程度呈负相关,且年龄较大、入院NIHSS评分高、血清铁及Hb水平低是老年脑卒中患者PSCI的独立危险因素。入院时血清铁水平对老年脑卒中患者PSCI风险具有较好预测价值,有望作为预测老年脑卒中患者PSCI的独立指标。Objective To investigate the correlation between serum iron-related indexes and the risk of cognitive impairment in elderly stroke patients.Methods The information of 200 elderly stroke patients admitted to Handan People’s Hospital from August 2021 to August 2023 was collected,and the patients were divided into PSCI group(n=126)and non-PSCI group(n=74)according to whether PSCI appeared within 2 weeks after stroke.Univariate analysis was used for the basic data such as the severity of stroke and serum iron-related laboratory data in the two groups,Pearson correlation coefficient analysis was used for the correlation between serum iron level and cognitive impairment in patients.Multivariate Logistic regression was used to analyze the influencing factors for patients with PSCI,and ROC curve was used to analyze the predictive efficacy of influencing factors on the risk of PSCI in elderly stroke patients.Results There were significant differences in age,years of education,admission NIHSS score,serum iron and Hb levels between the two groups(P<0.05).Pearson correlation coefficient analysis showed that serum iron level was positively correlated with MMSE score(r=0.438,P<0.001).Multivariate Logistic regression coefficient analysis showed that older age(OR=1.089),higher admission NIHSS score(OR=2.953),lower serum iron(OR=0.564)and lower Hb level(OR=0.950)were the independent risk factors for elderly stroke patients with PSCI(P<0.05).The ROC curve showed that the area under the curve(AUC)of age was 0.607(95%CI:0.529-0.685),the AUC of admission NIHSS score was 0.716(95%CI:0.645-0.787),the AUC of serum iron was 0.846(95%CI:0.789-0.902),and the AUC of Hb was 0.725(95%CI:0.654-0.796).Conclusion The serum iron level of elderly stroke patients is negatively correlated with the degree of cognitive impairment,and older age,higher admission NIHSS score and lower serum iron and Hb levels are independent risk factors for elderly stroke patients with PSCI.Among them,the serum iron level at admission has a good predictive value for t

关 键 词：脑卒中 卒中后认知障碍 铁 血清 相关性 

分 类 号：R749.13[医药卫生—神经病学与精神病学]