Stroke：急性脑出血患者入院时血钙水平低或与其血肿体积较大相关

　　日本一项研究表明，急性脑出血的患者入院时血清低钙水平与血肿体积较大和美国国立卫生研究院卒中量表（NIHSS）评分较高相关，相关论文5月14日在线发表于《卒中》（stroke）杂志。

　　研究共入选273例因脑出血发病入院24之内的患者，并根据入院时血清钙水平将其划分为四分位组[分别为Q1（≤9.0）， Q2 （9.1–9.3），Q3 （9.4–9.7），Q4 (≥9.8 mg/dL）]。

　　结果显示，四组患者（Q1—Q4）的中位血肿体积分别为18、9、10和9 mL （P=0.005），中位NIHSS评分分别为16、11、11和 9 （P=0.010）。多元分析显示，与Q4组患者相比，Q1组患者的血肿面积和NIHSS评分均较高。校正危险因素和共病后，改良Rankin评分在0— 2之间的患者在Q1组较少，但这种关系在校正血肿体积和NIHSS评分的其他因素后不存在。改良Rankin评分在5— 6之间和存在致死性转归的患者在Q1组更多，但校正之后这种关系不存在。

与脑出血相关的拓展阅读：

• 急性脑出血患者入院时血钙水平低或与其血肿体积较大相关
• Circulation：卒中和脑出血对感染性心内膜炎有负面影响
• Stroke：血管内卒中治疗合用替罗非班增加脑出血风险
• ANN NEUROL：防止脑出血新方法
• Neurology：常服抗抑郁药或增加脑出血风险
• STROKE：采用MIS治疗自发性幕上脑出血获益更多
更多信息请点击：有关脑出血更多资讯

Low Serum Calcium Levels Contribute to Larger Hematoma Volume in Acute Intracerebral Hemorrhage.
BACKGROUND AND PURPOSE
We investigate whether admission serum calcium levels are associated with hematoma volume, stroke severity, and outcomes in patients with acute intracerebral hemorrhage.
METHODS
A total of 273 patients admitted within 24 hours after intracerebral hemorrhage onset was divided into quartiles based on admission serum calcium levels (Q1 [≤9.0], Q2 [9.1-9.3], Q3 [9.4-9.7], Q4 [≥9.8] mg/dL).
RESULTS
Median hematoma volumes for each quartile (Q1 to Q4) were 18, 9, 10, and 9 mL (P=0.005), and median National Institutes of Health Stroke Scale scores were 16, 11, 11, and 9 (P=0.010), respectively. On multivariate analysis, Q1 had larger hematoma volume (P=0.025) and higher National Institutes of Health Stroke Scale score (P=0.020) than Q4. There were fewer patients with modified Rankin Scale scores 0 to 2 in Q1 than Q4 after adjustment for risk factors and comorbidities (odds ratio, 0.31; 95% confidence interval, 0.11-0.84) but not after additional adjustment for hematoma volume and National Institutes of Health Stroke Scale score. There were more patients with modified Rankin Scale scores 5 to 6 (P=0.016) and with fatal outcomes (P=0.048) in Q1 than Q4 as crude values, but not after adjustment.
CONCLUSIONS
Low admission serum calcium levels were associated with larger hematoma volume and higher National Institutes of Health Stroke Scale score among patients with acute intracerebral hemorrhage.