Association between serum ferritin level and perihematoma edema volume in patients with spontaneous intracerebral hemorrhage
Association between serum ferritin level and perihematoma edema volume in patients with spontaneous intracerebral hemorrhage
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DOI：
10.1161/strokeaha.107.501213
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发表时间：
2008-04-01
期刊：
影响因子：
8.3
通讯作者：
Selim, Magdy
中科院分区：
文献类型：
--
作者：
Mehdiratta, Manu;Kumar, Sandeep;Selim, Magdy
背景和目的-临床前证据表明铁在脑出血后神经元损伤和水肿形成中起关键作用。然而，铁在ICH患者中的临床作用尚未得到充分研究。我们进行了这项探索性研究，以探讨血清铁蛋白，作为身体铁负荷的指标，与血肿周围水肿后ICH.Methods -我们回顾性分析前瞻性收集的临床和实验室数据，从23例连续急性自发性脑出血患者入院时进行了CT扫描和血清铁蛋白检查，并随访CT扫描3至4天后。我们在入院和随访扫描时测量血肿和水肿体积，并计算相对水肿体积以校正血肿体积。我们使用斯皮尔曼相关系数，以确定各种变量与相对perichamma水肿volume.Results的关联，而从基线到第3天至第4天的中位血肿体积增加了约28%，相对水肿体积几乎翻了一番，在这段时间内。我们观察到血清铁蛋白和相对血肿周围水肿体积在第3至4天显著正相关（r = 0.78; P = 0.002），但在基线时不相关;血肿体积变化和相应的相对水肿体积之间几乎没有相关性（r = 0.14）。体温和相对水肿volumes.Conclusions之间呈正相关的趋势-我们的研究结果支持这一概念，即延迟铁毒性在脑出血后引起脑损伤和水肿形成中起作用。这些发现是初步的，需要在未来的研究中进一步调查。
Background and Purpose - Preclinical evidence indicates that iron plays a key role in mediating neuronal injury and edema formation after intracerebral hemorrhage (ICH). However, the clinical role of iron in patients with ICH has not been well studied. We undertook this exploratory study to investigate the association of serum ferritin, as an indicator of body iron load, with perihematoma edema after ICH.Methods - We retrospectively reviewed prospectively-collected clinical and laboratory data from 23 consecutive patients with acute spontaneous ICH who had a CT scan and serum ferritin checked on admission, and a follow-up CT scan 3 to 4 days afterward. We measured hematoma and edema volumes on admission and follow-up scans, and calculated the relative edema volume to correct for hematoma volume. We used Spearman correlation coefficient to determine the association of various variables with relative perihematoma edema volume.Results - Whereas the median hematoma volume increased by approximately 28% from baseline to day 3 to 4, the relative edema volume almost doubled during this time period. We observed a significant positive correlation between serum ferritin and relative perihematoma edema volume on day 3 to 4 (r = 0.78; P = 0.002), but not at baseline; and little correlation between the changes in hematoma volumes and corresponding relative edema volumes (r = 0.14). There was a trend for a positive correlation between body temperature and relative edema volumes.Conclusions - Our findings support the notion that delayed iron toxicity plays a role in causing brain injury and edema formation after ICH. These findings are preliminary and need to be further investigated in future studies.