血红蛋白-红细胞分布宽度比值与脑卒中的关联：基于NHANES数据库-现代医学

血红蛋白-红细胞分布宽度比值与脑卒中的关联：基于NHANES数据库

单位：中山市小榄人民医院神经内科二区, 广东中山 528415

分类号：R743.3

出版年·卷·期（页码）：2025·53·第二期（155-162）

摘要：

目的：采用横断面分析的方法探讨血红蛋白-红细胞分布宽度比值(HRR)与脑卒中患病率的相关性。方法：选取2017—2020年美国国家健康与营养调查(NHANES)数据库的12 213例参与者作为研究对象，基于血红蛋白浓度和红细胞分布宽度计算HRR，根据健康状况问卷判断脑卒中患者。采用多因素Logistic回归分析探讨HRR与脑卒中患病的相关性，构建限制性立方样条模型以明确两者间的剂量-反应关系。亚组分析探讨HRR与其他传统危险因素的交互作用。结果：最终纳入参与者2 647例，其中包括脑卒中患者126例，脑卒中患病率为4.76%。研究对象总体HRR为10.31±1.59，脑卒中患者HRR低于对照组，组间差异有统计学意义(t=5.021，P<0.001)。多因素Logistic分析结果表明，在调整了年龄、种族、受教育程度、家庭收入水平等社会人口特征和吸烟史、高血压史、糖尿病史、体力活动、心血管病家族史等因素后，高水平的HRR与脑卒中患病风险降低独立相关(Q₃：OR=0.53，95%CI：0.30~0.96；Q₄：OR=0.45，95%CI：0.26~0.78)。剂量-反应关系结果显示，HRR与脑卒中患病风险显著相关(P<0.001)，且两者呈负向线性关系(非线性P=0.077)。亚组分析显示，所有因素均未对HRR与脑卒中患病风险之间的关联产生显著影响(P_交互>0.05)。结论： HRR与脑卒中患病风险独立相关，高水平HRR对脑卒中患病具有保护作用。

Objective: To investigate the association between the hemoglobin-to-red cell distribution width ratio(HRR) and the prevalence of stroke using a cross-sectional analysis. Methods: Data from 12 213 participants in the 2017-2020 National Health and Nutrition Examination Survey (NHANES) database were used as the study population. HRR was calculated based on hemoglobin concentration and red cell distribution width, and stroke patients were identified through a health status questionnaire. Multivariate Logistic regression analysis was conducted to explore the correlation between HRR and stroke prevalence. A restricted cubic spline model was constructed to clarify the dose-response relationship between the two. Subgroup analyses were performed to investigate the interaction between HRR and other traditional risk factors. Results: A total of 2 647 participants were ultimately included, among which 126 were stroke patients, with a stroke prevalence of 4.76%. The overall HRR level of the study population was 10.31±1.59, and the HRR in stroke patients was observed to be lower than that in the control group, with a statistically significant difference(t=5.021, P<0.001). The results of the multivariate logistic regression analysis showed that, after adjustments for sociodemographic characteristics such as age, race, education level, and household income, as well as factors like smoking history, history of hypertension, diabetes history, physical activity, and family history of cardiovascular disease, higher HRR was independently associated with a reduced risk of stroke(Q₃:OR=0.53, 95%CI:0.30-0.96; Q₄:OR=0.45, 95%CI:0.26-0.78). The dose-response relationship between HRR and stroke risk was found to be significant(P<0.001), with a negative linear relationship(non-linearity P=0.077). It was observed that none of the factors significantly influenced the association between HRR and stroke risk in the subgroup analysis(P_interaction>0.05). Conclusion: HRR is found to be independently associated with stroke risk, namely higher HRR levels providing a protective effect against stroke.

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