多种血清标志物预测老年急性缺血性脑卒中患者卒中后认知障碍的研究

目的 分析多种血清标志物预测老年急性缺血性脑卒中（AIS）患者卒中后认知障碍（PSCI的价值。方法 回顾性收集2019年1月至2023年1月哈尔滨医科大学附属第一医院神经内科收治的326例老年AIS患者的资料。根据发病后6个月的简易精神状态量表（MMSE）评分，将患者分为PSCI组（MMSE评分≤26分）和非PSCI组（MMSE评分>26分）。比较两组患者的一般资料和血清指标。采用多因素Logistic回归分析老年AIS患者发生PSCI的危险因素，并采用受试者工作特征（ROC）曲线下面积（AUC）分析血清标志物预测老年AIS患者发生PSCI的效能。结果 326例患者中，127例（38.96%）在发病后6个月发生PSCI。PSCI组年龄>75岁、患糖尿病、有脑卒中史的患者比例，入院时NIHSS评分，同型半胱氨酸、尿酸水平，中性粒细胞/淋巴细胞比值（NLR），低密度脂蛋白胆固醇（LDL-C）水平，C-反应蛋白（CRP）水平均高于非PSCI组，差异均有统计学意义（均P<0.05）；高密度脂蛋白胆固醇（HDL-C）低于非PSCI组，差异有统计学意义（P<0.05）。多因...

Research of multiple serological markers predicting post-stroke cognitive impairment in elderly patients with acute ischemic stroke

Objective To assess the role of multiple serological markers in the prediction of post-stroke cognitive impairment （PSCI） in elderly patients with acute ischemic stroke （AIS）. Methods A total of 326 patients with AIS treated in the Department of Neurology of the First Affiliated Hospital of Harbin Medical University from January 2019 to January 2023 were retrospectively enrolled. According to the Mini Mental State Scale （MMSE） score at 6 months after onset， patients were divided into PSCI group （MMSE score ≤26 points） and non PSCI group （MMSE score ＞ 26 points）. General information and serological indicators were compared between the two groups. Risk factors for PSCI were screened using multifactorial Logistic regression. The efficacy of serological markers in predicting PSCI was rated using receiver operating characteristic （ROC） area under curve （AUC）. Results Among 326 patients， 127 （38.96%） experienced PSCI 6 months after onset. The proportion of patients with age ＞ 75， diabetes and stroke history， NIHSS score， homocysteine， uric acid， neutrophil/lymphocyte ratio （NLR）， low-density lipoprotein cholesterol （LDL-C）， C-reactive protein （CRP） at admission of PSCI group were significantly higher than those of non PSCI group （P＜ 0.05）； The high-density lipoprotein cholesterol （HDL-C） of PSCI group was lower than that of non PSCI group， and the difference was statistically significant （P ＜ 0.05）. The results of multifactorial logistic regression analysis showed that age ＞75 years （OR=1.422， 95%CI：1.050-1.926， P=0.023）， high NIHSS score at admission （OR=1.791， 95%CI：1.324-2.423，P ＜ 0.001）， high CRP （OR=1.305， 95%CI：1.077-1.581， P=0.007）， high NLR （OR=1.520， 95%CI： 1.196-1.933， P ＜ 0.001）， and high LDL-C （OR=1.387， 95%CI：1.132-1.699， P=0.002） were all the independent risk factors for the development of PSCI in elderly patients with AIS. The ROC curve analysis results showed that the AUC of CRP， NLR， and LDL-C predicting PSCI in elderly AIS patients were 0.655 （95%CI： 0.595-0.715）， 0.813 （95%CI： 0.766-0.859）， and 0.735 （95%CI： 0.680-0.789）， respectively. Conclusions CRP， NLR and LDL-C are independent risk factors for the occurrence of PSCI in elderly patients with AIS， and they have a certain predictive ability for PSCI， with NLR having the highest predictive performance.