Study On The Correlation Between Cerebrovascular Reactivity Measured By TCD And Cognitive Impairment After Stroke

Objective: To explore the correlation between cerebrovascular reactivity an d cognitive impairment after stroke and its predictive effect on the developmet trend of cognitive impairment.Methods: A total of 162 patients with acute ischemic stroke were selected,the onset time was less than 7 days,and the relevant data collection and scale evaluation were completed after the vital signs were stable.They were divided into post-stroke cognitive impairment(PSCI)and no cognitive impairment(NCI)groups based on scale scores.Transcranial Doppler(TCD)and hold breath test to observe the blood flow velocity of the middle cerebral arteries on both sides,calculate the breath-holding index(BHI),and use this value to reflect cerebrovascular reactivity(CVR);Occurrence;Collect general information of patients and compare with BHI;Use multivariate regression analysis to explore risk factors affecting cognitive impairment after stroke;Use linear correlation analysis to explore the correlation between BHI value and cognitive score;BHI the ROC curve was used to analyze the critical value of cognitive impairment after stroke;the acute phase cognitive impairment group was followed up for 3 months,and the BHI value in the acute phase of the follow-up population was compared.Results: 1.78 cases(48.1%)in the PSCI group and 84 cases(51.8%)in the NCI group.The comparison of general data showed that the PSCI group and the NCI group had high blood pressure,education level,previous stroke history,infarct side,the number of old lacunar infarcts,intracranial and external aortic stenosis,fasting blood glucose,and BHI values were statistically significant between groups(P<0.05).2.Multivariate analysis showed that high education level and high BHI value are independent protective factors of cognitive impairment after stroke;fasting blood glucose and severe intracranial and external aortic stenosis are independent risk factors of cognitive impairment after stroke;3.BHI value correlation analysis with MMSE and MoCA scores showed that the correlation coefficients r were 0.353 and0.461,respectively,which were statistically significant(P<0.05).4.Patients with cognitive impairment in the acute phase were followed up for 3 months.The BHI value in the acute phase of the non-recovery group and the cognitive functionrecovery group was statistically significant.Using the acute phase BHI value as the ROC curve showed the best cut-off value of 0.73.That is,if the BHI value is less than this value,the possibility of cognitive impairment recovery is less at 3 months,and if it is greater than this value,the cognitive impairment is expected to recover after 3months.Conclusions: 1.The incidence of cognitive impairment is higher after stroke.2.The BHI value of the acute phase PSCI group is lower than that of the NCI group,and there is a positive correlation between the BHI value and the MMSE and MoCA scores.BHI value is an independent influencing factor of PSCI and has a protective effect on the occurrence of PSCI.3.After follow-up of patients with cognitive impairment,it was found that CVR detected by TCD has a certain predictive effect on the development trend of cognitive impairment after stroke.