Study On The Association Of Post-stroke Cognitive Impairment With Plasma Hcy And TH Levels

Objective: To investigate the correlation between Hcy and Th levels and PSCI and the predictive value of PSCI.Methods: There are 115 patients with acute cerebral infarction who met the criteria of entering the group were selected from the second neurology department of The People’s hospital of Jilin Provincial from november2019 to August 2020.All the patients in the Group recorded the age,sex,race,education level,drinking and smoking history,hypertension,hyperlipidemia,diabetes,heart disease and stroke history,and gave comprehensive physical examination and nervous system examination as well.All subjects were taken elbow vein blood after 12 hours fasting for blood test index.Hcy was measured by Hitachi 7600 automatic biochemical analyzer,and TSH 、 FT3 and FT4 were detected by chemiluminescence immunoassay,also blood routine,blood biochemistry,glycosylated hemoglobin,hypersensitive C-reactive protein,vitamin B12 and folic acid levels,infectious diseases comprehensive antibody and other laboratory tests were collected.2 weeks later,the subjects were assessed by MMSE,MOCA(Beijing version),Hachinski ischemic scale(HIS)and Hamilton Depression Scale(HAMD),ADL and HAMD by the professional neurologists who were trained in standardization.All the patients were divided into two groups,one is Non PSCI group and another is PSCI group according to whether there was cognitive impairment with them.Spss24.0 software was used to analyze the collected data.The total mean number was expressed by mean ± standard deviation((?)±s).The difference was statistically significant,When P < 0.05.Results:1.The incidence of PSCI was 61.73% in the second week after stroke.2.There was no significant difference in general test information between the two groups(P > 0.05).3.The difference of MMSE and MOCA between the two groups showed that the MMSE scale score P = 0 < 0.05,MOCA scale score p= 0 < 0.05,the difference was statistically significant.4.Comparison of serum Hcy,TSH,FT3 and FT4 levels between the two groups showed as follows: Hcy P = 0.009 < 0.05,FT3 P = 0.040 P < 0.05,TSH P = 0.496 > 0.05,FT3 = 0.828 P > 05.The differences between Hcy and FT3 levels in the two groups have the statistically significant.5.The correlation between Hcy,FT3 and MMSE and MOCA scores in the PSCI group showed that the Hcy level was negatively correlated with the MMSE(r=-0.301 P<0.01)and MOCA scales(r=-0.353 P<0.01).FT3 level was positively correlated with MMSE(r=0.276 0.01< P<0.05)and MOCA scores(r=0.363 0.01< P<0.05).6.Multivariate analysis of Hcy and FT3 showed that Hcy(OR=1.088 P=0.015)and FT3(OR=0.392 P=0.010).7.The predictive value of Hcy and FT3 levels on the occurrence of PSCI was analyzed.The results showed that the area under the Hcy ROC curve was 0.712,P = 0 < 0.05,The area under the ROC curve of FT3 was 0.612,P = 0.064> 0.05.The area under ROC curve of Hcy combined with FT3 was 0.741,P = 0.00 < 0.05.Conclusion:1.The cognitive impairment after acute cerebral infarction has a higher incidence rate at the second weeks.2.Blood Hcy level is independent risk factors for PSCI,and FT3 is a protective factor for PSCI.3.Hcy and Hcy combined with FT3 have the predictive value for PSCI.