Relationship Between Serum APN,sCD40L,Hcy Levels And Cognitive In Patients With Acute Cerebral Infarction

BackgroundOne fourth to one fifth of patients with acute cerebral infarction(ACI)had cognitive impairment(CI)as a result of cerebral infarction(ACI),which results in the loss of brain tissue and loss of neurological function.there are also many patients with cognitive impairment after cerebral infarction.The onset form usually starts from mild cognitive impairment and gradually develops to severe cognitive impairment,which seriously affects the life of patients.Early recognition of this disease can improve the symptoms.A new study suggests that certain factors in serum may be used to recognize post stroke cognitive impairment(PSCI)as a way of intervening to improve the quality of life of patients.In this study,the effects of serum adiponectin,sCD40L and Hcy on PSCI were analyzed.Objective1.To explore the relationship between serum levels of APN,Hcy and serum levels of sCD40L and PSCI,aiming to discover the diagnostic value of the three serum factors for PSCI,so as to provide theoretical basis for early recognition and intervention treatment of cognitive impairment after cerebral infarction.2.The PSCI group was divided into three groups according to the size of cerebral infarction,so as to understand the correlation between the three serum factors and the size of cerebral infarction.3.ACI patients were divided into the middle-aged group and the elderly group.Serum indexes were analyzed to understand the levels of serum APN,sCD40L,Hcy in patients of different ages.MethodsUsing the method of group test,Choice From October 2018 to April 2020,the second clinical of xinxiang medical university affiliated hospital neurology patients of acute cerebral infarction patients as the research object,which included 141 patients with acute cerebral infarction,according to the Montreal scale(montreal cognitive assessment,MOCA)in patients with ACI can be divided into PSCI and normal Cognitive function after cerebral infarction group(Post Stroke No Cognitive Impairment,PSNCI)group,improve the general data after admission and biochemical indicators,ultimately to determination of APN,Hcy and sCD40L,Analyze and compare the data.The data were imported into Excel,and SPSS 22.0 was used for descriptive statistical analysis,independent sample T-test,one-way analysis of variance,pearson correlation analysis,and ROC.Inspection levelα=0.05.P<0.05 indicated a statistically significant difference.Results1.There was no statistical significance in age,smoking and drinking history and other general data between PSNCI and PSCI groups(P>0.05).There were no significant differences in serum cholesterol(TC),Triacylglycerol(TG),low-density lipoprotein(LDL),high-density lipoprotein(HDL),UA and Cys-C between PSNCI and PSCI groups(P>0.05).2.MOCA score in PSCI group was significantly lower than that in PSNCI group,while NIHSS score was higher than that in PSNCI group,and the comparison between groups was statistically significant(P>0.05).3.There were significant differences in serum Hcy,APN and sCD40L levels between PSNCI and PSCI groups(P<0.05).4.The analysis of serum factors after age group showed no statistical significance.5.The three groups were divided according to the size of cerebral infarction.Finally,after analysis,the concentration of serum APN decreased with the increase of cerebral infarction size,but there was no statistical significance in comparison.Serum SCD40L and Hcy in the three groups showed no statistical significance.6.Multivariate Logistic regression was performed to evaluate the effects of Hcy,APN and sCD40L on PSCI risk factors.The results showed that there were significant differences between the levels of adiponectin,sCD40L,Hcy and cognitive impairment(P<0.05).With the decrease of adiponectin,the risk of cognitive dysfunction after cerebral infarction increased,while the level of sCD40L and Hcy increased.Logistic regression equation:LogicP=-1.314+0.029X1-0.240X2+1.836X3.7.The area under ROC curve of APN was 0.694(95%confidence interval:0.607～0.781,P<0.05).When APN concentration was 7.375μg/mL,the sum of specificity and sensitivity(Youden index)was the highest,and the sensitivity and specificity were 48.5%and 84.9%.The area under the ROC curve of sCD40L was 0.725(95%confidence interval:0.640～0.810,P<0.05).When the sCD40L concentration was 1.136ng/mL,the sum of the corresponding sensitivity and specificity(Youden index)reached the maximum,the sensitivity was 82.2%,and the specificity was 58.8%.The area under the ROC curve of Hcy was 0.570(95%confidence interval:0.476～0.665,P<0.05).When the Hcy concentration was 10.74μmol/L,the sum of the corresponding sensitivity and specificity(Youden index)reached the maximum,and the sensitivity was 83.8%and the specificity was 23.1%.8.Pearson correlation analysis showed that MOCA score was positively correlated with adiponectin(r=0.432,P=0.000),while MOCA score was negatively correlated with sCD40L(r=-0.288,P=0.000)and Hcy(r=-0.197,P=0.019),the differences were statistically significant(P<0.05).ConclusionsCognitive dysfunction after cerebral infarction is closely related to Hcy,adiponectin and sCD40L.Serum adiponectin is a protective factor of cognitive function after cerebral infarction,Serum levels of sCD40L and Hcy are risk factors for cognitive function after cerebral infarction.there was a negative correlation between cerebral infarct size and serum APN.