The Correlation Between Serum Levels Of MMP-9,TIMP-1,hs-CRP And Cognitive Impairment In Patients With Ischemic Stroke

BackgroundStroke is a disease that seriously endangers human health and life safety.Cognitive dysfunction is a common clinical manifestation after stroke,which seriously affects the quality of life of patients.Cognitive impairment after stroke is influenced by related vascular disease and infarct location,considering that there are few studies on biological indicators related to cognitive impairment after stroke,the research on serological indicators related to cognitive impairment in patients with ischemic stroke has certain clinical application value.Whether serum MMP-9,TIMP-1,hs-CRP levels are related to cognitive impairment in patients with cerebral infarction is still unclear.Objective1.To explore the correlation of serum MMP-9,TIMP-1,hs-CRP levels with cognitive dysfunction and its severity in patients with cerebral infarction.2.To investigate the sensitivity and specificity of serum MMP-9,TIMP-1 and hs-CRP levels in predicting cognitive dysfunction in patients with cerebral infarction.Methods204 patients with first onset cerebral infarction were selected.General data of the patients were collected on admission and the hs-CRP level was detected by latex-enhanced immunoturbidimetry in the laboratory of our hospital,and the levels of MMP-9,TIMP-1 in the serum of the patients were detected by enzyme-linked immunosorbent assay.The Montreal Cognitive Assessment-Basic（Mo CA-B）was used to evaluate the cognitive function of the patients and the activity of daily living scale（ADL）to judge the severity of cognitive impairment at 3 months.According to the Mo CA-B assessment results,the patients were divided into cognitive impairment group of 96 cases（study group,Mo CA-B<26）and 84 cases of no cognitive impairment（control group,Mo CA-B≥26）.ADL results divided the study group into post-stroke cognitive impairment non-dementia group（group A）and dementia group（group B）.The data were statistically processed by t test, X~2test,Spearman correlation analysis,multivariate Logistic regression analysis,ROC curve.Results1.Comparison of general data of the study group and control group of patientsThere was no significant difference in age,gender,years of education,admission Mo CA-B score and hyperlipidemia between two groups of patients（all P>0.05）.There were significant differences in diabetes,hypertension,coronary heart disease,hyperhomocysteinemia,carotid plaque and hypouricemia between the two groups（all P<0.05）.2.Comparison of serum MMP-9,TIMP-1 and hs-CRP levels between two groups of patients.The t test results showed that the serum MMP-9 level in the experimental group was significantly higher than that in the control group,and the serum TIMP-1 level was significantly lower than that in the control group,and the differences were statistically significant（all P<0.05）.The serum hs-CRP level in the experimental group was significantly higher than that in the control group,and the difference was statistically significant（P<0.05）.3.The influence of imaging factors in the two groups of patientsThe X~2test results showed that,compared with the control group,the incidence of frontal lobe,temporal lobe and bilateral basal ganglia infarction,white matter lesions and brain atrophy in the experimental group were significantly higher than those in the control group（all P<0.05）,the incidence of parietal and occipital lobe infarction between the two groups was not statistically significant（P=0.402,0.323）.4.Comparison of serum MMP-9,TIMP-1 and hs-CRP levels in patients with different degrees of cognitive impairmentThe t test showed that among patients with different degrees of cognitive impairment,the levels of serum MMP-9 and hs-CRP in A group were significantly lower than those in B group（all P<0.05）.The level of serum TIMP-1 in A group was significantly higher than that in B group（t=4.466,P<0.05）.5.The correlation between serum MMP-9,TIMP-1,hs-CRP and Mo CA-B score of cognitive function and the relationship between serum hs-CRP and MMP-9,TIMP-1 in experimental group.5.1 The results of Spearman correlation analysis showed that the serum MMP-9 level in the experimental group was negatively correlated with the Mo CA-B score（r=-0.681,P<0.05）,and the serum TIMP-1 level was positively correlated with the Mo CA-B score（r=0.501,P<0.05）,and the serum hs-CRP level was negatively correlated with the Mo CA-B score（r=-0.758,P<0.05）.5.2 The results of Spearman correlation analysis showed that the serum hs-CRP level in the experimental group was positively correlated with the serum MMP-9 level（r=0.689,P<0.05）,which was negatively correlated with serum TIMP-1 level（r=-0.539,P<0.05）,and the serum MMP-9 level was negatively correlated with the serum TIMP-1level（r=-0.367,P<0.05）.6.The analysis of the influencing factors of cognitive dysfunction in patients with cerebral infarctionMultivariate Logistic regression analysis showed that frontal lobe infarction,bilateral basal ganglia infarction,hyperhomocysteinemia,carotid plaque,high serum MMP-9 level,and low TIMP-1 level were the main causes of cerebral infarction in patients with cerebral infarction.Independent influencing factors for cognitive impairment（all P<0.05）.7.ROC curve analysis resultsROC curve analysis showed that when the concentration of serum MMP-9 was468.47μg·L^-1,the sensitivity of predicting cognitive impairment in patients with cerebral infarction was 0.795,and the specificity was 0.895;the concentration of serum TIMP-1was 26.09μg·L^-1,the sensitivity of predicting cognitive impairment in patients with cerebral infarction was 0.974,and the specificity was 0.118.Conclusions1.The Serum levels of MMP-9,TIMP-1 and hs-CRP are associated with cognitive impairment and its severity in patients with cerebral infarction.2.High serum MMP-9 levels and low serum TIMP-1 levels are independent risk factors for cognitive dysfunction in patients with cerebral infarction,and the combined detection of its serum level is helpful for early identification of the occurrence of cognitive impairment after stroke.