| Objective:The risk of cognitive impairment in elderly hypertensive patients is significantly higher,and most patients have mild early symptoms of cognitive impairment,which are difficult to be found,or only mild cognitive impairment(MCI)is easy to be ignored.Early detection and diagnosis of the cognitive impairment level of hypertensive patients is of great significance.At the same time,in view of the fact that the diagnosis of cognitive impairment still depends on the scores of neural scale and lacks objective auxiliary data,this study actively seeks for early blood markers to facilitate early diagnosis.Neurofilament light chain protein(NFL)is a cytoskeletal protein located in the cytoplasm of neurons to maintain the structure of neurons.NFL is highly expressed in myelinated nerve fibers.When axonal injury is caused by neurodegenerative diseases,it is easily released into CSF.NFL in cerebrospinal fluid has been proved to be associated with various neurological diseases,which may indicate the existence of neurodegenerative diseases.Therefore,the purpose of this study is to explore the correlation between cognitive impairment of essential hypertension and serum neurofilament light chain protein(sNFL)level.Methods:A cross-sectional study was used to collect 173 patients with essential hypertension aged ≥ 60 years who met the enrollment criteria and were hospitalized and outpatients in the General Medical Department of the Affiliated Hospital of Chengde Medical College from July 2021 to November 2022.All patients signed the informed consent form.All the patients in the group received general data,unified physical examination,a series of neuropsychological scale examinations,and then completed blood routine examination,thyroid function,liver and kidney function,blood lipids,sNFL and other blood tests and systematic head magnetic resonance scanning.All patients were evaluated with the unified MMSE,Mo CA and other neurological scales,and the final diagnosis was made with the participation of at least two neurologists,and the they had no idea about the grouping of the patients.According to the MMSE score,they were divided into four groups.Finally,85 cases in the normal cognitive function group(MMSE>21 points),45 cases in the mild cognitive impairment group(21-26points),29 cases in the moderate cognitive impairment group(MMSE 10-20points),and 14 cases in the severe cognitive impairment group(MMSE ≤9 points)were collected.All patients collected peripheral blood on fasting for8 hours in the morning of the next day,and the concentration of sNFL was detected by ELISA(Enzyme-linked immunosorbent assay).Compare the level of sNFL in different cognitive function groups of elderly patients with essential hypertension,analyze the correlation between the level of sNFL and its cognitive function,and its predictive value as a diagnostic index.Results:1.The sNFL level of elderly patients with essential hypertension in different cognitive impairment groups were: normal cognitive function group(2896.806 ± 1399.838)pg/m L,mild cognitive impairment group(3121.693± 1549.606)pg/m L,moderate cognitive impairment group(3371.000 ±1511.329)pg/m L,and severe cognitive impairment group(4191.157 ±2298.210)pg/m L,respectively.The sNFL level of patients with different cognitive impairment groups were compared,and the difference was statistically significant.Among them,the sNFL level in the severe cognitive impairment group was the highest.The sNFL level of the group with normal cognitive function was the lowest,followed by the group with mild cognitive impairment and the group with moderate cognitive impairment.2.The correlation analysis between sNFL and neuropsychological scale score showed that the correlation coefficient between serum sNFL level and MMSE score was-0.185,and showed a significant difference of P<0.05,suggesting that there might be a negative correlation between sNFL level and MMSE score.The correlation coefficient between sNFL level and Mo CA score was-0.163,and showed a significant difference of P<0.05,suggesting that there may be a negative correlation between sNFL level and Mo CA.3.The sNFL level and cognitive impairment of elderly patients with essential hypertension were analyzed by multiple ordered multi-classification regression analysis.The results showed that age,education level,sNFL level,MMSE score and Mo CA score were significant influencing factors of cognitive impairment(P<0.05).4.The ROC curve analysis of sNFL in the diagnosis of cognitive impairment in elderly patients with essential hypertension showed that the area under the ROC curve was 0.70,the sensitivity was 0.565,and the specificity was 0.849,suggesting that sNFL might have certain diagnostic value in the diagnosis of cognitive impairment in elderly patients with essential hypertension.Conclusions:There is a certain correlation between sNFL and cognitive impairment in elderly patients with essential hypertension,and there is a negative correlation between sNFL and neurological scale score,that is,the more severe the cognitive impairment,the higher the level of sNFL;sNFL may have certain diagnostic value in the diagnosis of cognitive impairment in elderly patients with essential hypertension. |
PDF Full Text Request