Study Of The Correlation Between Cognitive Dysfunction And Plasma Hcy,HbA1c Levels In Patients With Acute Cerebral Infarction

Objectives:To investigate the relationship between cognitive dysfunction and plasma levels of glycosylated hemoglobin(HbAlc)and homocysteine(Hcy)in patients with acute cerebral infarction.Methods:A total of 93 first-episode acute infarction patients who met the inclusion criteria after exclusion criteria were excluded were enrolled in Department of Neurology,Dalian Center Hospital from October 2016 to October 2017.When the patient's condition is stable,communicate with each patient and their families and get consent,Each patient enrolled in the study was assessed using the MMSE,MoCA(Beijing version),HIS,referring to the diagnostic criteria of Vascular Cognitive Impairment(VCI)proposed by Rockwood et al.,And divided into normal cognitive function Group(without VCI group)and cognitive dysfunction group(with VCI group).Among them,64 cases were in VCI group and 29 cases were in non-VCI group.We collected general information such as sex,age,education level,history of alcohol and tobacco,history of hypertension and so on in each patient.On the second day after admission,fasting blood samples were taken to examine plasma Hcy,HbA1c levels,determination of Plasma Hcy levels using double reagent circulating enzyme method,determination of Plasma HbAlc levels using high performance liquid chromatography,Patients' plasma triglyceride(TG),low density lipoprotein(LDLC)and total cholesterol(TC)levels were also detected.Data analysis using SPSS23.0 statistical software,using independent samples T test,Chi-square test,binary Logistic regression analysis,Spersman correlation analysis and other statistical methods,P<0.05 that the difference was statistically significant.Results:1.Comparison of factors between the two groups:The mean scores of MoCA and MMSE in the VCI group were lower than those in the no VCI group,P<0.05 in both groups,the differences were statistically significant.Two groups of patients in gender,age,education time,drinking history,smoking history,history of hypertension,history of atrial fibrillation,history of coronary heart disease,different infarct sites,TC,TG were P>0.05,the difference was not statistically significant;The levels of Hey,HbAlc and LDL in patients with VCI were significantly higher than those without VCI(P<0.05),The differences were statistically significant.The results of regression analysis,Hey(OR =1.160,95%CI=1.014-1.328,P = 0.030),HbA1c(OR = 1.435,95%CI=1.007-2.045,P = 0.046),and LDL(OR = 1.744,95%CI= 0.895-3.397,P = 0.102).2.Spearman correlation analysis:The Hey levels in patients with VCI were negatively correlated with MoCA(r=-0.510 P=0.000),visual spatial and executive function(r=-0.417 P=0.001),naming,(r=-0.352 P=0.004)and language ability(r=-0.280 P=0.025),respectively,and the differences were statistically significant.The HbA1c levels in patients with VCI were negatively correlated with MoCA(r=-0.486 P=0.000),visual spatial and executive function(r=-0.446 P=0.000),naming(r=-0.282 P=0.024),ability(r=-0.307 P=0.014),attention and computation abilities(r=-0.433 P=0.000),respectively,and the differences were statistically significant.Conclusions:1.High plasma levels of Hey and HbAlc may be risk factors for cognitive dysfunction after acute cerebral infarction.2.High level of plasma Hey may be related to impairment of visual space and executive function,naming and language ability of patients with acute cerebral infarction.High levels of plasma HbAlc may be related to impairment of visual space and executive function,naming,abstract ability,attention and computation abilities of patients with acute cerebral infarction.3.Plasma Hcy,HbAlc levels may have some predictive value for cognitive dysfunction after acute cerebral infarction.