The Study On The Correlation Between Serum SCD40L?A?1-42 And Congnitive Impairment After Ischemic Stroke

Objective Investigate the serum levels of soluble CD40 ligand s CD40 L and serum ?-amyloid 1-42(A?1-42)in patients with post-stroke cognitive impairment(PSCI)and their clinical diagnostic efficacy.Methods In First Affiliated Hospital,Shihezi University School of Medicine from November 2016 to June2017,118 patients with acute cerebral infarction and 51 healthy volunteers hospitalized in the Department of Neurology,were enrolled to study(the subjects are required to MMSE?27 points).Cognitive function was evaluated in 3 months of cerebral infarction with the Montreal Cognitive Assessment Scale(Mo CA).According to Mo CA results,patients with cerebral infarction were divided into two groups: cognitive impairment group and normal cognitive group.All incoming objects received the fasting venous blood sample.The serum s CD40 L and A?1-42 levels were determined by ELISA method,and the differences of serum s CD40 L and A?1-42 levels were compared;the relationship between serum s CD40 L and A?1-42 was explored;serum s CD40 L and A ?1-42 were studied for ischemic Diagnostic efficacy of cognitive impairment after stroke.Results(1)The serum A?1-42 level(94.40±37.33pg/ml)in the cognitive impairment group was significantly lower than that in the cognitive normal group(127.94±34.88pg/ml)and the control group(158.02±35.99pg/ml),P<0.01,and the difference was statistically significant.The serum s CD40 L level(3.82±1.24ng/ml)in the cognitive impairment group was significantly higher than that in the cognitive functional group(3.26±1.13ng/ml)and the control group(2.66±1.30ng/ml),and the P<0.05 the difference was statistically significant.(2)Spearman correlation analysis showed that the MOCA score at 3 months after Cerebral Infarction was significantly negatively correlated with serum scd40 l level(r=-0.64,P<0.01),and significantly positively correlated with serum A?1-42 level(r=0.76,P<0.01).(3)Perarson correlation analysis showed that the level of serum s CD40 L was negatively correlated with the serum level of A?1-42 in patients with cerebral infarction(r=-0.96,P<0.01).(4)The scores of the cognitive impairment group in visual space performed function,directional force,memory,attention,language,abstraction and naming were lower than those in the normal cognitive group,and the difference was statistically significant(P<0.01).(5)The ROC curve used the serum A?1-42 s CD40 L level to judge the PSCI.The area under the ROC curve of s CD40 L was 0.64(P<0.01);the area under the ROC curve of A?1-42 was 0.74(P<0.01);The ROC curvilinear area was 0.92(P<0.01)after scd40 l combined with A?1-42.(6)According to the Jordan index,the threshold of s CD40 L was 3.60 ng·ml-1,the sensitivity was 57.81%,and the specificity was 72.22%.When the value of A?1-42 is 114.34 pg· ml-1,the sensitivity is 71.88% and the specificity is75.92%.The sensitivity of the two factors was 96.88% and the specificity was 87.04%.Conclusions(1)The level of A?1-42 in patients with cognitive impairment of cerebral infarction was significantly lower than that in patients with normal cognition of cerebral infarction and healthy controls.(2)The level of serum s CD40 L in patients with cognitive impairment of cerebral infarction is significantly higher than that in patients with normal cognition of cerebral infarction and healthy controls.(3)There was a significant negative correlation between Mo CA score and serum s CD40 L concentration in cerebral infarction patients,which was positively correlated with serum A?1-42 concentration.(4)Serum s CD40 L was highly negatively correlated with A?1-42 concentration in cerebral infarction patients.(5)Serum s CD40 L and A?1-42 in patients with cerebral infarction can be used as a biomarker for predicting cognitive impairment after ischemic stroke.