| Background and objective:Post-stroke cognitive impairment affects one-third of post-stroke survivors.Even a mild stroke can have an impact on cognition.There are many studies on vascular cognitive impairment after stroke.However,in addition that age and some vascular risk factors have been linked to post-stroke cognitive impairment,the direct effects of stroke events on cognition are still unknown,some even contradictory.There is also a lack of researches on blood pressure variability and post-stroke cognitive impairment.The purpose of our study was to investigate the association between post-stroke vascular cognitive impairment and blood pressure variability,to analyze relevant risk factors,and to establish a predictive model of poststroke cognitive impairment.Methods:We continuously included 110 patients with acute ischemic post-stroke cognitive disorder(abbreviated as "PSCI")and 33 patients with acute infarction free of cognitive impairment(abbreviated as " the infarction group ")who were admitted to the Wuhan Union Hospital and 35 patients as control group from the physical examination center from December 1,2017 to December 1,2018.We compared medical records between groups,including past infarction history,drinking history,smoking history,diabetes,hypertension,homocysteine,uric acid,MoCA score,blood pressure variability index,imaging data at onset.Statistics were used to analyze the association between post-stroke cognitive impairment and blood pressure variability,and to analyze the relationship between relevant risk factors and post-stroke cognitive impairment.We also established a logistic model and a multilayer perceptron neural network model as prediction models of PSCI,and their advantages and disadvantages were analyzed.Results: Between the infarction group and the post-stroke cognitive impairment group,single factor analysis confirmed infarction in the cognitive domain(P=0.009),large infarction size(P<0.001),previous infarction history(P=0.009),and high homocysteine(P=0.043),dominant hemisphere infarction(P=0.002),high SSD were risk factors of PSCI,and systolic blood pressure variability was correlated with MoCA score,Logistic regression confirmed that patients in the highest quartile of SSD had an increased risk of PSCI than those in the lowest quartile.If the infarction position occurred in cognitive function area,the risk of PSCI was 11.77 times that of infarction occurring in non-traditional brain cognitive function area;the risk of PSCI in patients with previous infarction was 11.34 times that in patients without previous infarction;risk of PSCI in patients with inferior hemisphere infraction was 5.55 times that of those with non-dominant hemisphere patients;compared with large infarct size,the incidence of PSCI in small infarct size was only10.1% of it.In the control group and post-stroke cognitive impairment group,advanced age(P=0.003),high uric acid(P=0.031),high homocysteine(P=0.003),hypertension(P<0.001)diabetes(P= 0.002),high systolic blood pressure at admission(P = 0.029),high diastolic blood pressure at admission(P = 0.006),and high variability parameters of blood pressure were all risk factors.Conclusion: Between the infarction group and the PSCI group,infraction in the cognitive area,large infarct size,a history of past infarction,dominant hemispheric infarction and high homocysteine were risk factors for PSCI.Those in the highest quartile of SSD had an increased risk of PSCI compared with those in the lowest quartile.And some index of systolic pressure variability were correlated with cognitive scores for PSCI.Between the control group and the PSCI group,advanced age,high uric acid,high homocysteine,diabetes,a history of previous infarction,high blood pressure at admission,and high variability parameters of blood pressure were risk factors. |
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