Research On The Risk Factors Of Cognitive Impairment After Cerebral Infarction

Objective:Cognitive disorder attack lies seriously,is not easy to be perceived by people in the early stage,so it is easy to be ignored.While with the development of science technology and the improvement of medicine technical method,the cognitive disorder is gradually be known by people.Cognitive disorder caused by cerebral infarction is a common pattern of cognitive disorder,which seriously affects the life and prognosis of patients.Meanwhile the morbidity is gradually increasing year by year,with a speed 10% during each five years[1].From tremendous science expe riment,it can be discovered that the atherosis[2],endothelium dysfunction[3],insulin resistance[4] and etc play an important role in the cognitive disorder after cerebral infarction.At present the useful cure treatment of cognitive disorder after cerebral infarction is unavailable.While the early nursing care and social assistance can improve the patients' life quality.Therefore to keep the steady and efficient biology indicator is in crying need after diagnosis of cerebral infarction cognitive disorder.Therefore, the purpose of this paper is to explore and analyze the change charact eristics of serological components in acute cerebral infarction,as well as the correlation between serum pentraxin 3(PTX3)and serum matrix metalloproteinase-9(mmp-9)and cognitive impairment after cerebral infarction.Methods:A total of 278 new patients with cerebral infarction within 3 days of onset admitted to the affiliated hospital of Chengde Medical college from January 2019 to June 2019 were collected.It is to collect the common clinical data of patients such as age,sex,hypertension and diabetes history,smoke and drinking history,to gather the common bio-indicat or of patients such as alanine transaminase(ALT),aspartate aminotransfer ase(AST),gamma-glutamyltransferase(?-GT),total bilirubin(TBIL),alkaline phosphatase(ALP),total bile acid(TBA),creatine kinase isoenzyme(CK-MB),senlm amyloid A(SAA),serum pentraxin 3,(PTX3),matrix metalloproteinase-9(MMP-9),Creatine kinase(CK)and etc.To collect the Moca and NIHSS test score after morbidity 14 days of the accepted patients.The patients are divided into two groups according the Moca score,cerebral infarction cognitive disorder group(Moca<26)and cerebral infarction cognitive normal group(MoCA?26).First through pairwise comparison,it is to recognize the each indicator differences between these two groups.Then through correlation analysis,it is to explore the relationship between the research object and Moca and its application in forecasting the diagnostic value of cognitive impairment after cerebral in farction.By utilizing the Logistic regression analysis,we are to explore the risk factor of cognitive impairment after cerebral infarction.Results:1.To compare the basic clinical data except the age between Cerebral infarction caused cognitive impairment group and none cognitive impairment after cerebral infarction group,it was not statistically significant.The study is based on 278 new cerebral infarction patients.165 patients are in cognitive impairment after cerebral infarction group,and 113 patients are the cognitive normal after cerebral infarction.The average age of combination of cognitive impairment after cerebral infarction group is 68.56 ± 8.21 years old,and the average age of cerebral infarction patients without cognitive impairment group is 62.98 ± 8.23 years old.In addition to the patients age,we also collect the data between the two groups of patients,such as gender,history of hypertension,diabetes,smoking,alcohol,and other indicators.The differences between above factors are with no statistical significance(P> 0.05).2.Biochemical data and NIHSS were compared between cognitive impairment group and non-cognitive impairment group.The serum data of cognitive impairment group patients such as PTX3?MMP-9?SAA level(P<0.05,P<0.05,P<0.05)is rising higher than that of the cognitive normal group patients meanwhile the serum total bilirubin value is lower than that of the cognitive normal patients.The differences are statistical meaningful.3.Independent risk factor analysis:By application of Logistic regression analysis,it shows that PTX3(OR=1.133 P<0.05 95% credibility interval 1.013-1.266),MMP-9(OR=1.139 P<0.05 95% credibility interval 1.035-1.146),SAA(OR=1.505 P<0.05 95% credibility 1.144-1.980)and age(OR=1.089 P<0.05 95% credibility interval 1.035-1.146).The above factors are independent factors of combination cognitive impairment after cerebral infarction,serum total bilirubin value(OR=0.0840 P<0.05 95% credibility interval 0.772-0.914)is protec tive factor of cerebral infarction cognitive impairment.4.Correlation analysis of PTX3,SAA,mmp-9 and TBIL levels with Moca score in patients with cerebral infarction combined with cognitive impairment.It shows that the serum total bilirubin value is positive related to Moca.There was no significant linear correlation between PTX3,SAA,mmp-9 and Moca?5.The indicator characteristic curve of the test object: PTX3?SAA?MMP-9?Serum total bilirubin of the diagnosed cognitive disorder after cereral infarction.The area under the test curve is separately 0.751,0.751,0.900,0.678(P<0.05).The diagnosis dividing value is separately 16.78 ng/ml,5.6mg/L,20.80ng/ml,12.73umol/L.The specificity is separately 82.140%,63.390%,89.290%,81.250%.Conclusion:1.The age,PTX3,MMP-9,SAA value of Cognitive impairment after cerebral infarction is rising sharply and serum total bilirubin is reducing apparently.2.The increase of PTX-3,MMP-9,SAA and age of Cognitive impairment after cerebral infarction are independent risk factor,the serum total bilirubin value is protective factor.3.To test the value of PTX3?MMP-9?SAA and serum total bilirubin of cerebral infarction do help to recognize the cognitive impairment after apoplexy.