Related Factors Analysis Of Mild Cognitive Impairment In Atrial Fibrillation Complicated With Lacunar Cerebral Infarction

Objective: To explore the influencing factors of Mild Cognitive Impairment(MCI)in patients with atrial fibrillation combined with lacunar cerebral infarction,so as to provide a basis for the prevention of Cognitive Impairment in such patients.Method: According to the inclusion criteria and exclusion criteria,collected in October 2018-October2019 in the first affiliated hospital of Shihezi university school of medicine nonvalvular atrial fibrillation with 380 cases of lacunar cerebral infarction patients,the Montreal cognitive assessment scale(Montreal cognitive assessment,MoCA)evaluation of cognitive function in patients with mild cognitive dysfunction according to whether the merger into atrial fibrillation combined lacunar cerebral infarction,MCI groups and atrial fibrillation combined lacunar cerebral infarction cognitive function in normal group.General data such as age and education level of all patients were collected,as well as laboratory examination results such as serum uric acid,homocysteine,magnetic resonance imaging(MRI)of the skull,clinical classification of atrial fibrillation and common associated diseases.Statistical software SPSS22.0 was used for data processing.Measurement data were expressed as mean ± standard deviation,and t test was used for comparison between the two groups.The enumeration data were expressed by rate or composition ratio,and the comparison of the two groups of data rates was analyzed by chi-square test.Pearson correlation coefficient was used for measurement data of bivariate correlation normal distribution,and spearman correlation coefficient was used for counting data.Logistic regression was used for multivariate analysis,and P < 0.05 showed statistically significant differences.Results:1.380 cases of patients with atrial fibrillation combined with lacunar cerebral infarction who met the study criteria were assessed with MoCA,148 cases in the MCI group and 232 cases in the control group,and the MoCA score of the MCI group was lower than that of the control group(P < 0.05).Single factor analysis showed that the two groups of age,gender,level of education,the types of health insurance,marital status,smoking history,drinking history,body mass index(BMI),blood urea nitrogen,serum creatinine,blood uric acid,homocysteine,urinary inhibition C,white blood cell count,hemoglobin,red blood cells deposited,red blood cell distribution width and testing for thyroid-stimulating hormone and free thyroxine,thyroxine,prothrombin time,prothrombin ratio,activated partial prothrombin time,fibrinogen and D dimer and carotid atherosclerosis,lacunar cerebral infarction range,type,type of antithrombotic drugs atrial fibrillation,coronary heart disease were statistically significant(P < 0.05).2.Merger atrial fibrillation patients with lacunar cerebral infarction MoCA score and age,male,medical insurance for urban employees,unmarried,and widowed,alcohol consumption,blood urea nitrogen,serum creatinine,homocysteine,urinary inhibition C,hemoglobin,red blood cells deposited,red blood cell distribution width,prothrombin time,prothrombin ratio,fibrinogen,D-dimer,coronary heart disease negatively correlated(P < 0.05);It was positively correlated with education level,non-smoking,free thyroxine and serum uric acid(P < 0.05),and was strongly correlated with education level(r=0.933,P <0.001).3.Multivariate analysis of factors affecting MCI in patients with atrial fibrillation complicated with lacunar cerebral infarction: MCI was used as the dependent variable,and education level,serum uric acid and thyroxine were the protective factors of MCI.Age,widowed,bilateral lacunar cerebral infarction,homocysteine,cystatin C,fibrinogen,d-dimer,and carotid atherosclerosis are risk factors for MCI.Conclusion:1.Advanced age,widowed,bilateral lacunar infarction,high homocysteine,high cystatin C,high fibrinogen,high D dimer and carotid atherosclerosis may be risk factors for MCI in patients with atrial fibrillation complicated with lacunar infarction..2.High Education,high serum uric acid and thyroxine may be protective factors for MCI in patients with atrial fibrillation complicated with lacunar cerebral infarction.