Correlation Between Cognitive Impairment And Severe Internal Carotid Artery Stenosis In Patients With Acute Cerebral Infarction

Research purpose:As the incidence of cerebral infarction events increases with an ageing population,cognitive impairment following cerebral infarction is of increasing concern.There are many risk factors for cognitive impairment after cerebral infarction,and severe stenosis of the internal carotid artery is increasingly attracting the attention of researchers as a factor that can be intervened.In this study,we investigated the correlation between cognitive impairment and severe stenosis of the internal carotid artery in patients with acute cerebral infarction through a retrospective study of 253 cases of acute cerebral infarction.Research methods:A total of 253 patients who were hospitalized and diagnosed with acute cerebral infarction in the second ward of the Department of Neurology,Sino-Japanese Friendship Hospital of Jilin University from October 2020 to January 2022 were collected.The Montreal Assessment Scale（Mo CA）scores were used to group the screened patients,and the patients were divided into a cognitively impaired group（Mo CA <23）and a non-cognitively impaired group（Mo CA ≥ 23）based on the presence of cognitive impairment after acute cerebral infarction,and the demographic characteristics（gender,age,education,BMI）,vascular risk factors（including hypertension,diabetes,atrial fibrillation,history of smoking,and vascular risk factors）were recorded for both groups.diabetes mellitus,atrial fibrillation,history of smoking,history of alcohol consumption,total cholesterol,triglycerides,HDL,LDL,fasting glucose,uric acid,creatinine,homocysteine,degree of internal carotid artery stenosis),and cerebral infarction characteristics（including cerebral infarction site,side of infarction lesion,TOAST typing of cerebral infarction,NIHSS score）.Statistical analysis was performed by SPSS 23.0 software.The differences in each factor between the above two groups of patients were firstly analysed using univariate analysis,and then the results in the univariate analysis were incorporated into a binary logistic regression model.The method used was stepwise regression to analyse the relationship between cognitive impairment and severe stenosis of the internal carotid artery after acute cerebral infarction.Research results:A total of 253 patients with acute cerebral infarction were included,in which hypertension,diabetes,coronary artery disease,atrial fibrillation,gender,BMI,history of smoking,number of history of alcohol consumption,triglycerides,total cholesterol,HDL,LDL,homocysteine,creatinine,fasting glucose and cerebral infarction lesion side were not statistically different between the two groups（P >0.05）.There was a statistically significant difference between the cognitively impaired group and the non-cognitively impaired group with 37 cases（23.9%）of severe intracarotid artery stenosis vs.8 cases（8.2%）,（P=0.001）.In addition,in a one-way ANOVA,the two groups of patients presented with cortical infarction in 67（43.2%）vs 27（27.6%）,（P=0.012）,large atherosclerotic type in 58（37.4%）vs 21（21.4%）,（P=0.008）,age（62.69±10.527）vs（58.21±9.604）years,（P=0.001）,length of education 9（6-12）vs 11.5（8-12）years,（P=0.001）,uric acid 316.28（262.98-369.94）vs338.82（302.10-399.28）umol/ml（P=0.004）,NIHSS score 2（1-4）vs 1（0-3）points（P=0.003）,MMSE score 28（27-29）vs 25（23-27）points（P<0.001）were statistically significant differences（P<0.05）.After the binary logistic regression model,it is known that age,length of education,and severe internal carotid artery stenosis were significant factors for cognitive impairment after cerebral infarction with ORs of 1.044,0.857,and 3.600,95%confidence intervals of（1.016-1.072）,（0.790-0.929）,and（1.553-8.347）,respectively,all with P <0.05.Research conclusion:1.There is a correlation between cognitive impairment and severe internal carotid artery stenosis in patients with acute cerebral infarction,and severe internal carotid artery stenosis is a risk factor for cognitive impairment.2.Age and education were also associated with cognitive impairment after cerebral infarction,with increasing age being a risk factor for cognitive impairment and increasing length of education being a protective factor for cognitive impairment.