| ObjectivesTo explore the relationship between cognitive impairment and serum thyroid hormone level and other related factors in patients with acute ischemic stroke,and to clarify the characteristics and influencing factors of cognitive impairment in patients with acute ischemic stroke in different periods,so as to provide theoretical basis and ideas for clinical prevention and treatment of cognitive impairment after stroke.Methods1.107 patients with acute ischemic stroke hospitalized in the Department of Neurology of the First Affiliated Hospital of Dali University from October 2020 to December 2021 were collected.The patients who met the inclusion criteria applied the simple mental state examination（MMSE）,connection test（TMT）,Boston Naming Test（BNT）,Hopkins Word Learning Test revised（HVLT-R）within 2 weeks and 3 months of cerebral infarction The cognitive function was assessed by Rey osterreith complex graphics test（CFT）.According to the MMSE score,the patients were divided into post-stroke cognitive impairment group and cognitive normal group.2.Basic information was collected from all the subjects（including age,gender,nationality,education level,body mass index）,diabetes history,history of hypertension,smoking history,drinking history,head and neck imaging data.Fasting venous blood was taken the next day after admission and sent to the laboratory department of our hospital to measure the levels of free triiodothyronine（FT3）,total triiodothyronine（TT3）,free thyroxine（FT4）,total thyroxine（TT4）,thyroid stimulating hormone（TSH）and other relevant laboratory indexes.3.SPSS 24.0 statistical software was used to statistically analyze the serum thyroid hormone level,general data and other related factors of cognitive impairment group and cognitive normal group within 2 weeks,cognitive impairment group and cognitive normal group within 3 months.Binary logistic regression was used to analyze the independent risk factors of cognitive impairment after acute ischemic stroke,Receiver operating characteristic curve（ROC）was used to analyze the diagnostic value of serum thyroid hormone level and other related factors in cognitive impairment after acute ischemic stroke.There was significant difference when p < 0.05.Result:1.MMSE score showed that the incidence of abnormal cognitive function within 2weeks of acute ischemic stroke was 42.10%,and the incidence of abnormal cognitive function at 3 months of acute ischemic stroke was 56.07%（P < 0.05）.2.The results of cognitive function evaluation within 2 weeks and 3 months after acute ischemic stroke showed that the scores of language function,memory function and visual space function at 3 months were lower than those within 2 weeks（P < 0.05）.3.The results of cognitive function within 2 weeks of ischemic stroke showed that the levels of FT3 and TT3 in cognitive impairment group were significantly lower than those in cognitive normal group（P < 0.05）,and the scores of HDL-C,CRP,NIHSS and age in cognitive impairment group were significantly higher than those in cognitive normal group（P< 0.05）.Using binary logistic regression analysis,high FT3 level is a protective factor of cognitive impairment,and age is an independent risk factor of cognitive impairment.The results of ROC curve showed that the area under FT3 curve was 0.764,P < 0.05,the area under age curve was 0.624,P < 0.05,and the area under FT3 combined age curve was 0.778,P < 0.05.4.The results of cognitive function at 3 months after ischemic stroke showed that the level of FT3 in cognitive impairment group was significantly lower than that in cognitive normal group（P < 0.05）,and the incidence of Hcy,age and cervical vascular plaque in cognitive impairment group was significantly higher than that in cognitive normal group（P <0.05）.Using binary logistic regression analysis,high FT3 level was the protective factor of cognitive impairment,and age and Hcy were the independent risk factors of cognitive impairment.ROC curve showed that the area under FT3 curve was 0.789,P < 0.05;The area under the age curve was 0.61,P > 0.05;The area under Hcy curve was 0.724,P < 0.05;The area under the FT3 combined Hcy curve was 0.845,P < 0.05.Conclusion:1.The incidence of cognitive impairment at 3 months after ischemic stroke was higher than that within 2 weeks.2.The decline of cognitive function at 3 months after ischemic stroke is mainly reflected in language function,memory function and visuospatial function.3.The risk factors of cognitive impairment within 2 weeks after ischemic stroke are HDL-C,NIHSS score and age.Among them,age is an independent risk factor and high FT3 level is a protective factor.4.The risk factors of cognitive impairment at 3 months after ischemic stroke are age,Hcy and cervical vascular plaque.Among them,age and Hcy are independent risk factors,and high FT3 level is protective factor.5.ROC curve analysis showed that FT3,age and their combination had predictive value for cognitive impairment within 2 weeks after ischemic stroke;Hcy,FT3 and their combination have predictive value for cognitive impairment 3 months after acute ischemic stroke. |
PDF Full Text Request