| Objective:By observing the cognitive impairment of acute ischemic stroke patients at different ages and serum interleukin-6(IL-6)levels,analyzing the main influencing factors of cognitive impairment in patients after acute ischemic stroke.By analyzing the severity of cognitive impairment of acute ischemic stroke patients with different levels of IL-6,we can attempt to provide clinical reference value for early diagnosis and diagnosis of cognitive impairment after acute ischemic stroke.Methods:Cases of acute ischemic stroke patients from the Department of Neurology of Wusong hospital from December 2018 to August 2021 were divided into 160 cases in the post-stroke cognitive impairment group(observation group)and 102 cases in the post-stroke without cognitive impairment group(control group)according to the results of the exact cognitive impairment.Observe whether there were statistical differences in the basic characteristics(gender characteristics,risk factors,etc.)between the two groups.All the enrolled patients were scored by MMSE.MoCA and NIHSS.The observation group further evaluated activity of daily living scale(ADL)to judge the severity of cognitive impairment.According to the results of ADL.the observation group was divided into non dementia(95 cases)and dementia group(65 cases)with cognitive impairment after stroke.Analyze the score difference of cognitive impairment patients in each cognitive domain of MoCA.Observe whether the level of IL-6 was statistically different between the cognitive impairment group and the control group.Then,according to different IL-6 levels,they were divided into four observation groups by quartile method,and the correlation between serum IL-6 indicators and cognitive impairment was observed.Also the correlation between IL-6 level and MoCA score was analyzed in patients with different infarct locations、different infarct sizes and different types.Result:1.The serum IL-6 level and age of the patients in the observation group were statistically different from the patients in the control group(P<0.05).There was no statistical difference in the relative proportions of the patients’ gender,history of hypertension、diabetes、coronary atherosclerotic heart、hyperlipidemia、smoking and drinking,as well as blood glucose,creatinine and cholesterol(P>0.05).2.The MoCA scores of the patients with cognitive impairment after acute stroke were significantly decreased in memory,visual space,naming,orientation,naming ability and other items,had statistical difference than the control group(P<0.001).3.Then the observation group was divided into two groups according to age above and below 60 years,and the subgroups divided according to the quartile of patients’ IL-6 level,had statistical differences in the scores of MMSE.MoCA,NIHSS than the control group(P<0.001).And the OR value showed an increasing trend with the increase of IL-6 level,suggesting that the increase of IL-6 level was positively correlated with the risk of cognitive impairment after acute stroke(P<0.05).4.Infarcts in frontal lobe,temporal lobe,basal ganglia and thalamus were more prone to cognitive impairment(P<0.001),cognitive impairment is more likely to occur after cerebral infarction in anterior circulation,but there was no significant difference in serum IL-6 level(P>0.05).The level of IL-6 decreased with the decrease of infarct size,and the score of MOCA increased with the decrease of infarct size(P<0.001).Conclusion:① The probability of acute ischemic stroke accompanied cognitive impairment increased with age..②There is a certain correlation between the level of IL-6 in serum and the cognitive dysfunction of patients with acute stroke。At present,the study did not find that the level of IL-6 was significantly related to the infarct site,but it was found that it was related to the infarct size and the severity of cognitive impairment.③IL-6,as a biological marker with convenient and rapid detection,reasonable cost and objective data,has certain clinical value in early detection of cognitive dysfunction after acute ischemic stroke and judgment degree,and its predictive role in cognitive dysfunction after acute ischemic stroke deserves our attention. |
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