| Objectives To investigate the association of coagulation-fibrinolysis related markers and vascular cognitive impairment through detecting the levels of coagulation-fibrinolytic related markers which including Fibrinogen(FIB),Thrombomodulin(TM),Tissue Factor Pathway Inhibitor(TFPI),Prothrombin Fragment1+2(F1+2),Plasminogen Activator Inhibitor-1(PAI-1)and D-dimer(D-D)in patients with ischemic cerebral small vessel diseases,so as to provide basis for etiological diagnosis and treatment of ischemic cerebrovascular disease.Methods 370 patients with ischemic cerebral small vessel diseases who were hospitalized in the department of neurology of the affiliated hospital of north China university of science and technology from January 2017 to December 2018 were selected as study subjects.Mini Mental State Examination(MMSE)was used to evaluate cognitive function.Patients with cognitive impairment(194cases,<27points)were treated as the case group(cognitive impairment group)and those with normal cognition(176cases,27~30 points)as the control group(normal cognitive group).The cognitive impairment group was further divided into mild cognitive impairment group(100cases,21~26points),moderate group(60cases,10~20points)and severe group(34cases,0~9points).The levels of FIB by coagulation,TM,TFPI,F1+2,PAI-1 were detected by ELISA and D-D was detected by enzyme-linked immunofluorescence.Compare and analyze the association of related markers of coagulation-fibrinolysis system(FIB,TM,TFPI,F1+2,PAI-1,D-D)and vascular cognitive impairment in patients with ischemic cerebral small vessel diseases.Results 1 Comparison of related factors between the cognitive impairment group and the cognitive normal group in patients with ischemic cerebral small vessel diseases showed that the levels of HCY,UA in the cognitive impairment group were increased,and the difference was statistically significant(all P<0.05).The difference in other indicators was not statistically significant(all P>0.05).2 Compared with the normal cognitive group,the levels of FIB,TM,PAI-1 and D-D were increased and TFPI was decreased in the cognitive impairment group,and the difference was statistically significant(all P<0.01),the level of F1+2 was increased,and the difference was no statistically significant(P>0.05).3 By taking FIB,TM,TFPI,F1+2,PAI-1,D-D greater than or equal to the mean as exposure,to univariate analyze the correlation between the levels of FIB,TM,TFPI,F1+2,PAI-1,D-D and vascular cognitive impairment in patients with ischemic cerebral small vessel disease and the results showed that the OR were FIB(OR=10.464,P<0.05),TM(OR=7.880,P< 0.05),TFPI(OR=0.480,P<0.05),F1+2(OR=0.758,P>0.05),PAI-1(OR=4.424,P<0.05),DD(OR=3.997,P<0.05).It indicates that the levels of FIB,TM,TFPI,PAI-1,D-D are related to vascular cognitive impairment in patients with ischemic cerebral small vessel disease and FIB is very closely related to vascular cognitive impairment,but F1+2 is not related to vascular cognitive impairment.4 Logistic regression analysis was conducted with the occurrence of cognitive impairment as the dependent variable and HCY,UA,FIB,TM,TFPI,PAI-1 and D-D as independent variables.The results show that the OR values are FIB(OR=6.126,P<0.05),TM(OR=3.628,P<0.05),TFPI(OR=0.472,P<0.05),PAI-1(OR=2.675,P<0.05),D-D(OR=2.485,P<0.05)respectively.It shows that after controlling the effect of HCY and UA,FIB,TM,TFPI PAI-1 and D-D are still associated with vascular cognitive impairment in patients with ischemic cerebral small vessel disease and FIB is most closely related to vascular cognitive impairment.Increased level of FIB,TM,PAI-1,D-D and decreased level of TFPI can increase the risk of vascular cognitive impairment in patients with ischemic cerebral small vessel disease.5 Comparison of the levels of FIB,TM,TFPI,PAI-1 and D-D among the groups with different degrees of cognitive impairment showed that the differences between the groups with the levels of FIB,TM,TFPI,PAI-1 and D-D were statistically significant(all P<0.01).It indicated that the level of FIB,TM,PAI-1,D-D increased,the level of TFPI decreased and the degree of vascular cognitive impairment increased in patients with ischemic cerebral small vessel disease.Conclusions 1 FIB,TM,TFPI,PAI-1 and D-D are related to vascular cognitive impairment in patients with ischemic cerebral small vessel disease,and FIB is most closely related to vascular cognitive impairment.2 The level of FIB,TM,PAI-1,D-D increased,the level of TFPI decreased and the degree of vascular cognitive impairment increased in patients with ischemic cerebral small vessel disease.Figure0;Table10;Reference 167... |
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