The Expression And Significance Of Plasma IL-18 In Patients With Vascular Cognitive Impairment

Objective:The vascular cognitive impairment(VCI)is a syndrome of varying degrees of cognitive dysfunction caused by many vascular factors,and its incidence increased year by year.However,its pathogenesis has not been clarified and there is no effective treatment in current clinic.Therefore,early diagnosis of the disease is particularly important to its prevention.In this article,we explored the possibility of interleukin-18(IL-18)for VCI diagnosis predictors through analysis of IL-18 expression levels in peripheral blood of VCI patients and its correlation with VCI development.Methods:165 patients in neurology department of Suzhou city hospital and Kunshan second people's hospital from March 2017 to March 2018 who had risk factors of cerebrovascular diseases and(or)cerebrovascular diseases were chosen as subjects.According to the Montreal Cognitive Assessment scale(MoCA)scores,?26 was divided into normal cognitive function group(NCI group,n =42),and<26 was divided into cognitive dysfunction group(VCI group,n = 123).Then according to the diagnostic criteria of American psychiatric association's diagnostic and statistical manual of mental illness,fourth revised edition(DSM-IV-R),123 cases of VCI patients were divided into vascular cognitive impairment-no dementia group(VCI-ND group,n=93)and vascular dementia group(VaD group,n = 30).The plasma IL-6 and IL-18 levels of all patients were detected by using enzyme linked immunosorbent assay(ELISA),and plasma C-reactive protein(CRP)level was tested by immunity transmission turbidity(ITA).The correlations between plasma IL-6,IL-18,CRP and MoCA score of three groups were analyzed by Pearson correlation coefficient.In 60 cases of post-stroke cognitive impairment(PSCI)patients,the correlations between plasma IL-6,IL-18,CRP and MoCA score by different types,different infarction areas and different infarction sizes were analyzed.Results:? The MoCA scores of three groups had significantly decreasing trend,the difference was statistically significant(P<0.01);In the memory,visual space function,named ability,attention and calculation ability,orientation ability,the scores of three groups had significantly decreasing trend,the differences were statistically significant(P<0.01);In fluency language ability and abstract epitome ability,the scores of three groups also had decreasing trend(P<0.01),but scores of NCI and VCI-ND group had no significant difference(P>0.05);? The plasma IL-6 and IL-18 expression levels of three groups had significantly decreasing trend,the difference was statistically significant(P<0.01);The plasma CRP expression level of three groups also had significantly trend(P<0.01),but it had no significant difference in NCI and VCI-ND group(P>0.05);? The plasma IL-6 and IL-18 expression levels of patients were negatively correlated with MoCA score(r = 0.61,P<0.05;R=0.82,P<0.82);The plasma CRP expression level and MoCA score of patients had no correlation(r = 0.34,P = 0.258).?In 60 cases of PSCI,the MoCA score of 40 cases of patients with cerebral arterial thrombosis was significantly less than 20 cases of patients with hemorrhagic arterial thrombosis,the difference was statistically significant(P<0.05);The plasma IL-6 and IL-18 expression levels of cerebral arterial thrombosis group were obviously higher than that of hemorrhagic arterial thrombosis group(P<0.05,P<0.01);The plasma CRP expression level of two groups had no significant difference(P>0.05);?In 40 cases of patients with cerebral arterial thrombosis,the MoCA score had obviously decreasing trend with the increasing infarction size(P<0.05),but there was no significant difference between small area size of infarction group and large area size of infarction group(t = 1.508,P=1.508);The plasma IL-6 and IL-18 expression levels of patients had obviously increasing trends with the increasing infarction size(P<0.05);The plasma CRP level of three groups had no significant difference(P>0.05);The plasma IL-18 expression level of patients was negatively correlated with MoCA score(r = 0.78,P<0.05),there was no correlation between plasma IL-6 expression level and MoCA score of patients(r = 0.41,P = 0.41);? In 40 cases of patients with cerebral arterial thrombosis,the MoCA scores of infarction area located in thalamus and temporal lobe were lower(P<0.05);The plasma IL-18 expression level of infarction area located in thalamus was higher(P<0.05);The plasma CRP level of different infarction areas had no significant difference(P>0.05).Conclusions:The plasma IL-6 and IL-18 expression levels of patients with VCI are increasing with the increase of the degree of cognitive impairment,particularly in memory,visual space function,named ability,attention and calculation ability and the directional ability;In PSCI patients,the plasma IL-6 and IL-18 expression levels of cerebral arterial thrombosis group are higher,and the degree of cognitive impairment is more serious;In patients with cerebral arterial thrombosis,the plasma IL-18 expression level of patients with larger infarction size and thalamus infarction is higher,and the degree of cognitive impairment is more serious.So IL-18 maybe a potential biological indicator for diagnosis and prediction of VCI especially ischemic PSCI,reflexing the severity of cognitive dysfunction.