The Association Between Serum β2-microglobulin And Cognitive Impairment In Maintenance Hemodialysis Patient Swith Cerebral Microhemorrhage

Purpose: To explore the relationship between serum β2-Microglobulin(β2-MG)and cognitive function in maintenance hemodialysis patients with cerebral cerebral microbleed.Methods: Prospective study.From October 2022 to March 2023,61 patients with MHD were enrolled in the Blood Purification Center of the Affiliated Hospital of Hangzhou Normal University,who underwent cranial magnetic resonance imaging(MRI)and magnetic sensitivity weighted imaging(SWI).General information of the patients was recorded,including gender,age(years),dialysis age(months),blood pressure before the first dialysis in a week,and hypotension(with or without)during dialysis;Laboratory test data for MHD patients in the past three months were obtained from the test system of the Affiliated Hospital of Hangzhou Normal University,including white blood cell count,red blood cell count,hemoglobin,hematocrit,C-reactive protein,serum albumin,urea nitrogen,serum creatinine,uric acid,parathyroid hormone,total cholesterol,triglycerides,serum β2-Microglobulin,etc.,improve the Montreal Cognitive Assessment Scale(Mo CA).According to the whether there is cerebral microbleed,the patients were divided into two groups:cerebral microbleeds positive group(CMB)and CMB negative group.According to the results of Mo CA score,they were divided into two groups: group and cognitive normal group.The characteristics of cognitive impairment and related factors in patients with CMB were analyzed.Result:1.The 61 patients,including 38 males(62.3%)and 23 females(37.7%);There were 32 patients with CMB positive and 29 patients with CMB negative.The prevalence of CMB in MHD patients was 52.46%(32/61);In the CMB positive group,there were 22 patients with cognitive impairment,10 patients with cognitive normal,the incidence of cognitive impairment in MHD patients with CMB was68.75%(22/32).2.CMB positive group and CMB negative group of the MHD patients: the comparison results between the two groups showed that there was no significant difference in age,gender,dialysis age,smoking history,diabetes history,hypertension history,dialysis hypotension,diastolic pressure,systolic pressure,KT/V,ultrafiltration volume/dry body reorganization(p>0.05);Red blood cell distribution width,platelet count,CRP,serum glucose,blood albumin,parathyroid hormone,potassium,triglycerides,white blood cells,red blood cell count,hematocrit,hemoglobin,absolute values of neutrophils.There was no significant difference in serumβ2-Microglobulin,calcium,phosphorus,magnesium,sodium,total cholesterol,creatinine,and uric acid(p>0.05);The difference in urea was statistically significant(p<0.05);3.Comparison of cognitive evaluation results between the two groups : CMB positive group and CMB negative groupCompared with the CMB negative group,the total score of Mo CA,visual space,execution,and delayed recall scores in the CMB positive group were lower(p<0.05);There was no significant difference in the scores of abstraction,attention,naming,language,and orientation(p>0.05).See Table 3.4.Distribution of microbleeding sites in patients with cognitive impairment and normal cognitive function in CMBThere was no difference in the distribution of microbleeds between the two groups : cognitive impairment group and the normal cognitive function group(p>0.05).5.Comparison of general data between CMB cognitive impairment group and CMB normal cognitive function groupThere was no significant difference in age,gender,smoking history,diabetes history,hypertension history,dialysis hypotension,diastolic blood pressure,systolic blood pressure,KT/V,ultrafiltration volume/dry body reorganization between the CMB cognitive impairment group and the cognitive normal group(p>0.05).6.Comparison of laboratory indicators between CMB cognitive impairment group and CMB normal cognitive function groupThere was a statistically significant difference in the levels of serum β2MG、uric acid and PTH(p<0.05);There were no statistically significant differences in red blood cell distribution width,white blood cells,red blood cell count,hematocrit,hemoglobin,platelet count,absolute neutrophil count,crp,serum glucose,albumin,calcium,potassium,phosphorus,magnesium,sodium,triglycerides,total cholesterol,creatinine,and urea(p>0.05).7.Logistic regression analysis of whether each laboratory indicator is a risk factor for cognitive impairmentserum β2 Microglobulin level is a risk factor for cognitive impairment,with an OR of 1.163(p<0.05).Conclusion:1.The patients in MHD with CMB can affect patients cognitive function,mainly affecting visual space and executive function,as well as delayed recall function.2.Serum β2-microglobulin is a risk factor for cognitive impairment patients in MHD with CMB.