炎症因子与住院缺血性脑卒中高龄患者认知衰弱相关性研究

Correlation between inflammatory biomarkers and cognitive frailty inhospitalized elderly patients with ischemic stroke

目的缺血性脑卒中高龄患者具有较高的认知衰弱患病率,其与炎性因子相关性尚不明确。文中探讨白细胞(WBC)计数、白细胞介素6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)与住院缺血性脑卒中高龄患者认知衰弱相关性。方法回顾性分析2018年7月至2019年12月东部战区总医院96例年龄≥80岁住院缺血性脑卒中患者的临床资料,根据Edmonton量表、临床痴呆评定量表及简易精神状态检查量表评分,对患者进行衰弱、认知功能评估并分为认知功能正常组16例(16.67%),认知功能障碍组15例(15.62%),衰弱组23例(23.96%),认知衰弱组42例(43.75%)。分析WBC、IL-6、CRP、PCT与缺血性脑卒中患者认知衰弱相关性。结果认知衰弱组IL-6、CRP、PCT水平显著高于认知功能正常组、认知功能障碍组及衰弱组(P<0.05);WBC水平认知衰弱组高于认知功能正常组及衰弱组(P<0.05),与认知功能障碍组比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,调整年龄、性别、糖尿病、高血压、冠心病、清蛋白等因素后,IL-6(OR=2.160,95%CI=0.448~1.092,P<0.05)、CRP(OR=3.529,95%CI=0.459~2.064,P<0.05)、PCT(OR=8.753,95%CI=6.628~57.578,P<0.05)与认知衰弱成正相关,而WBC与认知衰弱无显著相关性(P>0.05)。结论IL-6、CRP、PCT为住院缺血性脑卒中高龄患者认知衰弱的危险因素,早期血清学指标可作为临床评估指标。

Objective Elderly patients with ischemic stroke have a higher prevalence of cognitive frailty,and the correlation between them and inflammatory biomarkers is not yet clear.This paper discusses the correlation between white blood cell(WBC)count,interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)and cognitive frailty in hospitalized elderly patients with ischemic stroke.Methods 96 hospitalized patients with ischemic stroke aged≥80 years from July 2018 to December 2019 were retrospectively analyzed,patients were assessed for frailty and cognitive according to the Edmonton Scale,the Clinical Dementia Rating(CDR),and the Mini Mental State Examination Scale(MMSE),and were divided into normal cognitive function group(n=16),cognitive impairment group(n=15),frailty group(n=23),and cognitive frailty group(n=42).To analyze the correlation between WBC,IL-6,CRP,PCT and cognitive frailty in patients with ischemic stroke.Results The levels of IL-6,CRP,and PCT in the cognitive frailty group were significantly higher than those in the normal cognitive function group,cognitive impairment group,and frailty group(P<0.05).WBC level of the cognitive frailty group was higher than that of the normal cognitive function group and the frailty group(P<0.05),and there was no statistically significant difference compared with the cognitive impairment group(P>0.05).Logistic regression analysis showed that IL-6,CRP,and PCT were associated with cognitive frailty after adjusting for age,gender,diabetes,hypertension,coronary heart disease and albumin(P<0.05),while WBC was not significantly correlated with cognitive frailty(P>0.05).Conclusion IL-6(OR=2.160,95%CI=0.448-1.092,P<0.05),CRP(OR=3.529,95%CI=0.459-2.064,P<0.05),and PCT(OR=8.753,95%CI=6.628-57.578,P<0.05)were risk factors for cognitive frailty in hospitalized elderly patients with ischemic stroke,and early serological indicators can be used as clinical evaluation.