Narasimhalu Kaavya, Lee Jasinda, Leong Yi Lin, Ma Lu, De Silva Deidre A, Wong Meng Cheong, Chang Hui Meng, Chen Christopher
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Duke-NUS Graduate Medical School, Singapore.
Int J Stroke. 2015 Jun;10(4):513-8. doi: 10.1111/ijs.12001. Epub 2013 Mar 12.
Population-based studies have demonstrated the association of inflammation and cognitive impairment. However, few studies to date have examined this association in ischemic stroke patients.
The study aims to determine the association between inflammatory markers and cognitive impairment.
Ischemic stroke patients with baseline neuropsychological assessments at three-months poststroke were followed up with annual neuropsychological assessments for up to five-years. Inflammatory markers (C-reactive protein, interleukin 1β, interleukin 6, interleukin 8, interleukin 10, interleukin 12, and tumor necrosis factor-α) were assayed, and logistic regression analyses were performed to determine associations between inflammatory markers and both baseline cognitive status and subsequent cognitive decline.
There were 243 ischemic stroke patients in the study. In multivariable ordinal logistic regression analysis, age, education, ethnicity, stroke subtype, and interleukin 8 (OR 1.23 CI 1.05-1.44) levels were independently associated with baseline cognitive status. In multivariable logistic regression analyses, age, gender, recurrent strokes, and interleukin 12 (OR 25.02 CI 3.73 to 168.03) were independent predictors of subsequent cognitive decline.
Following ischemic stroke, higher serum interleukin 8 is independently associated with baseline cognitive impairment while higher serum interleukin 12 is associated with subsequent cognitive decline.
基于人群的研究已证实炎症与认知障碍之间存在关联。然而,迄今为止,很少有研究在缺血性中风患者中探讨这种关联。
本研究旨在确定炎症标志物与认知障碍之间的关联。
对缺血性中风患者在中风后三个月进行基线神经心理学评估,并随后进行每年一次的神经心理学评估,为期长达五年。检测炎症标志物(C反应蛋白、白细胞介素1β、白细胞介素6、白细胞介素8、白细胞介素10、白细胞介素12和肿瘤坏死因子-α),并进行逻辑回归分析以确定炎症标志物与基线认知状态及随后认知衰退之间的关联。
本研究中有243例缺血性中风患者。在多变量有序逻辑回归分析中,年龄、教育程度、种族、中风亚型和白细胞介素8(比值比1.23,可信区间1.05 - 1.44)水平与基线认知状态独立相关。在多变量逻辑回归分析中,年龄、性别、复发性中风和白细胞介素12(比值比25.02,可信区间3.73至168.03)是随后认知衰退的独立预测因素。
缺血性中风后,较高的血清白细胞介素8与基线认知障碍独立相关,而较高的血清白细胞介素12与随后的认知衰退相关。