Department of Neurology, The First Affiliated Hospital of China Medical University and The First people's Hospital of Shenyang., Shenyang, China.
Department of Neurology, The First people's Hospital of Shenyang, Shenyang, China.
Brain Behav. 2022 Mar;12(3):e2519. doi: 10.1002/brb3.2519. Epub 2022 Feb 11.
Mild ischemic stroke (MIS) has been proved to be closely related to post-stroke cognitive impairment (PSCI). However, there are relatively few studies on the risk factors of MIS. We aimed to evaluate the relationship between serum cystatin C (CysC) level and cognitive function in patients with acute MIS.
Four hundred consecutive patients with acute MIS were screened and 281 patients were eligible for this study. The serum CysC levels were detected within 24 h after admission. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) at 3 months after acute MIS. Logistic regression was used to identify the predictors of PSCI, and the receiver operating characteristic (ROC) curve was applied to explore the optimal cut-off value.
One hundred sixty-four (58.4%) patients were diagnosed with PSCI at 3 months follow-up. The serum CysC levels in patients with PSCI were significantly higher than patients without PSCI (p < .001). The binary logistic regression analysis showed that higher serum CysC level was an independent predictor for PSCI at 3 months (odds ratio [OR], 5.745; 95% confidence interval, [CI], 1.089-30.311; p = 0.039). The ROC curve showed that area under the curve (AUC) was 0.723, and at a 0.945 mg/l CysC cut-off point, the sensitivity and specificity for PSCI at 3 months were 79.9% and 58.1%, respectively.
Our findings suggested that the serum CysC levels were increased after acute MIS, and higher serum CysC levels at baseline might be an independent risk factor for PSCI in patients with acute MIS, but further research are warranted.
轻度缺血性脑卒中（MIS）已被证明与卒中后认知障碍（PSCI）密切相关。然而，关于 MIS 的危险因素的研究相对较少。我们旨在评估急性 MIS 患者血清胱抑素 C（CysC）水平与认知功能之间的关系。
连续筛选了 400 例急性 MIS 患者，其中 281 例符合条件。入院后 24 小时内检测血清 CysC 水平。急性 MIS 后 3 个月采用蒙特利尔认知评估（MoCA）评估认知功能。采用 Logistic 回归识别 PSCI 的预测因素，并应用受试者工作特征（ROC）曲线探索最佳截断值。
164 例（58.4%）患者在 3 个月随访时被诊断为 PSCI。PSCI 患者的血清 CysC 水平明显高于非 PSCI 患者（p<0.001）。二元 Logistic 回归分析显示，较高的血清 CysC 水平是 3 个月时 PSCI 的独立预测因素（优势比[OR]，5.745；95%置信区间[CI]，1.089-30.311；p=0.039）。ROC 曲线显示曲线下面积（AUC）为 0.723，当 CysC 截断值为 0.945mg/l 时，3 个月时 PSCI 的敏感性和特异性分别为 79.9%和 58.1%。
我们的研究结果表明，急性 MIS 后血清 CysC 水平升高，基线时较高的血清 CysC 水平可能是急性 MIS 患者 PSCI 的独立危险因素，但需要进一步研究。
