Dynamic changes of serum interleukin-18 and interleukin-33 in patients with cerebral infarction and their predictive value for post-stroke cognitive impairment
Objective To investigate the dynamic changes of serum IL-18 and IL-33 in patients with cerebral infarction and their predictive value for post-stroke cognitive impairment(PSCI).Methods According to whether PSCI occurred within 6 months after the acute cerebral infarction,72 patients with acute cerebral infarction were divided into the PSCI group(n=34)and non-PSCI group(n=38).Serum IL-18 and IL-33 were detected at admission and 1 d,7 d and 14 d after admission.MMSE was used to evaluate cognitive function,and NIHSS score was used to evaluate neurological function at 6 months follow-up.Pearson linear correlation analysis was used to analyze the relationship between serum IL-18,IL-33 levels and MMSE,NIHSS scores at each time point.ROC curve was used to evaluate the predictive value of serum IL-18 and IL-33 at each time point for PSCI.Results The levels of serum IL-18 and IL-33 in the PSCI group were significantly higher than those in the non-PSCI group at admission and 1 d,7 d and 14 d after admission(P<0.05-0.01).Compared with those in the non-PSCI group,MMSE score was significantly decreased,and NIHSS score was significantly increased in the PSCI group(all P<0.01).Pearson correlation analysis showed that serum IL-18 and IL-33 levels at admission and 1 d after admission were negatively correlated with MMSE score(P<0.05-0.01),and positively correlated with NIHSS score(P<0.05-0.01).ROC curve analysis showed that serum IL-18 at admission,1 d and 14 d after admission,and serum IL-33 at admission,1 d,7 d and 14 d after admission had predictive efficacy for PSCI.The area under the curve(AUC)of IL-18 in predicting PSCI at admission,1 d and 14 d after admission were 0.652,0.777 and 0.641,respectively(P<0.05-0.01);the sensitivity was 79.41%,64.71%and 52.94%,respectively;the specificity was 57.89%,86.84%and78.95%,respectively.The AUC of serum IL-33 at admission,1 d,7 d and14 d after admission in predicting PSCI was 0.640,0.775,0.668 and 0.660,respectively(P<0.05-0.01);the sensitivity was 58.82%,76.47%,58.82%and 61.76%,respectively;the specificity was 65.79%,89.47%,86.84%and 84.21%,respectively.Conclusions Serum expressions of IL-18 and IL-33 in patients with cerebral infarctionare are abnormally high and reached their peak at 1 d after admission,which is closely related to the degree of impairment of cognitive function and neurological function of patients.The occurrence of PSCI can be predicted by monitoring their dynamic changes.
acute cerebral infarctionIL-18IL-33post-stroke cognitive impairmentpredictive value
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