Study on correlation of serum β2-microglobulin and neuron-specific enolase levels with cognitive impairment after acute ischemic stroke
Objective To explore the correlation of serum β2-microglobulin(β2-MG)and neuron-specific enolase(NSE)levels with post-stroke cognitive impairment(PSCI)in patients with acute ischemic stroke(AIS),and analyze the predictive value of β2-MG and NSE levels on post-stroke cognitive impairment.Methods A total of 100 patients with AIS were grouped according to whether they had cognitive impairment,with 50 patients with post-stroke cognitive impairment(PSCI)as the PSCI group,and 100 patients with post-stroke non-cognitive impairment(PSNCI)as the PSNCI group.Comparison was made on basic data of age,gender,education level,life history,past history,lesion site and etiological classification,difference in laboratory test results[β2-MG,NSE,hypersensitivity C-reactive protein(hs-CRP),glycosylated hemoglobin(HbA1c),uric acid(UA),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),homocysteine(Hcy),body mass index(BMI)],and functional scales[National Institutes of Health Stroke scale(NIHSS),Montreal Cognitive Assessment(MoCA),and Mini-Mental Status Examination(MMSE)]between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of PSCI.The predictive value of serum β2-MG and NSE in cognitive impairment after ischemic stroke was evaluated by receiver operating characteristic(ROC)curve.Results There were significant differences in β2-MG,NSE,HbA1c,hsCRP,diabetes history,MoCA score,MMSE score and NIHSS score between PSCI group and PSNCI group(P<0.05).Logistic regression results showed that high β2-MG and NSE levels were independent risk factors for cognitive impairment after acute ischemic stroke(P<0.05).Serum β2-MG was negatively correlated with MMSE and MoCA scores(r=-0.254,-0.461,P<0.05).Serum NSE was negatively correlated with MMSE and MoCA scores(r=-0.261,-0.480;P<0.05).ROC curve analysis showed that the sensitivity,specificity and Youden's index of serum β2-MG combined with NSE in predicting PSCI were 70.00%,96.00%and 0.66,which were higher than either single prediction,and the difference was statistically significant(P<0.05).The optimal cut-off values of β2-MG and NSE for the prediction of PSCI were 8.70 U/L and 17.50 ng/ml,respectively.Conclusion High levels of serum β2-MG and NSE levels are independent risk factors for the development of cognitive impairment after acute ischemic stroke,and can be used as neonatal specific markers to predict cognitive impairment after acute ischemic stroke.
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