目的 探讨选取β2微球蛋白升高是否与缺血性脑卒中后认知功能障碍(post stroke cognitive impairment,PSCI)存在关联.方法 2022年12月至2023年12月在温州市人民医院住院的缺血性脑卒中患者140例纳入研究.入院后24 h内测定血清β2微球蛋白等生化指标,根据简明精神状态检查(mini-mental state examination,MMSE)量表评分结果,低于27分67例纳入PSCI组67例,达到或超过27分67例纳入无卒中后认知功能障碍(non-post stroke cognitive impairment,PSNCI)组,采用二元Logistic回归分析确定血清β2微球蛋白对卒中后认知功能障碍的预测价值.结果 其中PSCI组患者年龄、入院时美国国立卫生院神经功能缺损量表(National Institutes of Health Stroke Scale,NIHSS)评分、低教育程度比例、多发或者大面积梗死者占比、血清β2微球蛋白水平均高于PSNCI组.多因素Logistic回归分析结果显示年龄、入院时NIHSS评分、多发或者大面积梗死、血清β2微球蛋白水平是PSCI的危险因素,受教育程度是PSCI的保护因素.结论 β2微球蛋白水平较高是PSCI的独立预测因素,对脑卒中患者进行β2微球蛋白水平检测有可能实现对PSCI的早期发现.
Association of serum β2-microglobulin levels with post-stroke cognitive impairment
Objective To investigate whether an association existed between elevated serum β2-microglobulin levels and post stroke cognitive impairment(PSCI).Methods A total of 140 patients with ischemic stroke in Wenzhou People's Hospital during December 2022 to December 2023 were prospectively were enrolled including 73 patients in the PSCI group and 67 patients in the non-post stroke cognitive impairment(PSNCI)group.Serum β2-microglobulin and other biochemical indicators were measured within 24 hours after admission.PSCI was assessed using the mini-mental state examination(MMSE)score with a threshold of≥27 points serving as the diagnostic criterion.Results The age,National Institutes of Health Stroke Scale(NIHSS)score at admission,proportion of low education level,proportion of multiple or large area infarction and serum β2-microglobulin level in the PSCI group were higher than those in the PSNCI group.Multivariate Logistic regression analysis showed that age,NIHSS score at admission,multiple or large area infarction and serum β2-microglobulin level were risk factors for PSCI,and education level was a protective factor for PSCI.Conclusion The increase of β2-microglobulin level is a risk factor for cognitive impairment after ischemic stroke.The detection of β2-microglobulin level in stroke patients may realize the early detection of PSCI.
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