MnSOD、NfL、Lp-PLA2与卒中后认知障碍相关性及联合检测意义OACSTPCD

Objective To investigate the correlation between manganese superoxide dismutase(MnSOD),neuro-filament light chain(NfL),and lipoprotein-associated phospholipase A2(Lp-PLA2)and post-stroke cognitive impair-ment(PSCI)and the significance of combined measurement,and to provide a reference for early clinical evaluation and formulation of intervention strategies.Methods One hundred patients with stroke admitted to our hospital from June 2020 to January 2023 were divided into PSCI group and non-PSCI group according to whether PSCI occurred.The two groups were compared in terms of baseline data and MnSOD,NfL,and Lp-PLA2 levels at admission and two and four weeks after admission.Pearson analysis was performed to analyze the correlation between MnSOD,NfL,and Lp-PLA2 and the score of Montreal Cognitive Assessment(MoCA).Multiple linear regression analysis was used to analyze the in-fluencing factors for PSCI.Receiver operating characteristic(ROC)curves were plotted to determine the value of Mn-SOD,NfL,and Lp-PLA2 at admission and two weeks after admission in predicting the occurrence of PSCI.Results The PSCI group showed a significantly higher score of the National Institutes of Health Stroke Scale(NIHSS),a significantly higher percentage of white matter osteoporosis,a significantly higher percentage of cerebral at-rophy,and a significantly lower MoCA score than the non-PSCI group at admission(all P<0.05).MnSOD levels were significantly higher two and four weeks after admission than at admission for both groups;NfL and Lp-PLA2 levels were significantly lower two and four weeks after admission than at admission for both groups;two and four weeks after admis-sion,the PSCI group showed significantly lower MnSOD levels and significantly higher NfL and Lp-PLA2 levels than the non-PSCI group(all P<0.05).At admission and two and four weeks after admission,MnSOD levels were positively cor-related with MoCA scores,while NfL and Lp-PLA2 levels were negatively correlated with MoCA scores(all P<0.05).At admission,NIHSS score,white matter osteoporosis,brain atrophy,MnSOD,NfL,and Lp-PLA2 were all signifi-cantly correlated with MoCA score(all P<0.05).At admission and two weeks after admission,the area under the ROC curve(AUC)of the combination of any two indicators was larger than that of any single index,and the AUC of the com-bination of the three indicators was larger than that of the combination of any two indicators.The AUC of the combina-tion of the three indicators was 0.932 at admission,smaller than 0.944 two weeks after admission,with prediction sen-sitivity of 84.62%and specificity of 93.44%.Conclusion MnSOD,NfL,and Lp-PLA2 are important factors affecting the occurrence of PSCI,which can help early clinical evaluation and prediction of PSCI to facilitate subsequent treat-ment and improve patients prognosis.