摘要
Abstract
Objective:To explore the impact of acute stress on early cognitive function in patients with ectopic pregnancy(EP)based on the cognitive reserve theory,and to analyze the role of neuroinflammation in this process.Methods:A prospective cohort study was conducted in hospital from January in 2022 to December in 2023,included 98 EP patients(EP group)and 98 age-and education-matched healthy women(HC group).Acute stress levels,cognitive function,and serum neuroinflammatory markers(IL-1β,IL-6,TNF-α,HMGB1)were assessed preoperatively,at 7 days postoperatively,and at 3 months postoperatively in the EP group.Cognitive reserve was evaluated using an education-occupation composite index.Statistical analyses included repeated-measures ANOVA,correlation analysis,and multiple linear regression.Results:Preoperative stress physiological indicators and IES-R scores were significantly higher in the EP group than in the HC group(all P<0.01).Cognitive performance across all domains significantly declined at 7 days postoperatively compared to preoperative levels and the HC group(all P<0.01),with attention/processing speed and episodic memory most severely impaired.At 3 months postoperatively,partial recovery was observed,but attention/processing speed(DSST:52.89±9.12 vs.58.34±8.67)and episodic memory(RAVLT delayed recall:9.12±2.45 vs.10.45±2.34)remained below preoperative baseline(all P<0.05).Neuroinflammatory markers peaked at 7 days postoperatively,with IL-6,TNF-α,and HMGB1 levels remaining elevated at 3 months(all P<0.05).Correlation analysis showed that cognitive impairment at 7 days was positively correlated with preoperative cortisol(r=0.512)and postoperative HMGB1(r=0.634),and negatively correlated with cognitive reserve index(r=-0.421).Multiple regression indicated that HMGB1 at 7 days(β=-0.354,P<0.01)and cognitive reserve index(β=0.285,P<0.01)were significant predictors of attention function at 3 months.Patients with higher cognitive reserve exhibited milder inflammatory responses and better cognitive recovery.Conclusions:Acute stress in EP leads to early and widespread cognitive impairment,partially persisting up to 3 months postoperatively.Sustained neuroinflammation mediated by HMGB1 may be a key mechanism linking stress and cognitive dysfunction.Higher cognitive reserve appears to confer cerebral protection by modulating inflammatory responses and facilitating functional compensation.关键词
异位妊娠/急性应激/认知功能/神经炎症/高迁移率族蛋白B1/认知储备Key words
Ectopic pregnancy/Acute stress/Cognitive function/Neuroinflammation/HMGB1/Cognitive reserve分类
医药卫生
