肿瘤坏死因子水平及衰弱状态与老年脑卒中病人认知功能障碍的相关性

doi:10.3969/j.issn.1003-9198.2024.12.009

Abstract

Abstract: Objective To analyze the relationship of tumor necrosis factor α (TNF-α) and frailty with cognitive impairment in the elderly patients with stroke. Methods Ninety-four elderly patients with stroke admitted to Lianyungang Second People’s Hospital from October 2022 to October 2023 were enrolled in this study. All patients underwent the assessment using Montreal Cognitive Assessment (MoCA) scale, Fried frailty index and National Institutes of Health Stroke Scale (NIHSS), respectively. The patients with MoCA score ≥26 were divided into the normal group (n=53), and those with score <26 were divided into the cognitive impairment group (n=41). The levels of TNF-α, apoptosis markers including cysteine-dependent aspartate-specific protease-3 (Caspase-3), fatty acid synthase (Fas), Fas ligand (FasL), and neurotransmitters including dopamine (DA), serotonin (5-HT), norepinephrine (NE) were measured and compared between the two groups. Multiple Logistic regression analysis was conducted to identify the independent factors influencing the occurrence of cognitive impairment. The predictive value of frailty and TNF-α for cognitive impairment was assessed by the receiver operating characteristic (ROC) curve. Results The scores of Fried and NIHSS, and the levels of TNF-α, Caspase-3, Fas and FasL were significantly higher, and the levels of DA, 5-HT and NE were significantly lower in the cognitive impairment group than those in the normal group. Multivariable analysis revealed that Fried and NIHSS scores, and the levels of TNF-α, Caspase-3, Fas, FasL, DA, 5-HT, and NE were independent influencing factors of cognitive impairment (all P<0.05). The sensitivity and specificity of the Fried score predicting cognitive impairment was 92.7%, 60.4%, while the sensitivity and specificity of TNF-α was 82.9%, 83.0%, respectively. Conclusions Higher levels of TNF-α and frailty are associated with an increased risk of cognitive impairment in the elderly patients with stroke.

Key words: tumor necrosis factor-α, frailty, stroke, cognitive function, aged

CLC Number:

R 749.13

WANG Lingling, SHEN Xiaozhu, GONG Chen, HU Guangyun. Relationship of tumor necrosis factor and frailty with cognitive dysfunction in elderly patients with stroke[J]. Practical Geriatrics, 2024, 38(12): 1229-1233.

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Relationship of tumor necrosis factor and frailty with cognitive dysfunction in elderly patients with stroke

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