H型高血压合并AIS患者血清氨基酸类神经递质水平与认知障碍程度的相关性OA

Objective To investigate the association between serum amino acid neurotransmitter levels and the degree of cognitive impairment in patients with H-type hypertension complicated with acute ischemic stroke(AIS).Methods A cross-sectional study design was adopted.A total of 200 patients with H-type hypertension complicated with AIS admitted to the First Department of Neurology of Shaanxi Provincial People's Hospital from January 2022 to January 2024 were included as the research subjects.The included patients were divided into mild group(≤4 points,n=60),moderate group(5-20 points,n=85),and severe group(>20 points,n=55)based on the National Institutes of Health stroke scale(NIHSS)score.The levels of glutamate(Glu),aspartate(Asp),γ-aminobutyric acid(GABA),and glycine(Gly)in the serum of each group were determined by enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was used to verify the correlation between the changes in neurotransmitter levels and the condition of patients with H-type hypertension complicated with AIS.The cognitive function of 200 patients was evaluated by the mini-mental state examination(MMSE),and the patients were divided into cognitive impairment group(n=68)and normal group(n=132)based on the score.Logistic regression model was established to screen the risk factors for cognitive impairment.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy.Results The levels of Glu,Asp,and Gly in the mild group were significantly lower than those in the moderate and severe groups,while the level of GABA was higher(P<0.05).Spearman correlation analysis showed that the levels of Glu,Asp,and Gly were positively correlated with the condition of patients with H-type hypertension complicated with AIS(r=0.823,0.756,0.805),while GABA was negatively correlated(r=-0.769).Multivariate Logistic regression analysis showed that educational level(OR=2.046),stroke location(OR=2.277),NIHSS score(OR=2.248),Glu(OR=2.974),Asp(OR=2.210),GABA(OR=2.418),and Gly(OR=2.237)were independent influencing factors for cognitive impairment in patients with H-type hypertension complicated with AIS(P<0.05).The ROC curve analysis showed that the area under the curve(AUC)of the combined prediction of the four indicators for cognitive impairment reached 0.920,with the sensitivity of 88.8%,the specificity of 90.3%,which was significantly better than that of a single indicator.Conclusion The imbalance of serum amino acid neurotransmitter levels is closely related to the progression of neurological function damage and cognitive impairment in patients with H-type hypertension complicated with AIS.Combined detection can provide biomarker support for early intervention.