急性脑梗死患者血浆纤维蛋白原水平与疑似卒中后认知障碍的相关性OA

Objective To investigate the correlation between acute-phase plasma fibrinogen(FIB)level and Montreal Cognitive Assessment(MoCA)screening positivity/suspected post-stroke cognitive impairment(PSCI)at 3 months after diagnosis in patients with acute cerebral infarction.Methods A total of 85 patients with acute cerebral infarction admitted to the Department of Neurology of Lankao First Hospital from January 2023 to August 2024 were selected.Another 34 age-matched healthy individuals who underwent physical examination during the same period were selected as the healthy control group.Plasma FIB levels were measured within 24 h after diagnosis in patients with acute cerebral infarction and in healthy individuals.Cognitive function was assessed during follow-up using the MoCA.A MoCA score＜26 at 3 months after diagnosis,together with at least two consecutive MoCA scores＜26 during follow-up,was used as the criterion for MoCA screening positivity/suspected PSCI.According to the screening results,the patients were divided into the suspected PSCI group and the non-PSCI(NPSCI)group.They were also divided according to FIB level into the high-FIB group(＞4 g/L)and the low-FIB group(≤4 g/L).FIB levels and the MoCA screening positivity rate were compared among groups,and the correlation between FIB level and MoCA score was analyzed.Results Among the 85 patients with acute cerebral infarction,38 had suspected PSCI and 47 had NPSCI.The proportions of patients with a history of hypertension,a history of hyperlipidemia,higher admission National Institutes of Health Stroke Scale(NIHSS)scores,and anterior circulation infarction were higher in the suspected PSCI group than in the NPSCI group(P＜0.05).Multivariate logistic regression analysis showed that a history of hypertension,a history of hyperlipidemia,admission NIHSS score,anterior circulation infarction,and elevated plasma FIB level were all associated with an increased risk of MoCA screening positivity/suspected PSCI(P＜0.05).FIB levels in both the NPSCI group and the suspected PSCI group were higher than those in the healthy control group,and the FIB level in the suspected PSCI group was higher than that in the NPSCI group(P＜0.05).The MoCA screening positivity rate was higher in the high-FIB group than in the low-FIB group(P＜0.05).Plasma FIB level was negatively correlated with MoCA score(r=-0.807,P＜0.001).Conclusion Elevated plasma FIB level in patients with acute cerebral infarction is associated with an increased risk of MoCA screening positivity and lower MoCA scores at 3 months after diagnosis.These findings suggest that FIB may have value in early risk identification.However,because the assessment was mainly based on MoCA screening,it cannot be regarded as equivalent to a confirmed diagnosis of PSCI,and further studies are needed for validation.