【摘要】 目的 探讨脑卒中后认知功能障碍（PSCI）与炎症反应及线粒体动力相关蛋白（DRP1）的相关性。方法 选取2020-05—2023-08邯郸市人民医院PSCI患者60例为研究对象，收集同期卒中后不伴认知功能障碍（PSNCI）患者100例作对照。收集并比较所有研究对象的基线资料及实验室指标[白细胞介素-6(IL-6)、C反应蛋白（CRP）、纤维蛋白原（FIB）及线粒体动力相关蛋白（DRP1）]水平。采用Logistic回归法分析脑卒中后并发认知功能障碍的影响因素。绘制ROC曲线分析IL-6、CRP、FIB及DRP1预测PSCI的效能。结果 认知功能障碍组IL-6、CRP、FIB水平均显著高于认知功能正常组，DRP1相对表达量显著低于认知功能正常组（P<0.05）。认知功能障碍组年龄≥70岁、合并疾病（高血压、糖尿病及高脂血症）、吸烟、饮酒、文盲、无体育锻炼及卒中后情绪障碍比重均大于认知功能正常组（P<0.05）。2组性别及体重指数（BMI）比较无统计学差异（P>0.05）。Logistic回归分析显示，年龄≥70岁、高血压、糖尿病、吸烟、文盲，IL-6、CRP、FIB水平升高及DRP1水平降低是脑卒中并发认知功能障碍的独立危险因素（P<0.05）。IL-6、CRP、FIB及DRP1单独预测PSCI的AUC值分别为0.793(95%CI:0.724～0.861)、0.819(95%CI:0.745～0.893)、0.870(95%CI:0.816～0.924)及0.803(95%CI:0.733～0.873)，诊断效能较好。四者联合预测PSCI的AUC值为0.975(95%CI:0.955～0.995)，四者联合诊断预测PSCI的效能优于IL-6(Z=5.433,P<0.001)、CRP(Z=4.384,P<0.001)、FIB(Z=4.182,P<0.001)及DRP1(Z=5.050,P<0.001)单独诊断。结论IL-6、CRP、FIB及DRP1均与PSCI密切相关，是脑卒中后发生PSCI的独立影响因素，且能有效预测PSCI。更多还原

【Abstract】 Objective To investigate the relationship between post-stroke cognitive impairment(PSCI)and inflammation and mitochondrial dynamic associated protein(DRP1) after stroke.Methods Sixty patientswith PSCI in Handan People’s Hospital from May 2020 to August 2023 were selected as the subjects. At thesame time,100 patients with post stroke with post-stroke non-cognitive impairment(PSNCI) were collected ascontrols. Baseline data and laboratory indicators(interleukin-6(IL-6),C-reactive protein(CRP),fibrinogen (FIB)and mitochondrial dynamic-related protein(DRP1))levels were collected and compared in all subjects.Logistic regression was used to analyze the influencing factors for cognitive dysfunction after stroke. ROC diagramwas drawn to analyze the efficacy of IL-6,CRP,FIB and DRP1 in predicting PSCI.Results The levels of IL-6,CRP and FIB in cognitive dysfunction group were significantly higher than those in normal cognitive functiongroup,and the relative expression of DRP1 was significantly lower than that in normal cognitive function group(P<0.05). The proportion of age ≥70 years old,comorbidities(hypertension,diabetes and hyperlipidemia),smoking,drinking,illiteracy,no physical exercise and mood disorder after stroke in the cognitive dysfunctiongroup was higher than that in the normal cognitive function group(P<0.05). There were no significant differencesin gender and BMI between the two groups(P>0.05). Logistic regression analysis showed that age ≥70 yearsold,hypertension,diabetes,smoking,illiteracy,elevated IL-6,CRP,FIB and decreased Drp1 levels wereindependent risk factors for stroke complicated with cognitive dysfunction(P<0.05). The AUC value of IL-6,CRP,FIB and DRP1 independently predicted PSCI was 0.793(95% CI:0.724-0.861),0.819(95% CI:0.745-0.893),0.870(95% CI:0.816-0.924)and 0.803(95% CI:0.733-0.873),respectively,the diagnosticefficiency was better. The AUC value of PSCI predicted by the four parties was 0.975(95% CI:0.95-0.995),the combined diagnosis of PSCI was superior to IL-6(Z=5.433,P<0.001),CRP(Z=4.384,P<0.001),FIB(Z=4.182,P<0.001) and Drp1(Z=5.050,P<0.001) alone.Conclusion IL-6,CRP,FIB and DRP1 are closelyrelated to PSCI,which are independent influencing factors for PSCI,and can effectively predict PSCI.更多还原