Objective To explore the changes in serum angiotensin(Ang)and angiotensin Ⅳ(AngⅣ)levels in patients with acute cerebral infarction(ACI),and analyze the correlation of their lev-els with cognitive dysfunction and severity of the disease.Methods A total of 280 ACI patients admitted in our hospital from January 2020 to January 2023 were enrolled in this study.According to the results of Mini-Mental Status Examination(MMSE),they were divided into normal cogni-tive group(MMSE score:≥ 27,n=147)and cognitive impairment(score:＜27,n=133),and those in the latter group were further assigned into mild(score:21-26,n=50),moderate(score:10-20,n=44)and severe(score:＜10,n=39)cognitive impairment subgroups.In addition,Pul-licino formula was used to calculate the infarct volume(V),and then 280 ACI patients were clas-sified into mild(V＜5 cm3,n=80),moderate(V 5-10 cm3,n=130),and severe(with＞10 cm3,n=70)infarction groups.The serum levels of Ang and Ang Ⅳ were compared among above different groups.Pearson correlation analysis was applied to study the correlation of serum Ang and Ang Ⅳ levels with cognitive dysfunction and its severity in the ACI patients.Results The se-rum Ang and Ang Ⅳ levels were higher in the cognitive impairment group than the normal cogni-tive group(P＜0.01).Significant differences were seen in their levels among the mild,moderate,and severe cognitive impairment subgroups(P＜0.01),and the levels were significantly highest in the severe cognitive impairment subgroup,followed by the moderate and then the mild subgroups(P＜0.01).There were also obvious differences in the serum levels of the two indicators among the severe,moderate,and mild infarction groups(P＜0.01).Pearson correlation analysis indicated that their serum levels were positively correlated with cognitive impairment(r=0.764,P=0.000;r=0.792,P=0.000),and with severity of infarction(r=0.801,P=0.000;r=0.807,P=0.000).Multivariate logistic regression analysis revealed that age,hypertension,diabetes,hyperlipidemia,smoking,genetics,and Ang and Ang Ⅳ levels were high-risk factors for cognition impairment.Conclusion Serum Ang and Ang Ⅳ levels are higher in ACI patients,and their levels are raised with increasing severity of cognitive impairment and increasing infarct size,in a positive correla-tion.The serum levels can be used as marker for cognitive impairment and severity of ACI.In addition,there are many high-risk factors for cognition,and serum Ang and Ang Ⅳ levels are also one of them.Clinically,the treatment plan should be optimized by combining these high-risk fac-tors to reduce the incidence of cognitive impairment after ACI.

The development of neuroimaging has led to a high diagnostic rate of cerebral small vessel disease (CSVD).The hemorrhage transformation (HT) and clinical prognosis after intravenous thrombolysis in acute ischemic stroke (AIS) with CSVD have become hot topics in recent years.Relevant studies have shown that different subtypes of CSVD may have different influences in HT and clinical prognoses in AIS.In clinic,each subtype of CSVD may not exist alone in one patient,therefore,some scholars put forward the concept of total burden of CSVD to further quantitatively assess the severity of CSVD in the whole brain and their effects on HT and clinical prognosis after intravenous thrombolysis of AIS.This article reviews the researches on HT and clinical prognosis after intravenous thrombolysis in AIS with CSVD.