Influences of blood pressure control, long-term blood pressure variability and serum IL-6 in early cognitive impairment in patients with basal ganglia hypertensive intracerebral hemorrhage
10.3760/cma.j.cn115354-20240612-00341
- VernacularTitle:基底节区高血压脑出血患者血压控制水平、长时血压变异性及血清IL-6对早期认知障碍的影响
- Author:
Yi WU
1
;
Zhongyong WANG
;
Qing ZHU
;
Na ZHANG
;
Jun DONG
;
Qing LAN
Author Information
1. 苏州大学附属第二医院神经外科，苏州 215004
- Keywords:
Hypertensive intracerebral hemorrhage in basal ganglia;
Cognitive impairment;
Acute blood pressure control;
Seven d-duration standard deviation of systol
- From:
Chinese Journal of Neuromedicine
2024;23(8):769-776
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influences of blood pressure fluctuation and biochemical parameters in early cognitive impairment in patients with basal ganglia hypertensive intracerebral hemorrhage (HICH).Methods:A total of 148 patients with basal ganglia HICH, admitted to Department of Neurosurgery, Second Affiliated Hospital of Soochow University from January 2022 to January 2024 were enrolled. Four weeks after onset, these patients accepted Montreal cognitive assessment (MoCA) and were divided into cognitive impairment group (MoCA scores<26, n=62) and non-cognitive impairment group (MoCA scores≥26, n=86) accordingly. Clinical data and average blood pressure on 7 consecutive d (since admission) were collected, and differences of clinical data, mean systolic blood pressure (MSBP), mean diastolic blood pressure (MDBP), and long-term blood pressure variability indexes were compared between the two groups. Multivariate Logistic regression analysis was used to screen the independent influencing factors for cognitive impairment; spearman rank correlation was used to analyze the correlation between independent influencing factors and MoCA score; and receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of independent influencing factors in cognitive impairment. Results:Compared with the non-cognitive impairment group, the cognitive impairment group had significantly longer hypertension duration, statistically higher interleukin-6 (IL-6), MSBP, MDBP and 7 d-duration standard deviation of systolic blood pressure (7dSSD), and significantly lower albumin ( P<0.05). Multivariate Logistic regression analysis showed that hypertension duration ( OR=1.258, 95% CI: 1.134-1.396, P<0.001), MSBP ( OR=1.770, 95% CI: 1.267-2.473, P=0.001), 7dSSD ( OR=1.139, 95% CI: 1.038-1.249, P=0.006), and IL-6 ( OR=1.156, 95% CI: 1.076-1.241, P<0.001) were independent influencing factors for early cognitive impairment in patients with basal ganglia HICH. Spearman rank correlation showed that hypertension duration, MSBP, 7DSSD, and IL-6 were negatively correlated with MoCA score ( rs=-0.271, P=0.001; rs=-0.493, P<0.001; rs=-0.264, P=0.001; rs=-0.412, P<0.001). Area under ROC curve of combined use of MSBP, 7dSSD, hypertension duration and IL-6 in diagnosing early cognitive impairment was 0.932, with sensitivity of 0.855 and specificity of 0.895. Conclusion:MSBP, 7dSSD, hypertension duration and IL-6 might be hemodynamic and serological monitoring indexes for predicting early cognitive impairment in patients with basal ganglia HICH.
