血清神经肽Y联合神经丝轻链蛋白对脑梗死患者认知功能障碍的预测价值

The Predictive Value of Serum Neuropeptide Y Combined with Neurofilament Light Chain Protein for Cognitive Dysfunction in Patients with Cerebral Infarction

摘要: 目的：评价血清神经肽Y (neuropeptide Y, NPY)联合神经丝轻链蛋白(neurofilament light chain protein, NfL)对脑梗死患者认知功能障碍的预测价值。方法：回顾性总结2021年3月至2024年3月我院诊断脑梗死患者145例为研究对象，根据指南推荐进行恰当的临床治疗，出院后常规随访6个月。根据期间是否发生认知障碍，分为认知障碍组44例和无认知障碍组101例。采用ELISA法检测患者入院血清NPY和NfL水平，同时记录患者一般临床资料、临床治疗和血生化。结果：单因素比较发现，两组年龄、收缩压、舒张压、糖尿病病程、梗死体积、入院NIHSS评分、血清NPY、NfL、总胆固醇(TC)和同型半胱氨酸(Hcy)水平存在显著差异(P < 0.05)。多因素Logistic回归显示，NIHSS评分(OR = 1.412, 95%CI = 1.205~1.653, P < 0.001)、NPY (OR = 1.029, 95%CI: 1.008~1.051, P < 0.001)和NfL (OR = 1.036, 95%CI: 1.012~1.061, P < 0.001)是认知障碍的危险因素。受试者工作特征曲线显示，NPY联合NfL诊断认知障碍的AUC为0.836，显著高于单一指标(P < 0.05)。结论：脑梗死患者血清NPY和NfL水平升高往往提示认知功能障碍的发生风险较高，可作为辅助临床诊断认知功能障碍的新型生物标志物。

Abstract: Objective: To evaluate the predictive value of serum neuropeptide Y (NPY) combined with neurofilament light chain protein (NfL) for cognitive impairment in patients with cerebral infarction. Methods: A retrospective summary was conducted on 145 patients diagnosed with cerebral infarction into our hospital from March 2021 to March 2024. According to the guidelines, appropriate clinical treatments were recommended, then routine follow-up was conducted for 6 months after discharge. During hospitalization and follow-up, they were divided into cognitive impairment group (n = 44) and non-cognitive impairment group (n = 101) using Montreal Cognitive Assessment Scale (MoCA). ELISA method was used to detect serum NPY and NfL levels at admission, and patients’ general clinical data, clinical treatments, and blood biochemistry were recorded. Results: Univariate comparison revealed significant differences in age, systolic blood pressure, diastolic blood pressure, duration of diabetes, infarct volume, national institutes of health stroke scale (NIHSS) score at admission, serum NPY, NfL, total cholesterol (TC), and homocysteine (Hcy) levels between the two groups (P < 0.05). Multivariate logistic regression showed that NIHSS score (OR = 1.412, 95%CI: 1.205~1.653, P < 0.001), NPY (OR = 1.029, 95%CI: 1.008~1.051, P < 0.001) and NfL (OR = 1.036, 95%CI: 1.012~1.061, P < 0.001) were the risk factors for cognitive impairment in patients with cerebral infarction. Receiver operating characteristic (ROC) curve showed that area under curve (AUC) of NPY combined with NfL for diagnosing cognitive impairment in patients with cerebral infarction was 0.836, which was significantly higher than single indicator (P < 0.05). Conclusion: Elevated serum NPY and NfL levels in patients with cerebral infarction often indicate higher risk of cognitive impairment, which can serve as novel biomarkers for assisting clinical diagnosis of cognitive impairment.