Abstract: Objective　To explore the correlations between levels of homocysteine (Hcy), neuron specific enolase (NSE), and interleukin-2 (IL-2) and cognitive function in the acute phase of ischemic stroke, and to provide guidance for reducing the cognitive impairment. Methods　A total of 122 patients with acute phase of ischemic stroke (1-2 weeks after the onset) who were accepted by Department of Neurology, Yantai Yeda Hospital from April 2019 to May 2021 were selected as the research objects, including 70 males and 52 females, aged (66.67±9.16) years. The Mini-mental State Examination (MMSE) was used to evaluate the cognitive function, the fasting venous blood was collected to detect the levels of Hcy, NSE, and IL-2, and the baseline data survey was completed. The baseline data and levels of Hcy, NSE, and IL-2 of different cognitive function groups were compared, Pearson correlation analysis was used to analyze the correlations between levels of Hcy, NSE, and IL-2 and MMSE score, and the linear regression analysis was used to analyze the influencing factors of MMSE score. χ² test was used for the count data, one-way analysis of variance was used for comparison of the measurement data among multiple groups, and LSD method was used for pairwise comparison of the measurement data. Results　The 122 cases of acute phase of ischemic stroke were divided into a normal cognitive function group (65 cases), a mild cognitive impairment group (33 cases), a moderate cognitive impairment group (15 cases), and a severe cognitive impairment group (9 cases) according to the MMSE score. The levels of Hcy, NSE, and IL-2 in the mild, moderate, and severe cognitive impairment group were higher than those in the normal cognitive function group, and the levels of Hcy and NSE in the severe cognitive impairment group were higher than those in the mild cognitive impairment group [(29.49±8.64) µmol/L vs. (23.33±5.17) µmol/L, (33.25±8.32) ng/L vs. (24.28±6.12) ng/L], with statistically significant differences (all P<0.05). The levels of Hcy, NSE, and IL-2 were negatively correlated with MMSE score (r=-0.577, -0.549, and -0.498; all P<0.001). The linear regression analysis showed that age, Hcy, NSE, and IL-2 were the influencing factors of MMSE score in patients with acute ischemic stroke (all P<0.001). Conclusions　The levels of Hcy, NSE, and IL-2 are negatively correlated with the MMSE score in patients with acute phase of ischemic stroke. Age, Hcy, NSE, and IL-2 are related to the cognitive impairment of ischemic stroke. It may help to reduce the cognitive impairment to regulate the levels of Hcy, NSE, and IL-2.

Key words: Homocysteine, Neuron-specific enolase, Interleukin-2, Ischemic stroke, Acute phase, Cognitive function

摘要： 目的　探讨同型半胱氨酸（Hcy）、神经元特异烯醇化酶（NSE）及白细胞介素-2（IL-2）与缺血性脑卒中急性期患者认知功能的相关性，为减轻认知功能损伤提供指导。方法　将烟台业达医院神经内科2019年4月至2021年5月接收的缺血性脑卒中急性期（发病后1～2周）患者122例作为研究对象，其中男70例、女52例，年龄（66.67±9.16）岁。采用简易智力状态检查量表（MMSE）评测其认知功能，采集空腹静脉血检测Hcy、NSE及IL-2水平，并完成基线资料调查；对比不同认知功能组患者的基线资料、Hcy、NSE及IL-2水平。Pearson相关性分析Hcy、NSE及IL-2与MMSE评分的相关性；线性回归分析MMSE评分的影响因子。计数资料采用χ²检验，计量资料多组间比较采用单因素方差分析、两两比较采用LSD法。结果　122例缺血性脑卒中急性期患者根据MMSE评分被分为认知功能正常组（65例）、轻度认知功能障碍组（33例）、中度认知功能障碍组（15例）、重度认知功能障碍组（9例）。轻度认知功能障碍组、中度认知功能障碍组及重度认知功能障碍组的Hcy、NSE及IL-2水平均高于认知功能正常组（均P<0.05）；重度认知功能障碍组的Hcy、NSE水平均高于轻度认知功能障碍组［（29.49±8.64）µmol/L比（23.33±5.17）µmol/L、（33.25±8.32）ng/L比（24.28±6.12）ng/L］，差异均有统计学意义（均P<0.05）。Hcy、NSE、IL-2与MMSE评分均呈显著负相关性，相关系数分别为-0.577、-0.549、-0.498，均P<0.001。线性回归分析显示年龄、Hcy、NSE、IL-2均是缺血性脑卒中急性期患者MMSE评分的影响因子（均P<0.001）。结论　Hcy、NSE、IL-2与缺血性脑卒中急性期患者MMSE评分呈负相关性，年龄、Hcy、NSE、IL-2与缺血性脑卒中认知功能损伤有关，调控Hcy、NSE、IL-2水平可能有助于减轻其认知功能损伤。

关键词: 同型半胱氨酸, 神经元特异烯醇化酶, 白细胞介素-2, 缺血性脑卒中, 急性期, 认知功能