Abstract: Objective  To investigate the correlation between serum IL-6, cystatin C (CysC), triiodothyronine (T3) levels, and total imaging burden score with cognitive impairment in patients with cerebral small vessel disease (CSVD).
Methods  CSVD patients treated from January 2021 to January 2023 were retrospectively included and subsequently divided into the cognitive impairment group and the normal cognitive function group based on their MoCA scores during hospitalization. The demographic information, past medical history, and laboratory and imaging data of the patients were collected. The predictive value of serum IL-6, CysC, T3, and total imaging burden score for cognitive impairment in CSVD patients was analyzed. 
Results  A total of 142 patients with CSVD were included, with 61 cases (43.0%) in the cognitive impairment group and 81 cases (57.0%) in the normal cognitive function group. The levels of IL-6, Hcy, and CysC were higher, the level of T3 was lower, and the proportion of moderate to severe total imaging burden was higher in the cognitive impairment group, with statistically significant differences. Multivariate logistic regression analysis showed that elevated serum IL-6 levels (OR 1.070, 95%CI 1.039-1.103, P＜0.001), elevated CysC levels (OR 2.117, 95%CI 1.027-5.500, P=0.004), decreased T3 levels (OR 2.314, 95%CI 1.361-3.935, P=0.003), and moderate (OR 1.017, 95%CI 1.002-1.032, P=0.029) and severe (OR 9.032, 95%CI 6.076-18.012, P＜0.001) total imaging burden were risk factors for cognitive impairment in patients with CSVD. The AUC values for predicting cognitive impairment of serum IL-6, CysC, T3, and severe total imaging burden were 0.888, 0.812, 0.918, and 0.889, respectively, with the optimal cutoff values of 2.010 pg/mL, 0.982 ng/L, 1.302 nmol/L, and 3.6 points.
Conclusions  Elevated serum IL-6 and CysC levels, decreased T3 levels, and severe total imaging burden are correlated with cognitive impairment in patients with CSVD and can serve as a basis for identifying cognitive impairment in CSVD patients.

Key words: Cerebral small vessel disease; Cognitive impairment; Interleukin-6; Thyroid hormone; Total imaging burden

摘要： 目的 探讨血清IL-6、胱抑素C（cystatin C，CysC）、三碘甲状腺原氨酸（triiodothyronine，T3）水平以及影像学总负荷评分与脑小血管病（cerebral small vessel disease，CSVD）患者认知障碍的相关性。
方法 回顾性连续纳入2021年1月—2023年1月就诊的CSVD患者，根据住院期间MoCA评分分为认知障碍组和认知功能正常组。收集患者的人口学信息、既往病史、实验室及影像学检查等数据。分析血清IL-6、CysC、T3水平以及影像学总负荷评分对CSVD患者认知障碍的预测价值。
结果 共纳入CSVD患者142例，其中认知障碍组61例（43.0%），认知功能正常组81例（57.0%）。与认知功能正常组相比，认知障碍组IL-6、Hcy、CysC水平较高，T3水平较低，影像学总负荷中度和重度的比例较高，差异有统计学意义。多因素logistic回归分析显示，血清IL-6水平升高（OR 1.070，95%CI 1.039～1.103，P＜0.001）、CysC水平升高（OR 2.117，95%CI 1.027～5.500，P=0.004）、T3水平降低（OR 2.314，95%CI 1.361～3.935，P=0.003）以及影像学总负荷中度（OR 1.017，95%CI 1.002～1.032，P=0.029）和重度（OR 9.032，95%CI 6.076～18.012，P＜0.001）是CSVD患者发生认知障碍的独立相关因素。血清IL-6、CysC、T3水平和重度影像学总负荷预测认知障碍的AUC分别为0.888、0.812、0.918、0.889，最佳截断值分别为2.010 pg/mL、0.982 ng/L、1.302 nmol/L和3.6分。
结论 血清IL-6和CysC水平升高、T3水平降低以及中、重度影像学总负荷与CSVD患者发生认知障碍有相关性，可作为识别CSVD患者认知障碍的依据。

关键词: 脑小血管病; 认知障碍; 白细胞介素6; 甲状腺激素; 影像学总负荷