Objective To investigate the relationship between serum levels of thioredoxin 2 (Trx2) and C-X3-C chemokine ligand 1 (CX3CL1) and the degree of neurological impairment and cognitive disorders in patients with acute ischemic stroke (AIS).

Methods A total of 88 patients with AIS were selected as the study group and divided into mild (27 cases), moderate (52 cases), and severe (9 cases) groups based on the National Institutes of Health Stroke Scale (NIHSS) scores. They were also divided into cognitively normal group (54 cases) and cognitive disorder group (34 cases) based on the total Montreal Cognitive Assessment (MoCA) scores. Additionally, 90 healthy volunteers who underwent physical examinations during the same period were selected as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of Trx2 and CX3CL1. Spearman correlation analysis was conducted to determine the correlation between serum levels of CX3CL1 and Trx2 and the degree of neurological impairment. Logistic regression analysis was used to identify risk factors for cognitive disorders after AIS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum CX3CL1 and Trx2 levels for cognitive disordersafter AIS.

Results The serum levels of Trx2 and CX3CL1 in the study group were significantly higher than those in the control group (P < 0.05). The serum levels of CX3CL1 and Trx2 gradually increased in the mild, moderate, and severe groups, with statistically significant differences (P < 0.05). The serum levels of CX3CL1 and Trx2 in the cognitive disorder group were significantly higher than those in the cognitively normal group (P < 0.05). Spearman correlation analysis showed that serum levels of Trx2 and CX3CL1 were positively correlated with the degree of neurological impairment (r=0.473, 0.784, P < 0.001). Multivariate Logistic regression analysis revealed that elevated serum levels of Trx2 and CX3CL1 were independent risk factors for cognitive disorders after AIS (P < 0.05). The ROC curve analysis showed that the combined use of serum CX3CL1 and Trx2 had an area under the curve of 0.930 for predicting cognitive disorders after AIS, with a sensitivity of 97.06% and a specificity of 72.22%.

Conclusion The serum levels of CX3CL1 and Trx2 are abnormally elevated in patients with AIS and are closely related to the degree of neurological impairment. The combined detection of two biomarkers has high predictive value for cognitive disorders after AIS.