Effects of the interaction between serum nucleotide-binding oligomerization domain-like receptor protein 3 and heat shock protein 70 on cognitive impairment in elderly patients with minor ischemic stroke

Zhang Zhiwei; Wang Jieqing; Gao Xinru; Zhang Fan; Song Aixia

doi:10.3760/j.issn.1673-4777.2026.05.010

Abstract：Objective To analyze the effects of the interaction between serum nucleotide-binding oligome-rization domain-like receptor protein 3(NLRP3)and heat shock protein 70(Hsp70)on cognitive impairment in elderly patients with minor ischemic stroke(MIS).Methods A total of 219 elderly MIS patients admitted to the First Affiliated Hospital of Hebei North University from December 2024 to May 2025 were enrolled.Cognitive func-tion was assessed using the Montreal cognitive assessment scale 3 months after onset.Patients were divided into cognitive impairment group and non-cognitive impairment group.Serum NLRP3 and Hsp70 levels were compared between the two groups.Pearson correlation was used to analyze the correlation between serum NLRP3 and Hsp70.Logistic regression was used to analyze the relationship between serum NLRP3,Hsp70 and cognitive impairment.The interaction between NLRP3 and Hsp70 on cognitive impairment was analyzed.Receiver operating characteristic(ROC)curve and decision curve analysis were used to evaluate the predictive value of serum NLRP3 and Hsp70 for cognitive impairment in elderly MIS patients.Results Serum NLRP3 level in the cognitive impairment group was significantly higher than that in the non-cognitive impairment group[(137±13)ng/L vs(109±9)ng/L],and Hsp70 level was significantly lower[(22±4)μg/L vs(30±6)μg/L](both P＜0.05).Pearson correlation analysis showed that serum NLRP3 level was negatively correlated with serum Hsp70 level(r=-0.843,P＜0.05).Logistic regression analysis showed that age and serum NLRP3 were risk factors for cognitive impairment in elderly MIS patients,while education years and Hsp70 were protective factors(all P＜0.05).Interaction analysis showed that after adjusting for confounding factors,compared with low NLRP3+high Hsp70 group,the risk of cognitive impairment in high NLRP3+low Hsp70 group increased to 10.326 times.Serum NLRP3 and Hsp70 had a syner-gistic interaction effect on the risk of cognitive impairment(P＜0.05).ROC curve showed that the area under the curve of combined serum NLRP3 and Hsp70 prediction was 0.895,which was higher than that of single indicator(all P＜0.05).Decision curve showed that within the risk threshold of 0.01-0.99,the net benefit rate of combined detection of serum NLRP3 and Hsp70 was higher than that of single detection.Conclusion Serum NLRP3 is a risk factor and Hsp70 is a protective factor for cognitive impairment in elderly MIS patients.They have a synergistic interaction effect on cognitive impairment,and combined detection can improve the predictive value for the risk of cognitive impairment.