ObjectiveTo investigate the changes of Toll-like receptor 4 (TLR4) signaling pathway in elderly patients with cerebral infarction complicated with cognitive dysfunction, and the role of atorvastatin in regulating this pathway and its influence on cognitive function.

MethodsA total of 98 elderly patients with cerebral infarction and cognitive dysfunction were randomly divided into the observation group and control group(49 cases in each group). The control group was treated with aspirin enteric-coated tablets on the basis of routine treatment, while the observation group was treated with aspirin enteric-coated tablets combined with atorvastatin on the basis of routine treatment. The cognitive function, serum oxidized low-density lipoprotein(ox-LDL), transforming growth factor-β1(TGF-β1), high-sensitivity C reactive protein(hs-CRP), total cholesterol (TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C), TLR4 and nuclear transcription factor(NF)-κB, tumor necrosis factor(TNF)-α and interleukin(IL)-6 and the occurrence of adverse reactions in the two groups were compared before and six months after treatment.

ResultsAfter treatment, there were statistically significant differences in the levels of TC, TG, LDL-C, HDL-C, ox-LDL, hs-CRP, TGF-β1, TLR4, NF-κB, TNF-α and IL-6 between the two groups compared with before treatment(P < 0.05 to P < 0.01);the levels of TC, TG, LDL-C, ox-LDL, hs-CRP, TLR4, NF-κB, TNF-α and IL-6 in the observation group were lower than those in the control group, and the levels of HDL-C, TGF-β1 were higher than those in the control group(P < 0.01). After treatment, the MMSE and MoCA scores in the two groups were improved compared with those before treatment, and which in the observation group was higher than that in the control group(P < 0.01). There were no significant differences in the incidence of adverse reactions such as abnormal liver and kidney function, dizziness and headache, rash, myalgia and gastrointestinal reactions between two groups(P>0.05).

ConclusionsThe TLR4 signaling pathway is involved in the occurrence of cerebral infarction combined with cognitive dysfunction in elderly, and atorvastatin can exhibit the cerebral protective role in regulating TLR4 signaling pathway.