肢体远隔缺血预适应对脑梗死患者的临床预后及炎性因子表达水平的影响

The effects of remote ischemic preconditioning on clinical prognosis and inflammatory factors in patients with cerebral infarction

目的探讨肢体远隔缺血预适应(RIPC)对脑梗死患者的临床预后及血清炎性因子表达水平的影响。方法收集脑梗死患者271例为研究对象,随机分为RIPC组和对照组,RIPC组患者给予肢体缺血预适应训练及药物治疗,对照组给予单纯药物治疗;观察2组患者治疗28 d及6个月后的神经功能恢复情况,记录发病6个月内的脑缺血症状再发生情况,对比2组患者治疗28 d后血清中炎性因子的表达水平及患者治疗过程中发生的不良反应。结果治疗28 d及6个月后RIPC组NIHSS评分改善优于对照组(P<0.05);RIPC组的脑缺血再发生率低于对照组(P<0.05);治疗28 d后RIPC组血清炎性因子表达水平显著低于对照组(P<0.05);2组患者的不良反应发生率比较无明显差异(P>0.05)。结论肢体远隔缺血预适应可显著改善脑梗死患者的短期和长期预后,降低脑缺血再发率,减轻体内的炎症反应,是一种安全有效的治疗方法。

Objective To investigate the effects of remote ischemic preconditioning（ RIPC） on the clinical prognosis and serum inflammatory factors in patients with cerebral infarction. Methods 271 cerebral infarct patients were recruited in this study,which were divided into RIPC group and control group randomly. The patients in RIPC group received limb ischemic preconditioning and medication,while the control group received only medication. The neurological function recovery of 28 d and 6 months in two groups were observed,and the symptoms of cerebral ischemia in 6 months were recorded. The expression of inflammatory factors in two groups of patients was compared 28 d after treatment. Results After 28 d and 6 months,the NIHSS score in RIPC group were better than those in the control group,the difference was statistically significant（ P〈0. 05）,the incidence rate of cerebral ischemia in RIPC group was lower than that in the control group（ P〈0. 05）,the serum inflammatory cytokines in RIPC group was significantly lower than that in the control group after 28 d,the difference was statistically significant（ P〈0. 05）; the adverse reaction rate in two groups had no significant difference（ P〉0. 05）. Conclusion Limb ischemic preconditioning could obviously improve neurological deficits caused by ischemic stroke and prevent the recurrence of cerebral infarction,which also reduced inflammation in the body.