急性脑梗死病人缺血后适应治疗的效果

CLINICAL EFFECT OF ISCHEMIC POSTCONDITIONING IN PATIENTS WITH ACUTE CEREBRAL INFARCTION

目的探讨缺血后适应治疗急性脑梗死病人的效果。方法选取急性脑梗死病人104例,随机分为观察组和对照组,各52例。观察组采用缺血后适应治疗联合常规治疗,对照组仅采用常规治疗,两组均治疗28d。检测并比较两组病人治疗前、治疗14d血清C反应蛋白(CRP)、D-二聚体(D-D)水平及美国国立卫生研究院神经功能评分量表(NIHSS)评分、改良Rankin量表(mRs)评分,随访治疗后2年两组病人终点事件发生率。结果治疗前两组病人血清D-D、CRP水平比较差异无显著性(P>0.05);治疗后两组病人血清D-D、CRP水平均明显降低,且观察组低于对照组,差异有统计学意义(t=2.947~4.150,P<0.05)。治疗前两组病人NIHSS评分比较差异无统计学意义(P>0.05);治疗后两组病人的NIHSS评分均明显降低,且观察组低于对照组,差异有统计学意义(t=3.167~6.072,P<0.05)。治疗后观察组mRs评分0~1分病人占53.85%,对照组占34.62%,两组比较差异有统计学意义(χ~2=3.898,P<0.05)。所有病人均获随访,观察组脑出血、再发脑梗死、心血管事件以及短暂性脑缺血发作(TIA)发生率明显低于对照组,差异有统计学意义(χ~2=8.899,P<0.05)。结论缺血后适应治疗急性脑梗死病人效果显著,安全性良好,值得推广应用。

Objective To investigate the clinical effect of ischemic postconditioning in patients with acute cerebral infarction. Methods A total of 104 patients with acute cerebral infarction were randomly divided into observation group and control group,with 52 patients in each group.The patients in the observation group were treated with ischemic postconditioning combined with routine treatment,and those in the control group were given routine treatment alone.The course of treatment was 28 dfor both groups.The two groups were compared in terms of the serum levels of C-reactive protein（CRP）and D-dimer（D-D）,National Institutes of Health Stroke Scale（NIHSS）score,and Modified Rankin Scale（mRS）score before treatment and after 14 dof treatment.Both groups were followed up to 2 years after treatment to observe the incidence rate of outcome events. Results Before treatment,there were no significant differences in the serum levels of D-D and CRP between the two groups（P〉0.05）;after treatment,both groups had significant reductions in the serum levels of D-D and CRP,and the observation group had significantly lower levels than the control group（t=2.947-4.150,P〈0.05）.Before treatment,there was no significant difference in the NIHSS score between the two groups（P〉0.05）;after treatment,both groups had a significant reduction in the NIHSS score,and the observation group had a significantly lower NIHSS score than the control group（t=3.167-6.072,P〈0.05）.After treatment,there was a significant difference in the proportion of patients with an mRS score of 0-1 between the observation group and the control group（53.85% vs 34.62%,χ~2=3.898,P〈0.05）.All patients were followed up,and the observation group had significantly lower incidence rates of cerebral hemorrhage,recurrent cerebral infarction,cardiovascular events,and transient ischemic attack than the control group（χ~2=8.899,P〈0.05）. Conclusion Ischemic postconditioning has a good clinical effect and good safety in patients with acute cerebral infarction,and thus it holds promise for clinical application.