远端缺血预处理对皮质下缺血性血管性痴呆患者认知能力的改善作用

Effect of Remote Ischemic Preconditioning on Cognitive Ability of Patients with Subcortical Ischemic Vascular Dementia

目的:评价远端缺血预处理(RIPC)对皮质下缺血性血管性痴呆(SIVD)患者认知能力的改善作用。方法:选取2019年1月—2021年1月佳木斯市中心医院诊治的74例SIVD患者,按随机数字表法分为治疗组36例,对照组38例,治疗组进行RIPC治疗,对照组给予安慰剂治疗,为期3个月,比较两组治疗前后认知能力评分、血清炎症因子和磁共振成像参数。结果:治疗前两组认知能力评分、血清炎症因子和影像学参数比较差异均无统计学意义(P>0.05)。治疗后,治疗组霍普金斯词语学习测验修订版(HVLT-R)、受控口头词语联想测试(COWAT)、连线试验A和B(TMT-A、TMT-B)及线方向判断(JLO)评分优于治疗前(P<0.05);治疗组所有炎症因子均低于治疗前和对照组(P<0.05);对照组仅HVLT-R和TMT-B评分优于治疗前,差异均有统计学意义(P<0.05)。磁共振成像参数组间及组内治疗前后比较差异均无统计学意义(P>0.05)。所有患者均顺利完成治疗,无明显不良反应。结论:RIPC可在一定程度上改善SIVD患者的认知功能,且无明显不良反应。

Objective:To evaluate the effect of remote ischemic preconditioning(RIPC)on cognitive ability in patients with subcortical ischemic vascular dementia(SIVD).Method:A total of 74 patients with SIVD diagnosed and treated in Jiamusi Central Hospital from January 2019 to January 2021 were selected and divided into the treatment group(36 cases)and the control group(38 cases)according to random number table method.The treatment group was treated with RIPC treatment and the control group was treated with placebo for 3 months.The cognitive ability scores,serum inflammatory factors and MRI parameters of the two groups were compared before and after treatment.Result:There were no significant differences in cognitive ability scores,serum inflammatory factors and imaging parameters between the two groups before treatment(P>0.05).After treatment,Hopkins verbal learning test-revised(HVLT-R),controlled oral word association test(COWAT),trail making test A and B(TMT-A,TMT-B)and judgment of line orientation(JLO)scores in the treatment group were better than those before treatment(P<0.05);all the inflammatory factors in the treatment group were lower than those before treatment and those in the control group(P<0.05),in the control group,only HVLT-R and TMT-B scores were significantly better than those before treatment(P<0.05).Before and after treatment,there were no significant differences in MRI parameters between the two groups(P>0.05).All patients successfully completed the treatment without obvious adverse reactions.Conclusion:RIPC can improve the cognitive function of SIVD patients to a certain extent without obvious adverse reactions.