肢体远端缺血后处理对急性脑梗死患者血清谷氨酸浓度影响的临床观察  

A clinical observation of the role of distal limb ischemic postconditioning in the level of serum glutamate in patients with acute cerebral infarction

作　　者：孟明[1] 孙茂林[1] 王薇[1] 李建楠[2] 刘佳俊[1] 

机构地区：[1]齐齐哈尔医学院附属第一医院神经内科 [2]齐齐哈尔医学院临床医学系,黑龙江齐齐哈尔161041

出　　处：《临床和实验医学杂志》2016年第9期841-843,共3页Journal of Clinical and Experimental Medicine

基　　金：齐齐哈尔市科学技术计划项目(SFGG-201420)

摘　　要：目的探究运用无创性肢体远端缺血后处理(NDLIP)手段对急性脑梗死患者血清谷氨酸浓度的影响及神经功能恢复的作用。方法选择138例急性脑梗死的患者,随机分为对照组和实验组,每组各69例。对照组予以常规内科治疗;实验组在常规治疗的基础上加用NDLIP。NDLIP方法是由两名主治医师以上专职医生按相关文献报道方式进行操作:血压计袖带以充气压力200 mm Hg压迫左侧肱动脉,使缺血时程达到为5 min,接着放气再灌注5 min,右侧上肢肱动脉重复上述步骤,双侧上肢交替进行,连续3 d,每日一次3个循环。两组患者在治疗前和治疗后14 d均分别检测血清谷氨酸浓度并同期予以美国国立卫生研究院神经功能评分量表(NIHSS)评价神经功能。结果两组患者治疗后的血清谷氨酸浓度及NIHSS评分较治疗前均显著下降,且实验组血清谷氨酸水平下降差值和NIHSS下降差值明显大于对照组(P<0.01)。结论 NDLIP方法可抑制急性脑梗死患者血清中谷氨酸的释放,具有神经保护作用,可改善神经功能,疗效确切。Objective To evaluate the effect of non- invasive distal limb ischemic postconditioning（ NDLIP） on the level of serum Glutamate and protection of neurological function in patients with acute cerebral infarction. Methods One hundred and thirty- eight cases of acute cerebral infarction patients were randomly allocated to either receiving three 5- min cycles of ischemia consecutively for three days by inflation of a cuff on the arms alternately to 200 mmHg（ intervention group） or to placebo（ uninflated cuff）（ control group）. Each group consisted of 69 cases. The serum Glutamate and NIHSS were respectively measured before therapy and after the treatment of fourteenth days. Results The level of serum Glutamate and NIHSS score on 14 d after the treatment were significantly reduced in intervention group compared with those in control group（ P 〈0. 01）. Conclusion NDLIP can decrease the secretion of serum Glutama in patients with acute cerebral infarction. NDLIP may have a neuroprotective effect on acute cerebral infarction,can facilitate the recovery of neurological function in patients. NDLIP treatment on acute cerebral infarction is curative.

关 键 词：急性脑梗死 肢体远端缺血后处理 谷氨酸 脑保护 

分 类 号：R743.3[医药卫生—神经病学与精神病学]