远隔缺血后处理联合脑心通对大动脉粥样硬化型脑梗死的脑保护作用  

Neuroprotetctive effect of remote ischemic post conditioning combined with Naoxintong capsule on patients with LAA cerebral infarction

作　　者：李华钢[1] 刘煜敏[1] 孙冬[1] Li Huagang;Liu Yumin;Sun Dong(Zhongnan Hospital of Wuhan University,Wuhan 430071)

机构地区：[1]武汉大学中南医院

出　　处：《卒中与神经疾病》2019年第3期282-285,共4页Stroke and Nervous Diseases

摘　　要：目的探讨远隔缺血后处理(RIPostC)联合脑心通对大动脉粥样硬化型脑梗死的脑保护作用。方法将120例大动脉粥样硬化型脑梗死患者随机分为对照组(脑心通组)、RIPostC组和RIPostC+脑心通组,每组各40例;3组均按照缺血性脑卒中二级预防指南用药,并严格控制高血压、高血糖等危险因素。结果经过6个月的干预后RIPostC+脑心通组的症状改善率显著高于对照组(77.5%vs 32.5%,P<0.01)。RIPostC组症状改善率为52.5%,与对照组比较无显著差异(P=0.056),但显著低于RIPostC+脑心通组(P=0.017);与治疗前比较,3组患者治疗后的NIHSS评分均显著降低(P<0.01),且治疗后RIPostC+脑心通组的NIHSS评分显著低于RIPostC组(P<0.05);治疗后RIPostC组和RIPostC组+脑心通组患者BI指数均显著高于对照组(P<0.05,P<0.01);RIPostC+脑心通组的脑梗死再发率显著低于对照组(5%vs 20%,P=0.044)。结论远隔缺血后处理具有显著的脑保护作用,能够有效改善大动脉粥样硬化型脑梗死患者的神经功能缺损以及降低脑梗死的再发生,且RIPostC联合脑心通治疗效果更佳。Objective To investigate the effect of remote ischemic post conditioning combined with Naoxintong capsule on patients with large artery atherosclerosis(LAA) cerebral infarction.Methods A total of 120 patients with LAA cerebral infarction were randomly divided into control group(Naoxintong group), RIPostC group and RIPostC+Naoxintong group, 40 cases in each group. All groups were in strict accordance with the medication of ischemic attack secondary prevention guidelines controlled the risk factor, such as hypertension, hyperglycemia.Results After six months of treated intervention, compared with control group the symptoms of patients were improved significantly in RIPostC+Naoxintong group(77.5% vs 32.5%,P<0.01). The symptoms improvement rate in RIPostC group was 52.5%, which was not different from that in control group(P=0.056), but significantly lower than that in RIPostC+Naoxintong group(P=0.017). Compared with before treatment, the NISSH scores of the three groups were significantly decreased after treatment(P<0.01), and the score of RIPostC+Naoxintong group was lower than that of RIPostC group(P<0.05). The barthel index of RIPostC+Naoxintong group and RIPostC group after treatment was significantly higher than that of control group(P<0.05,P<0.01). The recurrent rate of cerebral infraction in RIPostC+Naoxintong group was significantly lower than that in control group(5% vs 20%, P=0.044).Conclusion Remote ischemic post conditioning had obviously cerebral protective effect, which could effectively improve the neurological deficits and reduce the recurrence of cerebral infarction in patients with LAA cerebral infarction, and RIPostC combined with Naoxintong had more effective rusult.

关 键 词：远隔缺血后处理 脑缺血 脑心通 神经功能缺损评分 

分 类 号：R743.32[医药卫生—神经病学与精神病学]