肢体缺血后处理对急性脑梗死患者血清MMP-2、MMP-9及hs-CRP的影响  

Effect of postconditioning for limb ischemic on serum MMP-2、MMP-9 and hs-CRP of patients with acute cerebral infarction

作　　者：吴岚[1] 李浩[1] 刘开祥[1] 周茜 谢卓汐 黄颖媚 WU Lan;LI Hao;LIU Kaixiang(Department of Neurology,The Affiliated Hospital of Guilin Medical University, Guilin 541001, China)

机构地区：[1]桂林医学院附属医院神经内科

出　　处：《华夏医学》2019年第3期1-5,共5页Acta Medicinae Sinica

基　　金：桂林市科学研究与技术开发计划项目(20170109-11)

摘　　要：目的:研究肢体缺血后处理(LRIP)对急性脑梗死患者的神经保护作用及其可能存在的机制。方法:从本院体检中心选取120例健康体检者作为健康对照组,并且在临床上选取符合实验标准的120例急性脑梗死患者为病例组,将病例组依次随机分为对照组(60例)和实验组(60例),实验组将医用血压计的袖带置于患者一侧肱动脉处,然后将袖带充气至压力200 mmHg维持远端肢体缺血短暂过程,持续充气5 min后再持续放气5 min,再放气5 min相当于肢体再灌注过程,同时给予另一侧上肢相同的缺血再灌注处理,采用NIHSS评分表对患者进行神经功能评分,并检测血清中的MMP-2、MMP-9及hs-CRP水平。结果:实验组治疗前后血清MMP-2、MMP-9、hs-CRP水平及NIHSS评分下降差值较对照组的下降差值更大,两组比较差异有统计学意义(P<0.01)。结论:LRIP可以降低急性脑梗死患者血清中MMP-2、MMP-9以及hs-CRP的水平,提示LRIP可能通过改善血脑屏障的通透性和炎症反应从而发挥脑保护作用。Objective: To study the protective effects of limb remote ischemic postconditioning(LRIP)on acute cerebral infarction and potential mechanisms of LRIP for patients suffering from acute cerebral infarction. Methods: 120 healthy people in the Health Center were selected as control group, 120 patients matching testing standards who were suffering from acute cerebral infarction belong to case group. Case groups were randomly divided into control group(60 cases)and experimental group(60 cases). Medical sphygmomanometer’s cuff shall be attached to one side of the patient’s radial artery radial artery in the experimental group, then aerate the device until there were 200 mmHg maintaining the short duration of ischemia on distal limb. Keeping this status for 5 minutes, then releasing the air for 5 minutes, then releasing for another 5 minutes, this was the limb ischemia-reperfusion process. Meanwhile the other upper limb was given with the same ischemic reperfusion treatment. NIHSS score table was used for score the neurological function of patients, and determine the level of MMP-2, MMP-9 and hs-CRP. Results: Before and after treatment, the decrease of difference value in levels of MMP-2, MMP-9, hs-CRP and NIHSS score in the LRIP group were more than control group,with the statistical significant difference(P<0.01). Conclusion: LRIP can lower the levels of MMP-2, MMP-9, hs-CRP on serum in patients with acute cerebral infarction, this suggests that LRIP may improve the permeability of the blood-brain barrier and reduce the inflammation.

关 键 词：肢体缺血后处理 急性脑梗死 MMP-2 MMP-9 HS-CRP 

分 类 号：R743.3[医药卫生—神经病学与精神病学]