远隔缺血后处理对急性脑梗死短期预后的影响  

The effect of remote ischemic postconditioning on the short-term prognosis of acute ischemic stroke

作　　者：方平 施雪英[1] 曹莉[1] 袁良津[1] 钱保进 方国真 FANG Ping;SHI Xue-ying;CAO Li(Anqing Hospital of Anhui Medical University,Anqing 246000,Anhui)

机构地区：[1]安徽医科大学附属安庆医院神经内科

出　　处：《安徽卫生职业技术学院学报》2020年第1期21-23,共3页Journal of Anhui Health Vocational & Technical College

基　　金：安庆市卫健委科研课题(编号:2018Z2019)

摘　　要：目的:评估远隔缺血后处理(RIPostC)针对急性缺血性脑卒中患者的可行性及短期疗效,同时探索其反应的潜在机制。方法:选择58例脑卒中患者,随机分为实验组与对照组,对照组30例患者仅予以除取栓及溶栓以外的脑梗死标准化治疗,实验组28例患者除该标准化治疗以外,同时予以缺血处理,患者接受7天的缺血处理,检测两组患者治疗前及治疗后的NIHSS评分、平均血小板体积(MPV)、纤维蛋白原(Fg)、D-二聚体(DD)、超敏C反应蛋白(hs-CRP)、神经元特异烯醇化酶(NSE)。结果:实验组较对照组NIHSS评分差值比较,差异有统计学意义(P<0.05);实验组MPV、Fg、DD、hs-CRP、NSE差值与对照组比较,差异均有统计学意义(P<0.05)。结论:RIPostC是一种简单、无创、耐受性好的治疗方法,针对脑梗死的急性期治疗有效,其作用机制可能与改善炎症反应及抗血小板聚集有关。Objective:This study aims to evaluate the feasibility and short-term efficacy of remote ischemic postconditioning(RIPostC)in patients with acute ischemic stroke,and to explore the potential mechanism.Methods:We perform a randomized blinded placebo controlled trial in 58 patients with acute ischemic stroke,divided into the LIPostC group and control group.The control group with 30 patients is only treated with standardized treatment of cerebral infarction except thrombolysis and stent thrombectomy,and the experimental group with 28 patients is treated with RIPostC in addition to the standardized treatment.Patients underwent the intervention from the time of enrollment to Day 7.The NIHSS score and MPV,Fg,DD,hs-CRP,NSE.Results:The difference of NIHSS score between the RIPostC group and the control group was P<0.05,the difference is statistically significant;Compared with the control group,the difference of MPV,Fg,DD,hs-CRP in the RIPostC group is significantly different(P<0.05).Conclusion:RIPostC is a simple,well tolerated and appears safe and feasible.It is effective in the treatment of acute cerebral infarction,and its mechanism may be related to the improvement of inflammatory reaction and antiplatelet aggregation.

关 键 词：急性缺血性脑卒中 远隔缺血后处理 内源性神经保护作用 炎症反应 

分 类 号：R743.3[医药卫生—神经病学与精神病学]