远隔缺血后适应对急性脑梗死患者神经功能及血管内皮功能的影响  

Effect of remote ischemic postconditioning on neurological function and vascular endothelial function in acute cerebral infarction patients

作　　者：李梦雨 李长颖 刘斌 吴小坤 毛文静 任伯 王瑞敏 Li Mengyu;Li Changying;Liu Bin;Wu Xiaokun;Mao Wenjing;Ren Bo;Wang Ruimin(No.1 Department of Neurology,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,Hebei Province,China)

机构地区：[1]华北理工大学附属医院神经内一科,唐山063000 [2]华北北理工大学公共卫生学院医学实验技术系

出　　处：《中华老年心脑血管病杂志》2021年第7期727-730,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省医学科学研究项目(20201226);华北理工大学研究生创新项目(2019S48)。

摘　　要：目的探讨远隔缺血后适应(RIP)对急性脑梗死患者神经功能及血清血管内皮因子可溶性细胞间黏附因子1(sICAM-1)和内皮素1(ET-1)表达的影响。方法选取首次发病且发病时间<72 h的前循环急性脑梗死患者227例,随机分为干预组113例和对照组114例。干预组予RIP治疗,1次/d,连续14 d。评估患者治疗前、治疗14、30和90 d时美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分。采用ELISA法检测患者血清sICAM-1和ET-1水平。采用多元线性回归分析治疗效果。结果2组NIHSS评分均随时间延长逐渐减低,BI评分均随时间延长逐渐升高,干预组NIHSS评分和BI评分各时间点变化的幅度显著大于对照组,具有组间、时间及交互效应,差异有统计学意义(P<0.05,P<0.01)。2组治疗14 d血清sICAM-1和ET-1水平均较治疗前降低,且干预组较对照组降低更显著[(105.86±34.57)ng/L vs(116.41±41.76)ng/L,P=0.039;(40.49±18.86)ng/L vs(45.89±16.94)ng/L,P=0.033]。多元线性回归分析示,RIP治疗对患者神经功能和日常生活能力改善有影响(P<0.05,P<0.01)。结论RIP可改变急性脑梗死患者血清sICAM-1、ET-1水平,促进神经功能恢复。Objective To study the effect of remote ischemic postconditioning(RIP)on neurological function and sICAM-1,and ET-1 in ACI patients.Methods Two hundred and twenty-seven ACI patients within 72 hours after the first onset of ACI were randomly divided into intervention group(n=113)and control group(n=114).The NIHSS score and BI score in two groups were recorded before treatment and after 14,30 and 90 days of treatment.The serum levels of sICAM-1 and ET-1 in two groups were measured by ELISA.The therapeutic efficiency in ACI patients was analyzed by multivariate linear regression analysis.Results The NIHSS score decreased gradually while the BI score increased gradually with the prolonged time in two groups.The NIHSS score and BI score were significantly higher in intervention group than in control group(P<0.05).The serum levels of sICAM-1 and ET-1 were significantly lower in two groups after 14 days of treatment than before treatment and in intervention group than in control group(105.86±34.57 ng/L vs 116.41±41.76 ng/L,P=0.039;40.49±18.86 ng/L vs 45.89±16.94 ng/L,P=0.033).The RIP,serum levels of sICAM-1 and ET-1 could improve the neurological function and the daily living ability in ACI patients(P<0.05,P<0.01).Conclusions RIP can change the serum levels of sICAM-1 and ET-1 and improve the neurological function in ACI patients.

关 键 词：脑梗死 内皮 血管 胞间黏附分子1 内皮缩血管肽1 

分 类 号：R743.33[医药卫生—神经病学与精神病学]