远隔缺血适应治疗老年脑出血的安全性和疗效研究  

Safety and efficacy of remote ischemic conditioning for cerebral hemorrhage in the elderly

作　　者：林梦 丁俭 练学淦[1] 杨松[1] Lin Meng;Ding Jian;Lian Xuegan;Yang Song(Department of Neurology,Changzhou First People's Hospital·Third Affiliated Hospital of Soochow University,Changzhou213003,Jiangsu Province,China)

机构地区：[1]常州市第一人民医院(苏州大学附属第三医院)神经内科,213003 [2]泰州市第二人民医院神经内科

出　　处：《中华老年心脑血管病杂志》2024年第12期1463-1466,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：常州市“十四五”卫生健康高层次人才培养工程—领军人才项目(2024CZLJ003)。

摘　　要：目的评估远隔缺血适应(remote ischemic conditioning,RIC)在治疗老年脑出血患者中的安全性和疗效。方法前瞻性选取2024年1~8月常州市第一人民医院收治的老年自发性脑出血患者40例,采用随机对照方法分为RIC组20例和对照组20例。RIC组接受常规治疗联合RIC干预,对照组接受常规治疗联合安慰性干预。比较2组血肿吸收和预后情况及不良反应。结果RIC组7 d血肿吸收率为(44.80±14.40)%,高于对照组的(38.50±20.80)%,2组比较无显著差异(P>0.05)。2组第7天美国国立卫生研究院卒中量表评分比较无显著差异(P>0.05)。RIC组与对照组第30天时改良的Rankin量表评分≤2分比例比较无显著差异(50.0%vs 35.0%,P>0.05)。RIC组袖带勒痕、皮肤出血点比例显著高于对照组(40.0%vs 0.0%,P<0.01;45.0%vs 0.0%,P<0.01),但未观察到皮肤瘀斑或严重不良事件。结论RIC治疗在老年自发性脑出血患者中展现出良好的安全性和耐受性。尽管它有促进血肿吸收和神经功能改善的潜在趋势,但短期疗效并不显著。Objective To evaluate the safety and efficacy of RIC in the treatment of elderly patients with ICH.Methods A prospective trial was conducted on 40 elderly patients with spontaneous ICH admitted to our hospital from January to August 2024.They were randomly assigned to a RIC group(20 cases,conventional treatment combined with RIC intervention)and a control group(20 cases,conventional treatment combined with sham intervention).Hematoma absorption,prognosis,and adverse reactions were compared between the two groups.Results The hematoma absorption rate at 7 d after admission was(44.80±14.40)%in the RIC group,which was higher than that of the control group(38.50±20.80)%,though no statistical difference was seen between the two groups(P>0.05).There was no significant difference in the NIHSS score on the 7th day between the two groups(P>0.05).At 30 d,the proportion of the patients with mRS≤2 was 50.0%in the RIC group and 35.0%in the control group,but there was no obvious difference between them(P>0.05).The proportions of patients with cuff marks and skin petechiae were notably higher in the RIC group than the control group(40.0%vs 0.0%,P<0.01;45.0%vs 0.0%,P<0.01),but no skin ecchymosis or serious adverse events were observed in both groups.Conclusion RIC treatment shows good safety and tolerability in treatment of spontaneous ICH in elderly patients.Although it has a potential trend towards promoting hematoma absorption and neurologic improvement,its short-term therapeutic effect is not significant.

关 键 词：脑出血 安全 预后 远隔缺血适应 

分 类 号：R743.34[医药卫生—神经病学与精神病学]