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远隔缺血预适应训练对缺血性脑卒中患者的脑保护作用
Cerebral protection effect of remote ischemia preconditioning training in patients with ischemic stroke

内科 202318卷05期 页码:415-418+426

作者机构:湖南省浏阳市集里医院神经内科七病室康复科,浏阳市410300

DOI:10.16121/j.cnki.cn45-1347/r.2023.05.02

  • 中文简介
  • 英文简介
  • 参考文献

目的 探讨远隔缺血预适应训练(RIPC)对缺血性脑卒中(IS)患者的脑保护作用。方法 将86例IS患者随机分为对照组和RIPC组,每组43例。对照组采用常规治疗,RIPC组在对照组的基础上加用RIPC,两组均治疗6个月。比较两组疗效、神经功能缺损程度、脑梗死体积、上肢功能、血清脑源性神经营养因子(BDNF)水平和血清神经生长因子(NGF)水平。结果 治疗6个月后,RIPC组的总有效率高于对照组(P<0.05)。治疗前,两组美国国立卫生研究院卒中量表(NIHSS)评分、脑梗死体积、Fuel-Meyer上肢运动功能评定量表(FMA-UE)评分、Wolf运动功能评价量表(WMFT)评分、血清NGF水平、血清BDNF水平差异均无统计学意义(均P>0.05);治疗3个月后和治疗6个月后,RIPC组的NIHSS评分、脑梗死体积均低/小于对照组,FMA-UE评分、WMFT评分、血清BDNF水平、血清NGF水平均高于对照组;NIHSS评分、脑梗死体积、FMA-UE评分、WMFT评分、血清BDNF水平、血清NGF水平的分组与时间均有交互效应(均P<0.05)。结论 RIPC可上调IS患者血清BDNF和NGF的表达,减轻神经功能缺损,减小脑梗死体积,改善上肢功能,是一种有效的脑保护方案。

Objective To investigate the cerebral protection effect of remote ischemia preconditioning training (RIPC) in ischemic stroke (IS) patients. Methods Eighty-six IS patients were randomly divided into a control group or an RIPC group, with 43 patients in each group. The control group was treated with routine therapy, based on which the RIPC group was treated with RIPC additionally, and both groups were treated for 6 months. The efficacy, degree of neurological deficit, cerebral infarction volume, upper extremity function, serum brain-derived neurotrophic factor (BDNF) level, and serum nerve growth factor (NGF) level were compared between the two groups. Results After 6 months of treatment, the overall effective rate of the RIPC group was higher than that of the control group (P<0.05). Before treatment, there was no statistically significant difference in the National Institutes of Health Stroke Scale (NIHSS) score, cerebral infarction volume, Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, Wolf Motor Function Test (WMFT) score, serum NGF level, or serum BDNF level between the two groups (all P>0.05); after 3 and 6 months of treatment, the NIHSS score and cerebral infarction volume of the RIPC group were lower/smaller than those of the control group, and the FMA-UE score, WMFT score, serum BDNF level, and serum NGF level were higher than those of the control group; there were interaction effects between grouping and time in the NIHSS score, cerebral infarction volume, FMA-UE score, WMFT score, serum BDNF level, and serum NGF level (all P<0.05). Conclusion RIPC can up-regulate the serum BDNF and NGF expressions in IS patients, reduce neurological deficit, shrink the cerebral infarction volume, and improve the upper extremity function, which is an effective cerebral protection approach.

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