摘要
目的探讨肢体远端缺血后适应(LRIPC)在急性脑梗死患者血管再通治疗后的临床应用价值。方法选择汕头大学医学院第一附属医院2017年6月至2019年3月收治的78例急性脑梗死患者,按随机数字表法分为观察组和对照组,每组39例,观察组给予LRIPC+常规内科治疗,对照组给予常规内科治疗。比较两组治疗前后美国国立卫生研究院卒中量表(NIHSS)和蒙特利尔认知评估量表(MoCA)评分、脑血流灌注量、脑梗死体积及血清神经功能相关指标的变化。结果观察组治疗后NIHSS评分低于对照组,MoCA评分高于对照组,差异有统计学意义(P<0.05)。观察组治疗后脑血流平均通过时间较对照组短,局部脑血流量、局部脑血容量较对照组高,差异有统计学意义(P<0.05)。观察组治疗后脑梗死体积小于对照组,差异有统计学意义(P<0.05)。观察组治疗后基质金属蛋白酶9、S-100B蛋白水平低于对照组[(142.45±36.23)mg/L比(176.89±42.63)mg/L、(2.52±0.46)μg/L比(3.61±0.75)μg/L],神经生长因子水平高于对照组[(143.49±10.58)μg/L比(124.96±13.62)μg/L],差异均有统计学意义(P<0.05)。结论LRIPC能改善急性脑梗死患者神经功能和认知功能,并能通过改善脑血流状况缩减脑梗死体积,对减轻患者血管再通治疗后产生的神经功能缺损亦有较好效果。
Objective To explore the clinical application value of limb remote ischemic postconditioning(LRIPC)in patients with acute cerebral infarction after recanalization.Methods A total of 78 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Shantou University Medical College from June 2017 to March 2019 were selected.According to the random number table method,they were divided into the observation group with 39 cases(LRIPC+conventional medical treatment)and the control group with 39 cases(conventional medical treatment).The National Institutes of Health Stroke Scale(NIHSS)and Montreal Cognitive Assessment scale(MoCA)scores,the changes of cerebral blood perfusion,cerebral infarction volume and the levels of nerve function indexes before and after the treatment were compared and analyzed.Results After the treatment,the NIHSS scores in the observation group were lower than thosein the control group,and the MoCA scores were higher than those in the control group,the differences were statistically significant(P<0.05).After the treatment,the mean transit time of cerebral blood flow in the observation group was shorter than that in the control group,while the regional cerebral blood flow and regional cerebral blood volume were higher than those in the control group,the differences were statistically significant(P<0.05).After the treatment,the volume of cerebral infarction in the observation group was lower than that in the control group(P<0.05).After the treatment,the levels of matrix metalloproteinase 9 and S-100B protein in the observation group were lower than those in the control group:(142.45±36.23)mg/L vs.(176.89±42.63)mg/L,(2.52±0.46)μg/L vs.(3.61±0.75)μg/L;and the level of nerve growth factor was higher than that in the control group:(143.49±10.58)μg/L vs.(124.96±13.62)μg/L,the differences were statistically significant(P<0.05).Conclusions LRIPC can improve the nerve functions,cognitive functions andreduce the volume of cerebral infarction by improving cerebral blood flow.It also has a good effect on alleviating the neurological functional impairment after vascular recanalization.
作者
刘潇强
陈荣波
方敬念
张儒焱
庄伟端
Liu Xiaoqiang;Chen Rongbo;Fang Jingnian;Zhang Ruyan;Zhuang Weiduan(Department of Neurology,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Department of Intervention,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)
出处
《中国医师进修杂志》
2022年第6期517-520,共4页
Chinese Journal of Postgraduates of Medicine
基金
汕头市第一批医疗卫生自筹经费类科技项目(汕府科[2017]119号)。
关键词
脑梗塞
缺血预处理
肢体远端
治疗结果
Brain infarction
Ischemic preconditioning
Limb remote
Treatment outcome
