摘要
目的观察缺血预适应训练治疗老年脑梗死的临床效果。方法择取104例老年脑梗死患者为研究对象,依照计算机随机分组模式分为对照组和实验组,每组52例。对照组给予常规治疗,实验组在对照组基础上给予缺血预适应训练。对比两组治疗效果、治疗前后脑氧代谢指标[颈静脉球血氧饱和度(SjvO2)、桡动脉与颈内静脉球氧含量差(Da-jvO2)、动脉血氧含量(CaO2)、氧摄取率(ERO2)]及血清学指标[色素上皮衍生因子(PEDF)、脑源性神经营养因子(BDNF)、基质金属蛋白酶9(MMP-9)及血清和肽素]。结果实验组总有效率为94.23%,明显高于对照组的80.77%,差异有统计学意义(P<0.05)。治疗后,两组SjvO2、Da-jvO2、ERO2、CaO2均明显优于本组治疗前,且实验组SjvO2(61.02±4.25)%明显高于对照组的(57.68±3.89)%,Da-jvO2、ERO2、CaO2分别为(50.22±2.15)ml/L、(15.14±1.36)%、(150.36±8.52)ml/L,明显低于对照组的(53.28±2.58)ml/L、(21.69±1.89)%、(160.96±9.63)ml/L,差异有统计学意义(P<0.05)。治疗后,两组BDNF、PEDF、MMP-9及血清和肽素均明显优于本组治疗前,且实验组BDNF、PEDF分别为(41.36±5.28)μg/L、(32.52±2.18)ng/ml,均明显高于对照组的(35.68±5.10)μg/L、(26.12±2.20)ng/ml,MMP-9、血清和肽素分别为(223.63±33.58)μg/L、(3.25±1.30)pmol/L,均明显低于对照组的(276.58±34.56)μg/L、(6.36±1.89)pmol/L,差异有统计学意义(P<0.05)。结论对老年脑梗死患者给予缺血预适应训练简便有效,能够明显改善患者脑氧代谢指标水平,缩小梗死面积,提高神经功能与PEDF、BDNF表达水平,具有较高的推广价值。
Objective To observe the clinical effect of ischemic preconditioning on cerebral infarction in the elderly.Methods A total of 104 elderly patients with cerebral infarction were divided into control group and experimental group according to the computer random grouping mode,with 52 cases in each group.The control group received conventional treatment,and the experimental group received ischemic preconditioning on the basis of the control group.Both groups were compared in terms of therapeutic effect,cerebral oxygen metabolism indexes[jugular venous oxygen saturation(SjvO2),arterial-jugular venous oxygen content difference(Da-jvO2),arterial blood oxygen content(CaO2),oxygen extraction ratio(ERO2)],serological indexes[pigment epithelium-derived factor(PEDF),brain-derived neurotrophic factor(BDNF),matrix metalloproteinase-9(MMP-9)and serum copeptin]before and after treatment.Results The total effective rate of the experimental group was 94.23%,which was significantly higher than that of 80.77%of the control group,and the difference was statistically significant(P<0.05).After treatment,SjvO2,Da-jvO2,ERO2 and CaO2 in both groups were significantly better than those before treatment in this group;SjvO2 of(61.02±4.25)%in the experimental group was significantly higher than that of(57.68±3.89)%in the control group;in the experimental group,Da-jvO2,ERO2 and CaO2 were(50.22±2.15)ml/L,(15.14±1.36)%and(150.36±8.52)ml/L,which were significantly lower than those of(53.28±2.58)ml/L,(21.69±1.89)%and(160.96±9.63)ml/L in the control group;the differences were statistically significant(P<0.05).After treatment,BDNF,PEDF,MMP-9 and serum copeptin in both groups were significantly better than those before treatment in this group;BDNF and PEDF in the experimental group were(41.36±5.28)μg/L and(32.52±2.18)ng/ml,which were significantly higher than those of(35.68±5.10)μg/L and(26.12±2.20)ng/ml in the control group;the levels of MMP-9,serum copeptin in the experimental group were(223.63±33.58)μg/L and(3.25±1.30)pmol/L,which were significantly lower than those of(276.58±34.56)μg/L and(6.36±1.89)pmol/L in the control group;the differences were statistically significant(P<0.05).Conclusion For the elderly patients with cerebral infarction,the ischemic preconditioning is simple and effective,and can significantly improve the level of cerebral oxygen metabolism indicators,reduce the infarct area,and improve the neurological function and the expression level of PEDF and BDNF,which contains high value of promotion.
作者
韩文伟
HAN Wen�wei(Huimin County People's Hospital,Binzhou 251700,China)
出处
《中国实用医药》
2023年第18期1-5,共5页
China Practical Medicine
关键词
缺血预适应
老年
脑梗死
脑氧代谢指标
脑源性神经营养因子
色素上皮衍生因子
Ischemic preconditioning
Old age
Cerebral infarction
Cerebral oxygen metabolism indicators
Brain-derived neurotrophic factor
Pigment epithelium-derived factor
