Limb remote ischemic preconditioning for ischemic cerebrovascular disease

作者：Xu, Shan; Zhang, Shanchao; Zhang, Xiuqing; Yuan, Jing; Si, Zhihua; Wang, Aihua^*

来源：International Journal of Clinical and Experimental Medicine, 2018, 11(7): 7247-7253.

• Limb remote ischemic preconditioning
• ischemic cerebrovascular disease
• curative effect

Objective: The aim of this study was to investigate the efficacy of limb remote ischemic preconditioning (RIPC) in patients with ischemic cerebrovascular disease (ICD). Methods: One hundred patients with confirmed ICD, admitted to the Department of Neurology in Qianfoshan Hospital Affiliated to Shandong University, between January 2015 and December 2016, were enrolled in this study. Patients were randomly divided into an intervention group or control group, with 50 patients in each group. Patients in the control group were treated with standard care while those in the intervention group received limb RIPC, in addition to standard care. The intervention period for all patients was 6 months At the end of intervention, improvement in neurologic function and rates of newly-developed cerebral infarction were compared between the two groups. Mean blood velocities in the middle cerebral artery, anterior cerebral artery, posterior cerebral artery, vertebral artery, and basilar arteries of patients were measured by transcramal Doppler ultrasonography. Results were compared between the two groups Barthel activities of daily living (ADL) index scores and 36-item short form health survey (SF-36) scores of patients, as well as serum matrix metalloproteinase-9 (MMP-9) and brain-derived neurotrophic factor (BDNF), were compared between the two groups. Results: Rates of newly-developed cerebral infarction (6% vs 20%, X-2=4.540, P=0.033) were strikingly lower but the improvement rate in neurologic 84% vs 62%, X-2=6.139, P=0.013) was remarkably higher in the intervention group than control group. Mean blood velocities in the middle cerebral artery, anterior cerebral artery, posterior cerebral artery, vertebral artery, and basilar artery (P < 0.05) as well as Barthel ADL index scores (70.2 +/- 6.3 vs 61.7 +/- 5.8, P=0.038) and SF-36 scores (67.2 +/- 6.1 vs 58.4 +/- 5.7, P=0.013) were all substantially higher in the intervention group than control group. Moreover, much lower serum MMP-9 (215.8 +/- 41.7 mu g/L vs 277.2 +/- 45.8 mu g/L) levels and markedly higher BDNF levels (34.2 +/- 7.2 mu g/L vs 20.5 +/- 6.9 mu g/L) were noted in the intervention group (both P < 0.001). Conclusion: Limb RIPC training is associated with a reduction in newly-developed cerebral infarction, improvements in neurologic function, blood velocities in the cerebral arteries, quality of life (QoL), serum MMP-9, and BDNF expression in ICD patients. Therefore, it is beneficial for patients with ICD.

• 出版日期2018
• 单位山东大学; 山东省千佛山医院