无创性肢体远隔缺血后处理对脑卒中患者血清指标影响的临床研究

Effect of noninvasive limb distal ischemic postconditioning on serum markers in stroke patients

摘要:

目的 探讨远隔缺血后适应（RIPostC）对缺血性脑卒中（CVA）患者血清指标的影响，并探讨其 临床意义。方法 选择就诊于该院的缺血性CVA 患者200 例，将其随机分为实验组和对照组，每组各100 例。 实验组采用远隔缺血后适应疗法12 个月，对照组不进行特殊处理。实验前后分别采集两组静脉血，对其血清 同型半胱氨酸（Hcy）、血脂水平[ 高密度脂蛋白（HDL）和总胆固醇（TC）]、血小板聚集率（PAR）及缺 血修饰白蛋白（IMA）水平进行检测。结果 治疗前两组血清生化指标水平比较无差异（P >0.05），均表现为 血清Hcy、TC、PAR 及IMA 水平较正常值升高，HDL 较正常值下降。治疗后两组血清Hcy、TC、PAR 及 IMA 水平比较，差异有统计学意义（P <0.05），且较治疗前下降，HDL 较治疗前升高，治疗前后比较，差异有 统计学意义（P <0.05），且实验组较对照组改善程度，差异有统计学意义（P <0.05）。结论 远隔缺血后适应 疗法能有效降低缺血性CVA 患者病情的危险程度，对其预后有较好的促进作用。

Abstract:

Objective To investigate the effect of posterior ischemic postconditioning (RIPostC) on serum markers in patients with ischemic stroke and potential clinical significance. Methods Totally 200 patients with ischemic stroke admitted in our hospital from January 2016 to June 2017 were enrolled. Patients received standard treatments. They were randomly divided into: experimental group who received additional RIPostC for 12 months (n = 100) and control group that no extra treatments were performed (n = 100). Serum levels of homocysteine, lipid levels (high density lipoprotein, total cholesterol), platelet aggregation rate and ischemic modified albumin were measured before and after thetreatments. Results Patients in both groups experienced increased levels of serum total cysteine, total cholesterol, platelet aggregation rate and ischemic albumin and decreased levels of high density lipoprotein prior to any treatments. No significant difference (P > 0.05) in serum markers were identified between the two groups. Standard treatment induced decrease of serum cysteine, total cholesterol, platelet aggregation rate and ischemic albumin and increase of HDL in the two groups (P < 0.05). Treatment of RIPostC witnessed more dramatic alteration of serum biomarkers compared to control group (P < 0.05). Conclusion RIPostC therapy effectively reduces the severity of ischemic stroke, promoting better prognostic outcome.