| Background and Objective Stroke has become the first cause of death in China in recent years,and ischemic stroke(IS)accounts for more than 60% of all stroke patients.Risk factors closely related to it include obesity and metabolic disorders.For the treatment of this disease,there is no effective method other than early thrombolysis.The high disability rate and mortality rate have seriously affected the quality of life of patients,while bringing a heavy burden to society.In the last century,some scholars discovered that Calorie Restriction(CR)can prolong life,reduce weight and improve glucose and lipid metabolism.In animal model studies,the researchers also found that this method can slow the progression and severity of age-related diseases,such as cardiovascular and cerebrovascular diseases(such as stroke and myocardial infarction),neurodegenerative diseases(such as Alzheimer’s disease)And Parkinson’s disease)and cancer,etc.,and is beneficial to protect neurons from degenerative damage.Recent studies in animal models of stroke have found that CR may reduce tissue damage and neurological dysfunction after ischemic stroke through various pathways such as inhibition of excitotoxicity,oxidative stress,inflammatory response and apoptosis.However,most studies on calorie restriction have been conducted in various animal models.However,there are few studies on the effects of interventions and related mechanisms in clinical acute ischemic stroke(AIS)patients.This study intends to observe the National Institutes of Health Stroke Scale(NIHSS score),Modified Rankin Scale(m RS)score,inflammatory factors,and oxidation before and after treatment of acute ischemic stroke(AIS)patients by observing different calorie-restricted diets.The impact of stress factors,metabolic indicators and nutritional indicators,preliminary discussion on the therapeutic effect,possible mechanism and safety of calorie restriction on AIS,aiming to provide new ideas and theoretical basis for clinical treatment of AIS and improving patient prognosis.Methods Collect 95 patients with AIS who were hospitalized in the Department of Neurology of the Fifth Affiliated Hospital of Zhengzhou University from January2019 to September 2019.All patients had no other serious medical diseases.They can cooperate with the study and sign the informed consent.According to the random principle,it was divided into three groups: 20% calorie restriction(mild food restriction group),40% calorie restriction(moderate food restriction group)and blank control group,and 87 cases were finally completed,including 30 cases in the 20%calorie restriction group 27 cases in the 40% calorie restriction group and 30 cases in the control group.All three groups were given conventional basic treatment,and the two intervention groups were given calorie-restricted dietary intervention methods based on the control group,to control patients’ daily calorie intake to 80% and 60% of the standard requirement,respectively.The NIHSS score was used to assess the degree of neurological deficits before and 1 month after treatment.On the second day after admission and 1 month after treatment,venous blood was centrifuged to collect plasma for biochemical and routine testing and follow-up Understand the prognosis m RS scores of patients after 3 months,and evaluate the NIHSS scores,inflammatory factor C-reactive protein(CRP)and transforming factor-β1(TGF-β1),oxidative stress factor reactive oxygen species(ROS)between and within the three groups Metabolic indicators blood glucose and blood lipids(TC,HDL-C,LDL-C)and nutritional indicators hemoglobin,total protein changes were statistically analyzed,regression analysis of factors affecting the patient’s prognosis.The statistical processing and analysis of the obtained data all use SPSS21.0 software.Results1.The NIHSS scores of the three groups of patients decreased after 1 month of treatment(all P <0.05);after 1 month,the NIHSS scores of the three groups were statistically significant(F = 9.102,P <0.05),medium Compared with the mild food-restricted group and the mild food-restricted group and the control group,the NIHSS score decreased significantly,and the difference was statistically significant(both P <0.05);the mild food-restricted group was not statistically different from the control group after treatment Significance(P> 0.05).2.This study found that the levels of TGF-β1,CRP,and ROS in the three groups were significantly improved after treatment one month after treatment,and the comparison was statistically significant(P <0.05).After treatment,the above indicators were statistically significant between the three groups(P <0.05).The changes in CRP,TGF-β1,and ROS levels in the moderate food-restricted group were more significant than those in the other two groups,with statistical significance(P<0.05).0.05).There was no statistically significant difference in the above indexes between the mild food-restricted group and the control group(P> 0.05).3.After treatment,the blood glucose,TC,LDL-C indicators of each group were significantly improved compared with before treatment,and were statistically significant(P <0.05).After treatment,there was no significant difference in HDL-C indicators of each group than before treatment(P > 0.05).After treatment,the blood glucose,TC and LDL-C were statistically significant(P <0.05),and the moderate food restriction group improved the above indicators more significantly than the other two groups,with statistical significance(P <0.05),Compared with the control group,the mild food restriction group improved significantly with the above indexes(P <0.05).There was no significant difference in HDL-C index changes between the three groups after treatment(P> 0.05).4.There was no statistically significant difference in the levels of nutritional indexes of hemoglobin and total protein between the three groups at admission(P>0.05),and there was no significant difference in the indexes of hemoglobin and total protein between the three groups after treatment(P> 0.05).There was no statistical difference between the three groups of patients before and after treatment(P> 0.05).5.The univariate analysis of the factors affecting the prognosis of patients with acute ischemic stroke included in this study found that intervention methods such as age,baseline NIHSS score,baseline infarct volume,CRP,TGF-β1,ROS,and calorie restriction are factors that affect prognosis.Through binary multivariate logisitic regression analysis,it was found that the baseline NIHSS score was an independent risk factor affecting the prognosis of patients with acute ischemic stroke,and moderate calorie restriction was a protective factor affecting the prognosis of patients with acute ischemic stroke.Conclusion1.A certain degree of calorie restriction may be through up-regulating the production of anti-inflammatory factor TGF-β1 to inhibit inflammatory response and down-regulating ROS to protect mitochondria to improve the neurological deficit of patients with acute ischemic stroke and improve the prognosis of patients.2.A certain degree of calorie restriction can improve metabolism in the short term and will not cause the patient’s nutritional indicators to decline,and has a certain degree of safety. |
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