| OBJECTIVETo observe the effect of remote ischemic preconditioning(RIPC) on the concentration of serum S-100βprotein,which induced by cardiopulmonary bypass(CPB),and the relation between remote ischemic preconditioning and the changes of the neurocognitive function.To discuss the effect and the mechanism of remote ischemic preconditioning on cerebral injury undergoing CPB.METHODSThirty-six adult patients(ASA physical statusⅡtoⅣ),underwent cardiac operation were randomised to the RIPC group(n=18) or the control group(n=18).Exclusion criteria were as follows:Neuro psychiatric disorders,Hypertension,renal insufficiency,carotid artery stenosis,Family history and Genetic risk factors,brain trauma,drug abuse et al.RIPC was induced by conditioning three 5-minute cycles of ischemia(inflation of a blood pressure cuff to 200 mmHg) and reperfusion on the unilateral upper limb before CPB.Patients' serum S-100βprotein levels were measured at four different times,Neurocognitive functions and MMSE before and after operation were examined and neuropsychological complications were recorded.RESULTS 1.The concentration of serum S-100βprotein has no significant difference(P＞0.05) at T1 time between the two groups;but at T2 and T3 time point,the serum S-100βprotein concentration increase significantly than T1 point(P＜0.05).2.At the third and sixth day after operation,the standardization of nervous system examination was no obvious positive signs.The MMSE scores has decreased after the operation,at the third day after operation,the rate of neurocognitive disfunction was higher in control group than RIPC group(P＜0.05).CONCLUSIONRemote ischemic preconditioning could inhibit the open-heart surgery patients with serum S-100βprotein release,and reduce the occurrence of neuropsychiatric disorders.It was considered that remote ischemic preconditioning could benefit to the patients undergoing open-heart surgery with cardiopulmonary bypass. |
