Protective Effect And Mechanism Of Limb Ischemic Postconditioning On Acute Cerebral Infarction

Backgrond Cerebral infarction is the leading cause of death and disability in the world.In theory,thrombolysis is the best treatment for cerebral infarction.But the result is not so good as expected.Therefore,we need to explore new treatment methods.Domestic and foreign researchers have shifted their attention to the study of endogenous protection,such as ischemic treatment.Many basic and clinical experiments abroad have confirmed the role of limb ischemic treatment,which has neuroprotective effect.At present,there is no report about the application of limb ischemic postconditioning in patients with acute cerebral infarction in China.This study is divided into two parts to investigate the protective effect and possible mechanism of limb ischemic treatment on acute cerebral infarction.PART 1 Protective effect of limb ischemic postconditioning on acute cerebral infarctionObjective To investigate the clinical effect of limb ischemic postconditioning in the treatment of acute cerebral infarctionMethods 158 patients with acute cerebral infarction who were treated in the first unit of Depart ment of Neurology,Henan Provincial People's Hospital from March 2015 to June 2016 we re enrolled in this study.These patients were diagnosed by magnetic resonance DWI,and they were not treated with thrombolysis.The patients were randomly divided into treatment group and control group according to the order of admission.All patients were given routine treatment.Patients in the treatment group were not only given conventionaltreatment,but also given limb ischemic postconditioning.NIHSS scores were compared between the two groups at the time of admission,14 days and 3 months.Comparison of m RS score at admission and 3 months was made.Comparison of the clinical efficacy at 14 days in two groups was made.Results 1.There was no significant difference between the two groups in NIHSS score at admission and at 14 days(P >0.05),and the difference was statistically significant at 3 months(P <0.05).2.The m RS score of the limb ischemic postconditioning group was lower than that of the control group at 3 months,the difference was statistically significant(P <0.05).3.The total effective rate(95.9%)in the postpartum limb ischemic postconditioning group was higher than that in the control group(79.0%)at 14 days,the difference was statistically significant(P <0.05).Conclusions 1.Limb ischemic postconditioning can improve NIHSS score and m RS score in patients with acute cerebral infarction.2.Limb ischemic postconditioning can improve the clinical efficacy of patients with acute cerebral infarction.PART 2 Effects of limb ischemic postconditioning on cerebral infarct volume and cerebral perfusion in patients with acute cerebral infarctionObjective To investigate the effect of limb ischemic postconditioning on cerebral infarct volume and cerebral perfusion in patients with acute cerebral infarctionMethods A total of 136 patients with acute cerebral infarction who were treated in the first unit of Department of Neurology,Henan Provincial People's Hospital from March 2015 to June 2016 were enrolled in this study.All the subjects completed the whole treatment cycles of limb ischemic postconditioning and follow-up visits on time.Relevant information of patients was collected by designated persons.The scan used the Siemens Trio Tim 3.0T Superconducting Systemic Magnetic Resonance Scannerwas.All patients enrolled in the study were measured by magnetic resonance at the specified time.Specific time was: admission(within 72 hours),14 days,1 month,3months.The infarct volume and PWI parameters was measured and compared at the time of admission(within 72 hours),14 days and 3months.Results 1.The infarct volume in the limb ischemic postconditioning group was reduced by 36% and 34% respectively at 1 month and 3 months compared with the control group(P <0.05).2.There was no significant difference in rr CBV,rr CBF,r MTT and r TTP between the limb ischemic postconditioning group and the control group at the admission and 14 days(P >0.05),and the difference was statistically significant at 3 months(P <0.05).Conclusions 1.Limb ischemic postconditioning can reduce the cerebral infarction volume in patients with acute cerebral infarction.2.Limb ischemic postconditioning can improve cerebral perfusion in patients with acute cerebral infarction.