The Protective Mechanism Study On The Remote Limb Ischemia Postconditioning In The Patients With Acute Infartion

Objective:This study mainly discussed the correlation between changes in serum NO and cAMP content after remote Limb ischemic postconditioning(RIPostC)of patients with acute cerebral infarction and the improvement of clinical symptoms of patients,and explored the related mechanism of endogenous brain protection of RIPostC.Methods:According to the criteria of admission and exclusion,80 patients with acute cerebral infarction(received treatment within 72 hours)who were hospitalized in Department of Neurology,first Hospital of Jilin University from April 2017 to December 2017 were collected.The scores of NIHSS were between 4 and 15 points.In order to exclude serious hypertension,atrial fibrillation,cerebral hemorrhage,severe cardiac insufficiency,severe abnormal liver and kidney function and so on,according to the medical ethics and according to the wishes of the patients,the collected patients were divided into RIPostC group and routine treatment group with 40 cases each.The above patients all signed informed consent;Twenty patients with non-cerebral infarction were selected as control group,who were matched in age and sex with patients with cerebral infarction.The patients in the routine treatment group(n=40)were given basic treatment,that is,aspirin and other anti-platelet aggregation drugs,lipid-lowering drugs such as Statins,improving blood circulation drugs and nutritional nerves and other drugs treatment;RIPostC group(n=40)was treated with RIPostC,twice a day for 1 week on the basis of basic treatment.The patients received 5min for one cycle and five cycles(5min/5min × 5 cycle),before and 1 day after treatment.Peripheral blood samples were collected before treatment and 1 day ?7 day after treatment.The peripheral blood samples were collected at the corresponding time points in the routine treatment group and the blood samples were collected from the control group on the same day of physical examination.The patients in the RIPostC group and the routine treatment group were evaluated with NIHSS score and ADL score before treatment and 7 days after treatment.The contents of NO and cAMP in serum of RIPostC group,routine treatment group and healthy control group were detected by ELISA technique.The changes of NIHSS score and NO and cAMP were compared between the two groups.Results:1.there was no significant difference in NIHSS score and ADL score between RIPostC group and routine treatment group before treatment(P > 0.05).The NIHSS and ADL scores in the two groups were significantly improved than those in the admission at 7 days after treatment(P < 0.05),but the NIHSS and ADL scores in the RIPostC group were significantly improved more than those in the routine treatment group on the 7th day after treatment(?NIHSS:P=0.001;?ADL:P=0.012).2?There was no significant difference in serum NO and cAMP levels between the two groups before treatment(P > 0.05).The serum NO and cAMP levels in RPostC group were higher than those in the routine treatment group 1 day after treatment(P < 0.05),and the serum NO and cAMP levels were higher than those in the routine treatment group at 7 days after treatment,There was statistical difference(P < 0.05).3?Before treatment,1 day after treatment and 7 days after treatment,the serum NO and cAMP levels in the routine treatment group showed a downward trend,but there was no significant difference(P > 0.05),while in the RIPostC group,at admission,1 day after treatment,and 7 days after treatment,the serum NO showed an increasing trend.Serum cAMP increased first and then decreased,but there was no significant difference(P > 0.05).Conclusion:the clinical symptoms of patients with cerebral infarction after RIPostC were significantly improved and RIPostC had a certain protective effect on cerebral infarction.2.RIPostC may play a protective role by regulating the contents of NO and cAMP.