| Objectives To observe the short-term and long-term clinical effects of remote ischemic postconditioning(RIPost C)in different degrees,and the effects of D-dimer,homocysteine,uric acid and inflammatory indexes of patients with acute cerebral stroke.Methods A total of 225 patients with non-cardiogenic acute ischemic stroke were selected for the first time from October 2017 to October 2019 by doctors of Neurology Affiliated Hospital of North China University of Technology.A total of 225 patients with non-cardiogenic acute ischemic stroke were selected for the first time from October 2017 to October 2019 by doctors of Neurology Affiliated Hospital of North China University of Technology.They were divided into the control group and experimental group,the control group was given conventional medication,the experimental groups all used remote ischemia postconditioning and divided into 4 circulations,8 circulations,12 circulations,14 circulations according to the time of applying the mercury column sphygmomanometer cuff to the upper limbs,it is 1 cycle with inflation and deflation for 5 minutes,applying for a week.The five groups of patients were discharged after 14 days of comprehensive treatment.The results of univariate and multivariate logistic regression analysis through using SPSS22.0 statistical software,the comparison of NIHSS scores,mRS scores,MBI scores,total effective rate,good prognosis rate before and after the treatment in each group and the comparison of D-dimer level,hs-CRP level,NLR level,Hcy level,UA level in 14 days before and after the treatment.Results 1 It is no significant adverse events occurred for patients using RIPost C with acute ischemic stroke,which suggests that it is safe for patients.2 The NIHSS scores of the five groups of patients of acute ischemic stroke(except for the 4 circulations group at 7 days after treatment)are lower than after the treatment.The NIHSS scores decreased most significantly in 8 circulations and 12 circulations in 3 months after the treatment,and there was no statistically significant difference between the two groups(pairwise comparison,P<0.001).3 The difference between the mRS score and MBI score in 3 months after the treatment and before was used as an indicator to evaluate the recovery of life self-care ability,the results of comparison between groups(P<0.05).The mRS scores decreased most significantly and the MBI scores increased most significantly in 8 circulations and 12 circulations in 3 months after the treatment,and there was no statistically significant difference between the two groups(comparison between groups,F=24.725,P<0.001;F=27.285,P<0.001).4 There were statistically significant differences in the total effective rate and good prognosis rate among the five groups of patients after treatment(P<0.05).Among them,the total effective rate(?~2=10.211,P=0.037)and good prognosis rate(?~2=50.653,P<0.001)of 8 circulations and 12 circulations are the highest in 14 days after the treatment.5 The difference between the levels of serum D-dimer,hs-CRP,NLR,Hcy,and UA in 3 months after the treatment and before was used as an indicator to evaluate the recovery of life self-care ability,the results of comparison between groups(P<0.05).Among them,the serum D-dimer(F=80.844,P<0.001),hs-CRP(F=293.009,P<0.001),NLR(F=101.696,P<0.001),Hcy(F=113.155,P<0.001),UA(F=650.346,P<0.001)levels of 8 circulations and 12 circulations decreased most significantly and there was no statistically significant difference between the two groups(P>0.05).6 The multivariate logistic regression analysis shows that the efficacy of 8 circulations remote ischemic postconditioning can be increased by nearly 3 times.Conclusions 1 Remote ischemic postconditioning is safe and effective for patients with acute ischemic stroke.2 An improvement of the clinical symptoms and prognosis of patients with acute ischemic stroke using 8 circulations remote ischemic postconditioning has the best comprehensive effect.3 The decrease of serum D-dimer level,hs-CRP level,NLR level,Hcy level and UA level is the most obvious when applying a total of 8 circulations ischemic postconditioning,which could reduce inflammatory responses to endothelial cell destruction,thrombosis,and recanalization of blood vessels in patients with acute ischemic stroke.Table 13;Reference 137... |
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