The Effect Of Remote Ischemic Postconditioningon Immune Regulatory Factors In Patients With Acute Cerebral Infarction

Objective:Effects of remote ischemic postconditioning on serum concentrations of catecholamine,cortisol and HMGB1 in patients with acute cerebral infarction.Methods:After the approval of the ethics committee of the first hospital of jilin university,78 patients with cerebral infarction within 72 hours who were admitted to the first hospital of jilin university from December 2018 to January 2020 were collected according to the inclusion criteria and exclusion criteria.All the patients signed the informed consent.According to the wishes of the patients,they were divided into two groups: the remote ischemicpostconditioning(RIPost C)group(39 cases)and the control group(39 cases).The control group was given the routine treatment of cerebral infarction,on the basis of routine treatment of cerebral infarction,patients in the RIPost C group were treated with remote ischemic postconditioning of both upper limbs.On the day after the patient was hospitalized,the patient was given one treatment in the morning and one in the evening with 6consecutive days of treatment.Complete ischemia/reperfusion of both upper limbs lasted for5 minutes as a cycle.The patient was given 5 cycles at a time.the appropriate pressure is selected according to the patient's own basic blood pressure to ensure that the pressure is greater than 30 mm Hg and above,in order to achieve the purpose of temporarily blocking limb blood flow.2ml of peripheral blood was collected at 6:00-8:00 on the second day after admission(before RIPost C)and at 6:00-8:00 on the eighth day after admission(after RIPost C6 days)by collecting blood vessels for coagulation.At the same time,the NIHSS scorewere evaluated on admission,General medical data of the patients were recorded(including blood routine,hyperlipidemia,etc.)and the contents of catechospholamine,cortisol and HMGB1 in the serum were detected by ELISA according to the reagent instructions.Results:(1)there was no correlation between catecholamine,cortisol,HMGB1 and NIHSS score,and the results were as follows:The correlation coefficients of catecholamine analysis R=-0.127,P=0.603;The correlation coefficient of cortisol analysis R=0.080,P=0.702;the correlation coefficient of HMGB1 analysis R=-0.358,P=0.079.(2)According to the literature,lymphocytopenia is that the lymphocyte count in the blood was less than 1.0×10*9;There was no correlation betweencatecholamine,cortisol,HMGB1 and lymphocytopenia,and the results were as follows: The correlation coefficients of catecholamine analysis R=0.268,P=0.109.The correlation coefficient of cortisol analysis was R=0.168,P=0.306.the correlation coefficient of HMGB1 analysis R=0.048,P=0.776.(3)The concentrations of catecholamine and HMGB1 on the 8th day were higher than those on the 2nd day,and cortisol on the 8th day were lower than those on the 2nd day,but there was no statistical significance.(4)the concentration difference of HMGB1 in RIPost C group was lower than that in the control group,and the concentration difference between the two groups was statistically significant(P=0.042).There was no significant difference in catecholamine concentration(P= 0.640)and cortisol concentration(P= 0.705)between RIPost Cgroup and control group.Conclusion:Give six days RIPost C(double arm completely ischemia/reperfusion for 5 minutes,five cycles)can reduce the concentration of the acute cerebral infarction patients serum HMGB1,this may be RIPost C alleviate one of the mechanismof peripheral immune suppressionafter acute cerebralinfarction.However,RIPost C had no significant effect on the serum concentrations of catechol and cortisol afteracute cerebral infarction.