| Objective: In symptomatic intracranial atherosclerotic stenosis(s ICAS)in the crowd,for 12 months in a row of dancers from remote ischemic conditioning(RIC),probes into the feasibility and clinical effectiveness of the safety of the RIC,evaluation of RIC on stroke recurrence s ICAS patients,clinical outcomes and serological indexes,the effects of explore the brain protection mechanism of RIC may reveal in the prevention and treatment of stroke occurrence and recurrence of important clinical value,provide important evidence for the subsequent clinical application.Methods: Choice in December 2018-December 2019 in the Second People’s Hospital of Wuhu in Anhui province after nerve internal medicine wards in the hospital for treatment of patients with cerebral infarction,in accordance with the relevant standards into groups,and according to the principle of randomized,double-blind divided into intervention group(RIC)and control group(Sham-RIC group).They were respectively to given standardized drug treatment + RIC/Sham-RIC treatment for 1 year and followed-up for 1 year.Patients were followed up in the outpatient department at the onset of the clinical endpoint event,and at the end of treatment at 3 months and 12 months,to observe the recurrence rate of stroke,clinical prognosis and changes in serological indicators during this period.Results:(1)A total of 80 patients completed treatment and follow-up and entered the final data analysis,including 40 cases in the RIC group(intervention group)and 40 cases in the sham-RIC group(control group).(2)After 3 months of treatment,the reoccurrence rate of ischemic stroke in RIC group was lower than that in control group(2.5% vs 23.5%,P=0.025).After 12 months of treatment,the reoccurrence rate of ischemic stroke in RIC group was lower than that in control group(7.5% vs 25.0%,P=0.034).(3)Before treatment,there was no significant difference in baseline NIHSS scores between the two groups(P>0.05);At 3 months after enrollment,NIHSS score[(8.45±2.55)points] in RIC group was lower than that before enrollment [(10.48±3.15)points](P<0.001);After 12 months of enrollment,the NIHSS score in RIC group[(5.93±1.62)points] was significantly lower than that before enrollment(P<0.001),and during the same period,it was also significantly lower than that in the control group[(8.18±1.55)points](P<0.001).(4)Before treatment,there was no significant difference in baseline m RS scores between the two groups(P>0.05);3 months after enrollment,the m RS score in RIC group [(2.40±0.50)points] was lower than that before enrollment[(3.23±0.70)points](P=0.011);After 12 months of enrollment,the m RS score in RIC group [(1.95±0.32)points] was lower than that before enrollment(P=0.001).Compared with the control group [(2.35±0.62)points] during the same period,the m RS score in RIC group also showed a obviously reduced tendency(P=0.001).(5)After 12 months of treatment,the hemoglobin(Hb)content in RIC group [(125.20±9.17)g/L] decreased compared with control group [(130.80±11.45)g/L](P=0.018),the neutrophil-to-lymphocyte ratio(NLR)level in RIC group(1.71±0.55)decreased compared with control group(2.46±0.39)(P<0.001),the mean platelet volume(MPV)in RIC group [(10.57±0.99)FL] decreased compared with control group [(11.30±1.06)FL](P=0.002),the platelet distribution width(PDW)level in RIC group[(15.98±1.58)%] was lower than that in control group [(17.36±1.67)%](P <0.001),and the level of high-sensitivity C-reactive protein(hs-CRP)level in RIC group[(4.17±0.75)mg/L] was lower than that in control group [(5.19±0.99)mg/L](P<0.001).(6)Comparison of changes before and after treatment showed that NLR,MPV,PDW and hs-CRP decreased significantly in RIC group compared with control group,with statistical significance(all P <0.05).Conclusion:RIC is a safe and effective method to reduce stroke recurrence rate and improve clinical prognosis in s ICAS patients.Its mechanism may be related to inhibition of platelet activation and resistance to inflammatory response.RIC can be used for secondary prevention in patients with ischemic stroke and has high clinical promotion value.However,further large sample multicenter clinical trials are still needed to verify the application. |
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