| 远隔缺血预适应对缺血性脑血管病疗效分析 |
| 投稿时间：2016-03-14 修订日期：2016-04-12 点此下载全文 |
| 引用本文：鲁慧,王彬成,崔宁宁,张艳春.远隔缺血预适应对缺血性脑血管病疗效分析[J].医学研究杂志,2016,45(11):176-179 |
| DOI：
10.11969/j.issn.1673-548X.2016.11.045 |
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| 中文摘要:目的 研究远隔缺血预适应（remote ischemic preconditioning，rIPC）对缺血性脑血管病的治疗效果。方法 筛选有短暂性脑缺血发作（transient ischemic attack，TIA）或脑梗死病史并经MRI检查确诊为缺血性脑血管病患者174例，采用数字表法随机分为远隔缺血预适应组（rIPC组，88例）和对照组（86例）；两组患者均严格按照指南用药，rIPC组额外给予肢体远隔缺血预适应训练，疗程6个月。观察两组患者神经功能改善情况，通过磁共振成像（magnetic resonance imaging，MRI）检测并计算再梗死发生率，采用SPECT技术观察脑血流状况并半定量分析额、颞、顶、枕叶及基底核和丘脑血流灌注情况，采用经颅多普勒（transcranial doppler，TCD）检测分析大脑中动脉（middle cerebral artery，MCA）、大脑前动脉（anterior cerebral artery，ACA）、大脑后动脉（posterior cerebral artery，PCA）、椎动脉（vertebral artery，VA）和基底动脉（basilar artery，BA）的平均血流速度。结果 与对照组比较，rIPC组神经功能显著改善（83.0% vs 64.0%），再梗死发生率显著降低，脑血流状况明显改善，基底核和丘脑部位血流灌注状况明显改善，MCA、ACA、PCA、VA和BA平均血流速度显著升高，上述差异均具有统计学意义（P<0.05，P<0.01）。结论 rIPC能够明显改善缺血性脑血管病患者神经功能、改善脑血流，提示rIPC对缺血性脑血管病具有良好的治疗效果。 |
| 中文关键词:远隔 缺血预适应 缺血 脑血管 治疗效果 |
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| Efficacy of Remote Ischemic Preconditioning on Ischemic Cerebrovascular Disease |
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| Abstract:Objective To investigate the efficacy of remote ischemic preconditioning (rIPC) on ischemic cerebrovascular disease. Methods A total of 174 patients with previous history of transient ischemic attack(TIA) or cerebral infarction patients were randomly divided into rIPC group(n=88) and control group(n=86). Both groups were given drug treatment in strict accordance with medical guide. At the same time, the patients in rIPC group were given limb ischemic preconditioning training, once a day for 6 months. The neurological improvement was observed. The re-infarction rate of patients was determined. The improvement of cerebral blood flow was observed by SPECT, and the perfusion in frontal, temporal, parietal, occipital lobe, basal ganglia and thalamus area, the average flow velocity in middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), vertebral artery (VA), basilar artery(BA) were detected by transcranial doppler (TCD). Results Compared with control group, the neurological deficits was significantly improved (83.0% vs 64.0%), the re-infarction rate was significantly decreased, the cerebral blood flow was significantly improved, the perfusion in basal ganglia and thalamus area were significantly improved and the average flow velocity in MCA, ACA, PCA, VA, BA were significantly increased. All of the difference above were significant(P<0.05, P<0.01). Conclusion rIPC can effectively improve the neurological deficits and cerebral blood flow, suggesting that rIPC have good treatment on ischemic cerebrovas-cular disease. |
| keywords:Remote Ischemic preconditioning Ischemia Cerebrovascular Efficacy |
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