| Objectives The clinical efficacy of remote limb ischemic preconditioning(RLIPC)in the treatment of patients with chronic cerebral circulatory insufficiency(CCCI)was investigated by performing RLIPC in patients with chronic cerebral ischemia,The clinical efficacy of RLIPC in the treatment of patients with chronic cerebral ischemic insufficiency can provide a clinical basis for individualized treatment of CCCI patients.Methods Patients who were diagnosed as CCCI in the Department of Neurology,Affiliated Hospital of North China University of Science and Technology from October2019 to December 2020 were randomly divided into routine group and study group,in which 61 patients in routine group and 58 patients in study group were respectively.According to the consensus of experts in the diagnosis and treatment of chronic cerebral insufficiency,61 patients in the conventional group were treated with comprehensive treatment such as antiplatelet,lipid regulation and improvement of cerebral circulation;the study group was treated with the intervention of remote limb ischemic preconditioning on the basis of the conventional group(the main operation flow and parameters were: YX02-D type preconditioning training instrument was used,the inflation method was to compress one side of brachial artery,the pressure value was between 180-220 mmhg,and adjusted according to the patient’s tolerance level.After 5minutes of ischemia,the patients were deflated and perfused for 5 minutesused for 5minutes.This process was a cycle,and the above cycle was repeated for 5 times,which was a treatment cycle.Repeated 2 times daily for the above treatments).Both groups had a10-day treatment cycle.Patients were recorded for pre-treatment,5 days of treatment,and10 days of treatment.The observation indexes mainly included four parts.One was the assessment of cognitive function,using the Montreal Cognitive Assessment Scale(MOCA)and the Simple Mental State Examination Scale(MMSE).Second,cerebral perfusion was evaluated by MRI ASL examination and hemorheology test(blood viscosity,CBF and relative CBF value,etc.).The third is the evaluation of clinical efficacy by calculating the effective rate of the two groups after treatment.The fourth is safety assessment,using the occurrence of adverse events to calculate.The above four aspects were used to evaluate the effect of remote limb ischemic preconditioning on the outcome of patients with chronic cerebral insufficiency.Results 1 Comparison of baseline data: There was no significant difference in the age,sex,years of education,symptom score and past history between the conventional group and the study group(P>0.05).2 Impact of remote limb ischemic preadaptation on outcomes in patients with chronic cerebral hypoperfusion.(1)In terms of cognitive function,the scores of MMSE and Mo CA in the routine group and the research group were higher than those at the time of admission on 5 and 10 days after treatment,and the differences were statistically significant(P<0.05).The scores of MMSE and Mo CA in the research group were higher than those of the conventional group,and the differences were statistically significant(P<0.05).(2)Hemorheology: On the 10 th day of treatment,the whole blood high shear reduction viscosity,whole blood low shear reduction viscosity,plasma viscosity and erythrocyte aggregation index in the study group were significantly lower than those in the conventional group(P<0.05).(3)For ASL magnetic resonance imaging,CBF and r CBF values on the affected side increased after treatment in both groups,showing statistical significance(P<0.05).The CBF and r CBF values on the side after treatment in the research group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).(4)Clinical efficacy: the effective rate of the study group after treatment was 91.4%,which was higher than that of the conventional group by 75.4%,the difference was statistically significant(P<0.05).3Safety: there were no adverse reactions in the conventional group and 2 adverse reactions in the study group.There was no statistical difference between the two groups(P>0.05).Conclusions 1 Remote limb ischemic preconditioning intervention can improve the cognitive function of patients with chronic cerebral ischemia and increase brain perfusion,with good clinical efficacy.2 Remote limb ischemic preconditioning has good safety in the treatment of chronic cerebral ischemia.Figure 2;Table 13;Reference 96... |
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