| ObjectiveThe aim of this study is to observe the neurological effects of Remote ischemic conditioning（RIC）on patients with acute cerebral infarction（ACI）and the changes in the concentrations of Cystatin C（Cys C）and Hypersensitive C-reactive protein（hs-CRP）and to investigate the possible mechanisms of RIC in the treatment of acute cerebral infarction.MethodsOne hundred and fifty patients with acute cerebral infarction who met the admission criteria were selected from December 2020 to January 2022 in the Department of Neurology of the Central Hospital of Shenyang Medical College,and were divided into experimental and control groups according to the principle of randomization,with 75 cases in each group.The control group was given other standard treatments such as anti-platelet aggregation,improvement of cerebral blood supply,nerve nutrition,dehydration and intracranial pressure lowering,lipid lowering and plaque stabilization,etc.The experimental group was given distal ischemic adaptation therapy on the first day of admission based on the control group,5 cycles were performed once a day for 12 ± 2 days,and baseline data collection was improved after admission（Baseline data includes gender,age,diabetes,hypertension,coronary heart disease,hyperlipidaemia,alcohol consumption,smoking）were collected and the National Institute of Health Stroke Scale（NIHSS）scores were administered to both groups on days 1,12±2 and 90±7 of admission.The Modified Rankin Scale（m RS）was administered to both groups on days 1 and 90 ± 7,and the serum concentrations of Cys C and hs-CRP were measured on days 1 and 12±2.Results1.There was no statistically significant difference between the NIHSS scores on day 1 of admission in the experimental group and the control group（8.84±2.96,8.89±3.34）（P>0.05）;the NIHSS scores on day 12± 2 and day 90 ± 7 after admission in the experimental group（5.73 ±2.94,2.84±1.95）were lower than the NIHSS scores on day 1 of admission（8.84± 2.96）;NIHSS scores on day 12±2 and 90±7 of admission（6.74± 2.92,4.36± 2.59）were lower than NIHSS scores on day 1 of admission（8.89±3.34）in the control group,with statistically significant differences（p<0.01）;NIHSS scores on day 12± 2 and 90± 7 of admission（5.73±2.94,2.84±1.95）were lower in the experimental group.（2.94,2.84±1.95）were lower than the NIHSS scores of the control group on day 12 ± 2 of admission（6.74±2.92,4.36± 2.59）and the differences were statistically significant（P<0.05,P<0.01）.In the experimental group,on day 90±7 after admission,there were 14 cases with m RS score 0,14 cases with score 1,29 cases with score 2,10 cases with score 3 and 3 cases with score 4,with an overall effective rate of 81.4%,while in the control group,on day 90 ± 7after admission,there were 10 cases with m RS score 0,16 cases with score1,16 cases with score 2,23 cases with score 3 and 6 cases with score 4,with an overall effective rate of 60.0%,with a statistically significant difference between the two groups(The difference between the two groups was statistically significant（P < 0.05）.2.There was no statistically significant difference between the serum Cys C level on day 1 of admission（1.11 ± 0.09,1.09 ± 0.07）in the experimental group and the control group（P>0.05）;the serum Cys C level on day 1 and day 12 ± 2 of admission（1.11 ± 0.09,0.82 ± 0.09）in the experimental group was compared with the serum Cys C level on day 1 and day 12± 2 of admission in the control group（1.11± 0.09,0.82± 0.09）.C levels（1.09± 0.07,1.07± 0.08）compared with those of the control group on day 1 and day 12±2 of admission,and the differences were statistically significant（P<0.01）.3.There was no statistically significant difference between the serum hs-CRP levels on day 1 of admission（13.90 ± 3.42,13.62 ± 3.57）in the experimental group and the control group（P>0.05）;the serum hs-CRP levels on day 1 and day 12±2 of admission（13.90± 3.42,10.13± 2.44）in the experimental group were compared with the serum hs-CRP levels on day1 and day 12 ± 2 of admission in the control group.12 ± 2 days serum hs-CRP levels（13.62 ± 3.57,12.14 ± 3.20）compared to the control group on day 1 and day 12 ± 2 of admission,all differences were statistically significant（p<0.01）.4.32 patients in the experimental group complained of pain and numbness in the compressed limb during the operation,and 3 patients had subcutaneous petechiae on the compressed upper limb,all of which disappeared completely within 1 day after the treatment.ConclusionsLimb distal septal ischemia adaptation therapy can reduce NIHSS and m RS scores and significantly lower serum hs-CRP and Cys C index levels in patients with acute cerebral infarction,indicating that adding RIC treatment to conventional treatment can improve neurological deficits and prognosis of ACI patients more effectively compared with conventional treatment.The potential brain protection mechanism is likely to be related to the inhibition of hs-CRP induced inflammatory response and reduction of Cys C-induced blood-brain barrier damage,which is a safe and effective treatment method for acute cerebral infarction. |
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