| Objective:Taking patients with acute anterior circulation cerebral infarction as the research object,to explore the relationship between the severity of acute cerebral infarction and peripheral blood neutrophils and whether remote ischemic postconditioning（RIPostC）regulates neutrophils to exert neuroprotective effects.Methods:According to the inclusion and exclusion criteria,38 patients with acute anterior circulation cerebral infarction who were hospitalized in the Neurology Department of the First Hospital of Jilin University from May 2021 to November 2021 and were within 72 hours of onset were screened,and 24 patients were divided into the conventional treatment group according to their wishes and RIPostC group 14 cases;another 15 cases of non-acute cerebral infarction adult volunteers matched with gender,age and risk factors were recruited during the same period.All patients were treated with conventional drugs after admission,and the RIPostC group was additionally trained with ischemia adaptor.Each training process included 5 cycles,each cycle included 5 minutes of ischemia and 5 minutes of reperfusion.Train continuously for 1 week.The general clinical data of the patients were recorded and the NIHSS scores on admission and 7 days after treatment and the Modified Rankin Scale（mRS）scores on admission and 3 months after discharge were evaluated.The patients in the RIPostC group and the control group were sampled at the same time points,that is,fasting peripheral blood samples in the morning before treatment,3d and 7d after treatment,while the control group only collected blood on the day of recruitment,and the collected blood samples were sent to the laboratory for processing within 2 hours.,the proportion of peripheral blood neutrophils（percentage of white blood cells）and the proportion of pro-inflammatory neutrophils（percentage of neutrophils）at each time point were analyzed by flow cytometry and Flowjo10 software.Results:1.Among the 38 patients with acute cerebral infarction collected in this study,11 patients who completed the first blood collection within 1 day of onset were screened out,and their NIHSS score on admission was proportional to the proportion of proinflammatory neutrophils in their peripheral blood.Correlation（r=0.618,p<0.05）.2.Compared with the control group,the proportions of peripheral blood neutrophils and pro-inflammatory neutrophils in patients with acute cerebral infarction were increased（p<0.05）.Compared with the conventional treatment group,the proportion of pro-inflammatory neutrophils in the peripheral blood of patients in the RIPostC group was lower,and the difference was most significant on the 7th day（P<0.05）;however,there was no statistical difference in the proportion of neutrophils.3.NIHSS score and mRS score:before and after treatment,the RIPostC group decreased more significantly than the conventional treatment group（p<0.05）.4.RIPostC treatment was started within 1-3 days after acute cerebral infarction,and the time of starting treatment had no significant relationship with the degree of improvement（p>0.05）,that is,RIPostC treatment within 3 days of onset had the same therapeutic effect.Conclusion:1.After acute cerebral infarction,the proportion of pro-inflammatory neutrophils in the peripheral blood of patients increases,and the more severe the disease,the higher the proportion of pro-inflammatory neutrophils,and the pro-inflammatory neutrophils may have a damaging effect.2.Remote ischemic postconditioning combined with conventional therapy can further improve the degree of neurological deficit and prognosis in patients with cerebral infarction in the acute stage,and the initiation of RIPostC within 3 days of onset has the same effect.3.Remote ischemic postconditioning can reduce the proportion of proinflammatory neutrophils in peripheral blood.Part of the neuroprotective effect of RIPostC may be achieved by regulating the proportion of pro-inflammatory neutrophils. |
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