The Effect Of Remote Ischemic Postconditioning On Vascular Endothelial Growth Factor Levels During Acute Phase Of Cerebral Infarction

Objective:To investigate the effect of remote ischemic postconditioning on vascular endothelial growth factor levels during acute phase of cerebral infarction and the clinical significance of vascular endothelial growth factor levels Methods:57 cases of acute cerebral infarction who received treatment within 72 hours in Department of Neurology,the First Hospital of Jilin University during April 2017 to December 2017,were taken as test subjects.All patients were confirmed diagnosis and anterior circulation infarction with MRI.Patients' NIHSS score were limited to 4 to 14 at admission and patients who was less than 18 years old or more than 80 years old were excluded from our study.The subjects voluntarily joined this study with informed consents and our study was approved by medical ethics committee.The patients were set into 2 groups according to patients voluntary: 27 cases as RIPostC treatment group and 30 cases as control group.The patients in control group received regular treatment(aspirin,statins,circulation improvement drugs and neuro nutrition drugs)and patients in experimental group received both regular treatment and RIPostC training.There are successive 7day for RIPostC treatment.The blood samples of patients in experimental group were collected at admission,1st day after RIPostC training and 7th day after RIPostC training.At admission and 7th day after training,we also assessed the NIHSS score for patients.The blood samples collecting and the NIHSS score assessing of patients in control group were done as the same time.We test VEGF levels with CBA(cytometric bead array,CBA).Then the VEGF levels and NIHSS score changes of two groups were compared.At last,we will study factors that effected the VEGF levels in experimental group.Results:1,The score of NIHSS for patients in two groups were no difference at admission(P>0.05).After seven days' treatment the score of NIHSS was reduced significantly in both groups(P<0.05).The changed score of NIHSS reduced significantly for patients in experimental group compared with control group(P<0.05).2,The VEGF levels in two groups were no difference at admission(P>0.05).Comparing with VEGF levels at admission,the VEGF level had no change after 1st day of treatment in control group and had rising trend after 7th day of treatment.But the degree of increasing unreached the significant level(P>0.05).The VEGF level continuously increased for patients in experimental group after received RIPostC training.At 7th day of training,the VEGF level was increased significantly(P<0.05).3,The NIHSS score decreased significantly for patients whose VEGF level increased more than one-fold after seven days' training compared with whose VEGF level increased less than one-fold(P<0.05).4,After analyzed the factors that can influence the effect of RIPostC training,we found that the VEGF increased significantly in experimental group with patients who were nonsmokers.Age,gender and prior stroke are not influence the expression of VEGF for patients received RIPostC training.Conclusion:1,During acute phase of cerebral infarction,RIPostC training can significantly improve patients' neurological deficit through increased VEGF level.2,Nonsmokers are sensitive to ischemic and anoxic stimulations caused by RIPostC training.Age,gender and prior stroke are not influence the sensitivity to RIPostC training.