| Objectives By observing the effect of remote ischemic conditioning(RIC)on the recovery of nerve function,the improvement of daily living ability and the function of vascular endothelium in patients with acute cerebral infarction,explore the effect of RIC on the therapeutic effect of patients with acute cerebral infarction and the possible mechanism of brain protection,and to provide objective evidence for the choice of treatment method and improvement of prognosis in patients with acute cerebral infarction.Methods 1 The patients with first anterior circulation acute cerebral infarction and onset time within 72 hours,NIHSS score between 5~15,who were hospitalized in the Department of Neurology,North China University of Technology Affiliated Hospital from November 2018 to October 2019 were selected and randomly divided into test and control groups.2 The control group was given conventional treatment,and the experimental group was given RIC based on conventional treatment for 14 days.3 The NIHSS score and BI score of patients before treatment,14 days,30 days and 90 days of treatment were evaluated.4 The levels of vascular endothelial function-related serum factors of two groups of patients,including vascular endothelial growth factor(VEGF),stromal cell-derived factor-1alpha(SDF-1?),soluble intercellular adhesion molecule-1(sICAM-1)and endothelin-1(ET-1),were detected by enzyme-linked immunosorbent assay before and after 14 days of treatment.5 Compared the changes of NIHSS score,BI score and vascular endothelial function indexes between the two groups of patients before and after treatment,and analyzed the effect of the changes of vascular endothelial function on the recovery of neurological function and the improvement of daily living ability of patients before and after treatment.6 Statistical method: statistical analysis using SPSS(22.0)software.The t test was used to compare the mean between two groups.The repeated measures analysis of variance was used to compare the mean of repeated measurement data at different time points between two groups.Comparison of median between two groups was performed using Mann-Whitney U rank sum test,and the counting data was performed using the ?2 test for the composition ratio or rate,and the multivariate analysis uses multiple linear regression model.P<0.05 was considered statistically significant.Results 1 There was no significant difference in NIHSS score and BI score between the two groups of patients before treatment(P>0.05).The NIHSS scores of the two groups of patients at 14 days,30 days,and 90 days of treatment were all lower than before,and the BI scores were higher than before,the change of the experimental group is more significant(P<0.05),the differences among groups,time and interaction effects were statistically significant(P<0.05).2 The level of VEGF,SDF-1?,sICAM-1,and ET-1 in serum of patients of the two groups were not significantly different before treatment(P>0.05).At 14 days of treatment,the levels of VEGF and SDF-1? in the serum of the two groups were higher than before,and the increase in the experimental group was more significant,the difference was statistically significant(P<0.05);the levels of sICAM-1 and ET-1 in the serum of patients of the two groups were lower than before treatment,and the decrease in the experimental group was more significant,the difference was statistically significant(P<0.05).3 Multivariate analysis showed that after excluding other influencing factors,whether or not to give RIC can still affecting the changes of patients' neurological function,daily living ability and endothelial function,the differences were statistically significant(P<0.05).In addition,the increase of VEGF and SDF-1? and the decrease of sICAM-1 can also affect the recovery of patients' neurological function.The increase of VEGF and sICAM-1 and the decrease of ET-1 can affect the improvement of patients' daily life ability,and the differences are statistically significant(P<0.05).Conclusions 1 RIC can promote the recovery of neurological function,improve the ability of daily life and the recent clinical prognosis in patients with acute cerebral infarction,and have no obvious adverse reactions.2 RIC can affect the expression of vascular endothelial function-related factors in patients with acute cerebral infarction,up-regulate VEGF and SDF-1?,and down-regulate sICAM-1 and ET-1,thereby improving vascular endothelial function.3 Increased levels of VEGF and SDF-1? and decreased levels of sICAM-1 can promote neurological function recovery in patients with acute cerebral infarction,Increased levels of VEGF and sICAM-1 and decreased levels of ET-1 can promote the improvement of daily life in patients with acute cerebral infarction.Figure 3;Table 15;Reference 127... |
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