Neuroprotective effect of limb remote ischemic preconditioning on patients with ischemic cerebrovascular disease / 中国脑血管病杂志

ABSTRACT

Objective: To investigate the neuroprotective effect of limb remote ischemic preconditioning (rIPC) on patients with ischemic cerebrovascular disease. Methods: A total of 145 patients with previous history of transient ischemic attack (TIA) or cerebral infarction treated regularly by drugs and all the risk factors controlled within the normal range were enrolled. They were diagnosed as multiple extracranial or intracranial stenosis with imaging. They were divided into a limb rIPC group (n = 85) and a control group (n = 60) according to the ratio of 3/2. Both groups were in strict accordance with the medication of U. S. Stroke and transient ischemic attack secondary prevention guidelines 2011 and controlled the risk factors. At the same time, the rIPC group was given limb ischemic preconditioning training, using a dual-arm sphygmomanometer to pressurize both upper limbs to 180-200 mm Hg, maintained for 5 minutes, and deflated and rested for 5 minutes as a cycle. The continuous training was 5 cycles each time, once a day for 6 months. The neurological improvement and re-infarction rate of patients were observed. Thirty-five patients in the rIPC group and 26 in the control group received single photon emission computed tomography (SPECT) examination. The improvement of cerebral blood flow and metabolism was observed. Results: Circled digit oneCompared to the condition before treatment, the neurological deficits were improved in 71 patients (83.5%) in the rIPC group and 40 in the control group after treatment. There was significant difference (P <0.05). Circled digit twoMRI examination showed that 3 patients (3.5%) in the rIPC group and 8 (13.3%) in the control group had recurrent cerebral infarction. There was significant difference (P <0.05). Circled digit threeCompared to the condition before treatment, the SPECT examination showed that cerebral metabolism and cerebral blood flow were improved in 29 patients (82.9%) in the rIPC group and 13 (50.0%) in the control group. There was significant difference between the 2 groups (P <0.01). Circled digit fourAfter rIPC, no patients had heart rate, blood pressure changes, and other discomforts. Conclusion: Limb ischemia preconditioning may obviously improve neurological deficits caused by ischemic stroke, improve the cerebral blood flow and metabolism, and prevent the recurrence of cerebral infarction.