远隔肢体缺血后适应对不同TOAST和OCSP分型脑梗死的影响

目的探讨远隔肢体缺血后适应(RIPostC)在脑梗死TOAST分型和OCSP分型中对不同亚型脑梗死短期预后的影响。方法按标准选取住院的急性脑梗死患者545例,在常规治疗的基础上进行远隔肢体缺血后适应干预,分别于住院时和治疗7d后进行NIHSS评分,计算好转率。同时对所有入组患者按标准进行TOAST分型和OCSP分型,比较每个分型中不同亚型的NIHSS评分好转率。结果 TOAST分型中大动脉粥样硬化型、心源性栓塞型、小动脉闭塞型、其他原因的卒中型和不明原因型亚型之间的NIHSS评分好转率差异无统计学意义(P0.05)。OCSP分型中,完全性前循环梗死和部分性前循环梗死亚型的NIHSS评分好转率优于腔隙性梗死和后循环梗死亚型,差异有统计学意义(P0.05)。结论远隔肢体缺血后适应在脑梗死TOAST分型和OCSP分型中,对不同亚型脑梗死短期预后产生不同的影响,提示RIPostC应在适宜的、有选择的脑梗死亚型中应用。

Effects of remote limb ischemic postconditioning on prognosis of cerebral infarction patients with different TOAST types and OCSP types

Objective To discuss the effects of remote limb ischemic postconditioning on prognosis of cerebral infarction pa-tients with different TOAST type and OCSP type.Methods 545 patients with acute cerebral infarction were selected.On the basis of routine treatment,the intervention of remote limb ischemic postconditioning.The NIHSS score was calculated during hospitali-zation and 7 days after treatment and calculated improvement rate.At the same time,all the patients were divided into TOAST and OCSP according to the standard and compared the NIHSS scores of different subtypes in each subtype.Results There was no sig-nificant difference in the NIHSS scores between the type of atherosclerosis,cardiac embolism,small artery occlusion,other causes of stroke,and unknown subtype in the TOAST typing(P >0.05).In the OCSP typing,the improvement rate of NIHSS score of the patients with complete anterior circulation infarction and partial anterior circulation infarction was better than that of lacunar infarction and posterior circulation infarction subtypes,there was statistical difference (P <0.05).Conclusion Remote limb ische-mic postconditioning has different effects on the short term prognosis of different subtypes of cerebral infarction in TOAST classi-fication and OCSP classification.It is suggested that RIPostC should be used in the appropriate and selective subtypes of cerebral infarction.