缺血预适应对 ACI 患者疗效和血清 MMP-9、VEGF 水平的影响

目的：研究缺血预适应对急性脑梗死（ACI）患者疗效和血清基质金属蛋白酶-9（MMP-9）、血管内皮生长因子（VEGF）水平的影响。方法：选择2012年1月～2015年12月在我院进行诊治在急性脑梗死前出现短暂性脑缺血发作的 ACI 患者60例，按照患者是否合并有2型糖尿病（T2DM）分为 ACI 组（n=36例）和 ACI+T2DM 组（n=24例），另选则同期入院诊治的20例在急性脑梗死前并无短暂性脑缺血发作的 ACI 患者为对照组。所有患者均进行常规对症治疗，比较三组患者的疗效、治疗前后血清 MMP-9、VEGF 水平、NIHSS 评分和 Barthel 指数、梗死灶体积。结果：ACI 组的有效率为94.44%，明显高于 ACI+T2DM 组和对照组；与 ACI+T2DM 组和对照组相比， ACI 组的 MMP-9水平和 NIHSS 评分明显降低，VEGF 水平和 Barthel 指数明显升高；ACI 组的梗死灶体积明显低于ACI+T2DM 组和对照组。结论：缺血预适应可以通过下调 MMP-9水平、上调 VEGF 水平，提高 ACI患者临床疗效，降低神经功能缺损程度，改善患者生活自理活动能力，但这种神经保护作用在 ACI 合并 T2DM 患者中并不明显。

Effect of ischemic preconditioning on the efficacy and serum MMP-9, VEGF levels of ACI patients

Objective To investigate the effect of ischemic preconditioning on the efficacy and serum MMP-9, VEGF levels of ACI patients. Methods Selected 60 cases of patients with ACI who were treated in our hospital from January 2012 to Decem-ber 2015, divided into ACI group (n=36) and ACI + T2DM group (n=24), and selected 20 patients as control group. All patients were given conventional symptomatic treatment, the efficacy, serum MMP-9, VEGF levels, NIHSS score, Barthel index, infarct volume were compared. Results The effective rate of ACI group was 94.44%, was significantly higher; the level of MMP-9 in ACI group reduced significantly, VEGF levels increased significantly, NIHSS score reduced significantly, Barthel index in-creased significantly; the infarction volume of ACI group was significantly lower than ACI+T2DM group and control group . Conclusion Ischemia preadaptation can reduce the MMP-9 levels, increase VEGF levels, improve the clinical efficacy of ACI patients, reduce the degree of nerve function defect, and improve life self-care ability, but the nerve protective effect is not ob-vious in ACI complicated with T2DM patients.