肢体远隔缺血预适应对缺血性脑梗死患者神经功能的保护作用

目的：探讨肢体远隔缺血预适应对缺血性脑梗死患者神经功能的保护作用。方法选择沧州市中心医院2013年3月—2014年4月收治的100例缺血性脑梗死患者，分为观察组（50例）和对照组（50例）。对照组采取单纯药物治疗，观察组在对照组基础上给予肢体远隔缺血预适应训练。治疗6个月后，比较治疗前后 NIHSS 评分、影像学表现（MRI、SPECT），评价临床疗效。结果两组治疗后 NIHSS 评分较治疗前均下降（ P ﹤0.05），治疗后观察组NIHSS 评分显著低于对照组（P ﹤0.01）；观察组总有效率（84.00%）显著高于对照组（62.00%），差异有统计学意义（P ﹤0.05）；MRI 显示新发梗死率观察组（4.00%）显著低于对照组（16.00%），SPECT 检查改善率观察组（82.00%）显著高于对照组（40.00%），差异均有统计学意义（P ﹤0.05，P ﹤0.01）。结论肢体远隔缺血预适应对缺血性脑梗死有良好的治疗效果，能显著提高神经功能水平，有效改善预后。

Effect of Limb Remote Ischemic Preconditioning on Neurological Function of Patients with Ischemic Cerebral Infarction

Objective To investigate the protective effect of limb remote ischemic preconditioning on neurologi-cal function of patients with ischemic cerebral infarction. Methods A total of 100 patients with ischemic cerebral infarc-tion admitted during March 2013 and April 2014 were divided into observation group( n = 50)and control group( n =50). The control group received only drug treatment,while the observation group was treated with limb remote ischemic preconditioning training on the basis of control group therapy. After 6 months of treatment,the National Institute of Health Stroke Scale(NIHSS)score and imaging findingsmagnetic resonance imaging(MRI),single photon emission compu-ted tomography(SPECT)]before and after the treatment were compared,and the clinical curative effects were also eval-uated in the two groups. Results The NIHSS scores after the treatment were decreased compared with those before the treatment in the two groups(P ﹤ 0. 05). After the treatment,the NIHSS score in observation group was significantly low-er than that in the control group( P ﹤ 0. 01);the total effective rate in observation group(84. 00% )was significantly higher than 62. 00% in the control group(P ﹤ 0. 05);MRI showed that new incidence rate of infarction in the observa-tion group(4. 00% )was significantly lower than 16. 00% in the control group,and SPECT showed that improvement rate in the observation group(82. 00% )was significantly higher than 40. 00% in the control group( P ﹤ 0. 05,P ﹤0. 01). Conclusion Limb remote ischemic preconditioning may achieve good therapeutic effect,significantly improve the level of neurological function and effectively improve the prognosis for patients with ischemic cerebral infarction.