Abstract:

Objective　To explore the effect of remote ischemic conditioning (RIC) combined with edaravone and dexamethasone for patients with acute cerebral infarction. Methods　One hundred and sixty patients with acute cerebral infarction treated at The Third Affiliated Hospital of Xi'an Medical University between July 2021 and July 2023 were selected for the randomized controlled trial. The patients were divided into a control group and a study group by the random number table method, with 80 cases in each group. There were 41 males and 39 females in the control group; they were (63.37±7.48) years old. There were 46 males and 34 females in the study group; they were (62.59±6.97) years old. The control group were treated with edaravone and dexamethasone; in addition, the study group were treated with RIC. The total effective rates, incidence rates of adverse reactions, and levels of pro-inflammatory factors [tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6)], levels of S100 calcium-binding protein B (S100B), neurological function [scores of the Modified Rankin Scale (MRS) and the National Institutes of Health Stroke Scale (NIHSS)], and levels of neuroprotective factors [vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF)] before and 2, 4, 12 weeks after the treatment were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　There was a statistical difference in the total effective rate between the study group and the control group [92.50% (74/80) vs. 80.00% (64/80); P<0.05]. There was no statistical difference in the total effective rate between the study group and the control group [12.50% (10/80) and 10.00% (8/80); P>0.05]. After the treatment, the levels of TNF-α, IL-1β, S100B, and IL-6 were lower than those before the treatment in both groups, and the levels in the study group were lower than those in the control group (all P<0.05). After the treatment, the levels of VEGF and BDNF were higher than those before the treatment in both groups, and the levels in the study group were higher than those in the control group (all P<0.05). Conclusion　RIC combined with edaravone and dexamethasone for patients with acute cerebral infarction is effective, and can improve their neurological function and prognosis.

Key words: Acute cerebral infarction,  Remote ischemic conditioning,  Edaravone and dexamethasone,  Neurological function,  Inflammatory markers

摘要：

目的　探讨远端缺血适应（RIC）联合依达拉奉右莰醇治疗急性脑梗死患者的效果。方法　采用前瞻性、随机对照研究，选取2021年7月至2023年7月西安医学院第三附属医院收治的160例急性脑梗死患者为研究对象，随机数字表法分为对照组（接受依达拉奉右莰醇治疗）和研究组（在对照组基础上接受RIC治疗），均治疗12周。对照组80例，男41例、女39例，年龄（63.37±7.48）岁；研究组80例，男46例、女34例，年龄（62.59±6.97）岁。比较两组患者总有效率及不良反应发生率，比较两组患者治疗前与治疗2、4、12周时的促炎因子［肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）、白细胞介素6IL-6）］、s100钙结合蛋白（S100B）、神经功能［采用修订Rankin量表（MRS）评分、美国国立卫生研究院卒中量表（NIHSS）评分］、神经保护因子［血管内皮生长因子（VEGF）、脑源性神经营养因子（BDNF）］水平。采用t检验、χ2检验进行统计分析。结果　研究组患者总有效率92.50%（74/80），高于对照组的80.00%（64/80），两组比较差异有统计学意义（P<0.05）。研究组患者不良反应发生率12.50%（10/80），对照组为10.00%（8/80），两组比较差异无统计学意义（P>0.05）。治疗后两组患者TNF-α、IL-1β、IL-6、S100B水平及MRS、NIHSS评分均低于治疗前，且研究组低于对照组（均P<0.05）；治疗后两组患者VEGF、BDNF水平高于治疗前，且研究组高于对照组（均P<0.05）。结论　RIC联合依达拉奉右莰醇治疗急性脑梗死疗效显著，可改善患者的神经功能，提高整体预后

关键词: 急性脑梗死； ,  , 远端缺血适应； ,  , 依达拉奉右莰醇； ,  , 神经功能； ,  , 促炎因子