【摘要】 目的探讨远隔缺血预适应(RIPC)对脑小血管病患者认知功能障碍及血管生长因子(VEGF)表达水平的影响。方法收集145例脑小血管病患者为研究对象,随机分为RIPC组及对照组,RIPC组给予双上肢远隔缺血预适应干预及常规内科药物治疗,对照组仅给予常规内科药物治疗,观察2组患者开始干预24 h内、第1个月、第6个月的蒙特利尔认知评估量表(MoCA)评分及VEGF表达水平的变化。结果 RIPC组与对照组相比,在干预24 h内及第1个月MoCA评分未见明显差异(22.73±1.297 vs 23.15±1.921,23.49±1.482 vs 23.91±1.648,P>0.05),第6个月RIPC组MoCA评分明显高于对照组,差异有统计学意义(25.62±1.223 vs 25.09±1.387,P<0.05)。RIPC组与对照组干预24 h内VEGF表达水平均高于正常水平,组间比较未见明显差异(425.309±98.125 vs 445.581±84.115,P>0.05),第1个月、第6个月RIPC组VEGF表达水平均逐渐升高,对照组VEGF表达水平下降,组间比较差异有统计学意义(469.394±98.537 vs 405.108±98.558,557.775±89.197 vs 333.824±87.845,P<0.05)。结论 RIPC治疗可显著改善脑小血管病患者认知功能障碍,提高VEGF的表达水平。更多还原

【Abstract】 Objective To investigate the effects of remote ischemic preconditioning(RIPC) on cognitive dysfunction and VEGF expression in patients with cerebral microvascular disease.Methods A total of 145 patients with cerebral microvascular disease were collected and randomly divided into RIPC group and control group.The RIPC group was given preconditioning intervention and conventional medical drug therapy for bilateral upper limb distant ischemia,while the control group was only given conventional medical drug therapy.The changes of Montreal cognitive assessment scale(MoCA) and vascular endothelial growth factor(VEGF) expression were observed within 24 hours,1 month and 6 months after intervention.Results Compared with the control group,there was no significant difference in MoCA in the first 24 hours after intervention(22.73±1.297 vs 23.15±1.921,23.49±1.482 vs 23.91±1.648,P>0.05),and the MoCA score in the RIPC group was significantly higher than that in the control group at the 6 th month,and there were statistical differences between the groups(25.62±1.223 vs 25.09±1.387,P <0.05).The expression levels of VEGF in the RIPC group and the control group were all higher than the normal level within 24 hours after intervention,and no significant difference was observed between the groups(425.309±98.125 vs 445.581±84.115,P>0.05).The expression levels of VEGF in the RIPC group at the first and sixth months were gradually increased,while the expression levels of VEGF in the control group were decreased,and there were statistical differences between the groups(469.394±98.537 vs 405.108±98.558,557.775±89.197 vs 333.824±87.845,P <0.05).Conclusion Remote ischemic preconditioning can improve the cognitive dysfunction of patients with cerebral microvascular disease and increase the expression level of VEG F.更多还原