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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。
Objective: To investigate the effect of ischemic preconditioning on the curative effect of acute cerebral infarction (ACI) and the level of serum matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF). Methods: From January 2012 to December 2015 in our hospital for diagnosis and treatment of acute cerebral infarction occurred in 60 cases of transient ischemic attack ACI patients, according to whether patients with type 2 diabetes mellitus (T2DM) were divided into ACI group (n = 36) and ACI + T2DM (n = 24). The other 20 patients with ACI who had no transient ischemic attack prior to acute cerebral infarction were selected as the control group. All patients were treated with conventional symptomatic treatment. The curative effect of three groups of patients was compared. The levels of serum MMP-9, VEGF, NIHSS, Barthel index and infarct volume before and after treatment were compared. Results: The effective rate of ACI group was 94.44%, which was significantly higher than that of ACI + T2DM group and control group. Compared with ACI + T2DM group and control group, the MMP-9 level and NIHSS score of ACI group were significantly decreased. The levels of VEGF and Barthel Index significantly increased; ACI group infarct volume was significantly lower than ACI + T2DM group and control group. Conclusion: Ischemic preconditioning can reduce the level of MMP-9, upregulate the level of VEGF, improve the clinical efficacy of ACI patients, reduce the degree of neurological deficits and improve the ability of patients to take care of themselves. However, Not obvious.