远程缺血调理可改善无症状颅内动脉粥样硬化患者的脑血流动力学:PET/CT 引导的随机对照研究。

IF 2.9 3区 医学 Q2 NEUROSCIENCES
Hong An, Hongrui Ma, Chuanjie Wu, Chunlei Cui, Longfei Wu, Wenbo Zhao, Bixiao Cui, Sijie Li, Di Wu, Wenli Hu, Xunming Ji
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引用次数: 0

摘要

无症状性颅内动脉狭窄(sICAS)患者的血流动力学状况很差,急性缺血性中风(AIS)复发率很高。我们旨在通过 PET/CT 评估脑血流(CBF)和脑葡萄糖代谢(CGM),评估远程缺血调理(RIC)对改善这种状况的疗效。随机化前6个月内患有大脑中动脉单侧sICAS和/或颈内动脉颅内段相关AIS或短暂性脑缺血发作的成人患者被纳入研究。排除了接受静脉溶栓或血管内治疗的患者,或由心脏栓塞、小血管闭塞或其他确定原因引起的 sICAS 患者。23 名符合条件的患者被随机分配到标准药物治疗(SMT)组(10 人)或 RIC 组(13 人)。RIC方案包括5个周期,每个周期为双侧上肢缺血5分钟和再灌注5分钟,每天两次,总疗程为3个月。10 名健康志愿者作为健康对照组。我们测试了静息阶段和甲氮酰胺诱导应激阶段的 CBF 和 CGM。所有患者均在基线和三个月随访时接受了 PET/CT 检查。在静息阶段和应激阶段,sICAS 患者同侧大脑半球的 CBF 和 CGM 均显著下降(p
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Remote ischemic conditioning improves cerebral hemodynamics in symptomatic intracranial atherosclerosis: A PET/CT-guided randomized controlled study

Remote ischemic conditioning improves cerebral hemodynamics in symptomatic intracranial atherosclerosis: A PET/CT-guided randomized controlled study

Patients with symptomatic intracranial arterial stenosis (sICAS) suffer embarrassed hemodynamic status and acute ischemic stroke (AIS) recurrence. We aimed to assess the efficacy of remote ischemic conditioning (RIC) on improving this status by evaluating cerebral blood flow (CBF) and cerebral glucose metabolism (CGM) via PET/CT. Adult patients with unilateral sICAS in middle cerebral artery and/or intracranial segment of internal carotid artery-related AIS or transient ischemic attack within 6 months prior to randomization were enrolled. Individuals who received intravenous thrombolysis or endovascular treatment, or sICAS caused by cardiac embolism, small vessel occlusion, or other determined causes were excluded. Twenty-three eligible patients were randomly assigned to standard medical treatment (SMT) (n = 10) or RIC group (n = 13). The RIC protocol consisted of 5 cycles, each for 5-min bilateral upper limb ischemia and 5-min reperfusion period, twice a day, with a total duration of 3 months. Ten healthy volunteers were enrolled as healthy control group. We tested CBF and CGM at the rest stage and the methazolamide-induced stress stage. All patients received PET/CT at baseline and three-month followup. Both CBF and CGM in ipsilateral hemisphere of sICAS patients were significantly decreased at the rest stage and the stress stage (p < .05), which were improved by three-month RIC (p < .05). The lesions decreased notably in RIC group compared to SMT group (p < .05). RIC ameliorated the hemodynamic status and glucose metabolism in regions at high risk of infarction, which might improve the resistance capacity towards ischemic load in sICAS patients.

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来源期刊
Journal of Neuroscience Research
Journal of Neuroscience Research 医学-神经科学
CiteScore
9.50
自引率
2.40%
发文量
145
审稿时长
1 months
期刊介绍: The Journal of Neuroscience Research (JNR) publishes novel research results that will advance our understanding of the development, function and pathophysiology of the nervous system, using molecular, cellular, systems, and translational approaches. JNR covers both basic research and clinical aspects of neurology, neuropathology, psychiatry or psychology. The journal focuses on uncovering the intricacies of brain structure and function. Research published in JNR covers all species from invertebrates to humans, and the reports inform the readers about the function and organization of the nervous system, with emphasis on how disease modifies the function and organization.
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