Effects of long range ischemic postconditioning on cerebral oxygen metabolism and serum BDNF and MMP-9 in patients with transient ischemic attack

YANG Yonggang; ZHANG Jianping; ZHAO Huiying; LI Guiqin

doi:10.3969/j.issn.1671-6450.2017.11.001

Abstract：Objective To observe the effects of remote ischemic postconditioning on cerebral oxygen metabolism and serum levels of brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) in patients with transient ischemic attack (TIA) and the mechanism of brain protection.Methods Two hundred patients were randomly divided into treatment group and control group,with 100 patients of each group.The control group received only secondary prevention guidelines of stroke and transient ischemic attack in 2011.The treatment group was trained with RIPC on the basis of medication in the control group.Cerebral oxygen metabolism indexes including SjvO2,CjvO2,Da-jvO2 and CaO2 were measured by cerebral blood oxygen monitor.Serum BDNF and MMP-9 levels were measured by enzyme linked immunosorbent assay (ELISA).The adverse reactions of the two groups were observed.Results The levels of SjvO2 and CjvO2 in patients with RIPC were higher than the control group (t =1.103,P =0.039;t =1.755,P =0.017),while Da-jvO2 and CaO2 were lower than the control group (t =1.096,P =0.042;t =3.302,P =0.019),the differences were statistically significant.The serum level of BDNF in treatment group was significantly higher than the control group (t =7.472,P =0.003),the expression of MMP-9 was significantly lower than the control group (t =7.894,P =0.001).Compared with the control group,a small number of patients in the treatment group showed numbness and pain in the limbs,but all of them could be relieved completely without any effect on the treatment.Conclusion Remote ischemic postconditioning training can regulate cerebral oxygen metabolism and serum BDNF and MMP-9 levels in patients with transient ischemic attack,further elaborated the cerebral protective mechanism of RIPC on TIA and providing the reliable data support for clinical treatment.