Effect of Remote Ischemic Adaptation on Cerebral Protection in Patients with Actute Cerebral Infarction:a Meta-analysis

Yang Ting; Peng Mingqing; Jin Hongli

doi:10.12102/j.issn.1672-1349.2018.10.032

Abstract：Objective To evaluate the effect of remote ischemic adaptation on actute cerebral infarction in patients with actute cerebral infarction.Methods The computer retrieve was performed in the databases of PubMed,Wed of Science and Cochrane Library for ran-domized controlled trials(RCTs) about the effect of remote ischemic adaptation on cerebral protection in patients with actute cerebral infarction.The patients in intervention group were treated with several ischemia-reperfusion preconditioning of upper or lower ex-tremities,and patients in control group without any ischemic preconditioning.The primary indices were the National Institutes of Health Stroke Scale(NIHHS) score,serum C-reactive protein (CRP),D-dimer(D-D),fibrinogen (FIB),Barthel index (BI),Fugl-Meyer (FMA) score. Meta-analysis was conducted by RevMan 5.3 software.Results Nine studies were enrolled,of which 589 cases were in the remote ischemic adaptation group and 575 cases in the control group. Meta-analysis showed that the NIHSS scores in the remote ischemic adaptation group was significantly lower than that in control group[MD=-3.53,95% CI (-4.70,-2.37), P＜0.05]. In a sub-group analysis of Ischemic treatment group for upper extremities and lower extremities,the NIHSS scores in treatment groups were lower than that in control group( P＜0.05). The values of serum CRP,D-D,and FIB were significantly lower in treatment group than in control group ( P＜0.05). BI scores and FMA scores were significantly higher in treatment group than in control group ( P＜0.05). Conclusion Remote ischemic adaptation can tolerate cerebral ischemia and hypoxia,improve neurological function,and protect brain tissue in patients with ischemic brain injury.