Department of Neurology, Stroke Center, The First Hospital of Jilin University, Chang Chun, Jilin, 130021, China.
Department of Neurology, Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Chang Chun, Jilin, 130021, China.
Ann Clin Transl Neurol. 2020 Jun;7(6):972-979. doi: 10.1002/acn3.51063. Epub 2020 May 29.
The objective of this study was to investigate the safety and efficacy of remote ischemic conditioning (RIC) combined with intravenous thrombolysis (IVT) in the treatment of acute ischemic stroke (AIS).
Patients with AIS who underwent IVT were enrolled and 1:1 randomized to the RIC group and sham-RIC group in this study. RIC (or sham-RIC) was performed twice within 6-24 h of IVT. The subjects in the two groups were followed up for 90 days. The safety outcome included the ratio of hemorrhagic transformation (HT), adverse events during the follow-up, blood pressure within the first 24 h after IVT, and laboratory tests 24 h after IVT. The efficacy outcome included the modified Rankin Scale (mRS) score, National Institute of Health Stroke Scale (NIHSS) score during the follow-up, and level of high-sensitivity C-reactive protein (hs-CRP) tested 24 h after IVT.
Forty-nine patients (24 in the RIC group and 25 in the sham-RIC group) were recruited. No significant difference was observed in the ratio of HT, adverse events, blood pressure, coagulation function or liver function between groups. In addition, there was no significant difference in mRS score and NIHSS score during the follow-up between groups. However, patients in the RIC group exhibited a significant lower level of hs-CRP compared with the control group (P = 0.048).
RIC combined with IVT is safe in the treatment of AIS. The neuroprotective and anti-inflammatory effects of this therapy warrant further study on a larger scale.
本研究旨在探讨远程缺血预处理（RIC）联合静脉溶栓（IVT）治疗急性缺血性脑卒中（AIS）的安全性和有效性。
本研究纳入接受 IVT 的 AIS 患者，并按 1:1 随机分为 RIC 组和假 RIC 组。RIC（或假 RIC）在 IVT 后 6-24 小时内进行两次。两组患者均随访 90 天。安全性结局包括出血转化（HT）比例、随访期间不良事件、IVT 后 24 小时内血压和实验室检查 24 小时后的 hs-CRP 水平。有效性结局包括改良 Rankin 量表（mRS）评分、随访期间 NIHSS 评分和 hs-CRP 水平。
共纳入 49 例患者（RIC 组 24 例，假 RIC 组 25 例）。两组间 HT 比例、不良事件、血压、凝血功能或肝功能无显著差异。此外，两组间随访期间 mRS 评分和 NIHSS 评分无显著差异。然而，RIC 组患者 hs-CRP 水平明显低于对照组（P=0.048）。
RIC 联合 IVT 治疗 AIS 安全。这种治疗的神经保护和抗炎作用值得进一步进行更大规模的研究。
