Department of Neurology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China.
Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
CNS Neurosci Ther. 2024 Apr;30(4):e14507. doi: 10.1111/cns.14507. Epub 2023 Nov 6.
Stroke is a leading cause of global morbidity and mortality, indicating the necessity and urgency of effective prevention and treatment. Remote ischemic conditioning (RIC) is a convenient, simple, non-intrusive, and effective method that can be easily added to the treatment regime of stroke patients. Animal experiments and clinical trials have proved the neuroprotective effects of RIC on brain injury including (examples of neuroprotective effects). This neuroprotection is achieved by raising brain tolerance to ischemia, increasing local cerebral blood perfusion, promoting collateral circulations, neural regeneration, and reducing the incidence of hematomas in brain tissue. This current paper will summarize the studies within the last 2 years for the comprehensive understanding of the use of RIC in the treatment of stroke.
This paper summarizes the clinical research progress of RIC on stroke (ischemic stroke and hemorrhagic stroke (HS)). This paper is a systematic review of research published on registered clinical trials using RIC in stroke from inception through November 2022. Four major databases (PUBMED, WEB OF SCIENCE, EMBASE, and ClinicalTrials.gov) were searched.
Forty-eight studies were identified meeting our criteria. Of these studies, 14 were in patients with acute ischemic stroke with onset times ranging from 6 h to 14 days, seven were in patients with intravenous thrombolysis or endovascular thrombectomy, 10 were in patients with intracranial atherosclerotic stenosis, six on patients with vascular cognitive impairment, three on patients with moyamoya disease, and eight on patients with HS. Of the 48 studies, 42 were completed and six are ongoing.
RIC is safe, feasible, and effective in the treatment of stroke. Large-scale research is still required to explore the optimal treatment options and mechanisms of RIC in the future to develop a breakthrough in stroke prevention and treatment.
脑卒中是全球发病率和死亡率的主要原因,这表明有效预防和治疗的必要性和紧迫性。远程缺血预处理(RIC)是一种方便、简单、非侵入性且有效的方法,可以很容易地添加到脑卒中患者的治疗方案中。动物实验和临床试验已经证明了 RIC 对脑损伤的神经保护作用,包括(神经保护作用的例子)。这种神经保护作用是通过提高大脑对缺血的耐受性、增加局部脑血流灌注、促进侧支循环、神经再生和降低脑组织血肿的发生率来实现的。本文将总结过去 2 年中关于 RIC 在脑卒中治疗中的应用的研究,以便全面了解。
本文总结了 RIC 治疗脑卒中(缺血性卒中和出血性卒中等)的临床研究进展。这是一项对截止到 2022 年 11 月,使用 RIC 治疗脑卒中的注册临床试验的研究进行的系统综述。检索了四个主要数据库(PUBMED、WEB OF SCIENCE、EMBASE 和 ClinicalTrials.gov)。
符合我们标准的研究有 48 项。这些研究中,14 项是发病时间在 6 小时至 14 天的急性缺血性脑卒中患者,7 项是接受静脉溶栓或血管内取栓术的患者,10 项是颅内动脉粥样硬化狭窄患者,6 项是血管性认知障碍患者,3 项是烟雾病患者,8 项是出血性脑卒中患者。48 项研究中,42 项已完成,6 项正在进行中。
RIC 治疗脑卒中安全、可行、有效。未来仍需要进行大规模研究,以探索 RIC 的最佳治疗方案和作用机制,为脑卒中的预防和治疗带来突破。