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远程缺血预处理改善急性缺血性脑卒中患者预后的研究进展

Research progress on remote ischemic conditioning for improving prognosis of patients with acute ischemic stroke.

作者信息

Ren Liyan, Cui Junyi, Sun Lu, Zhou Lihua, Han Chunru, Ma Shuyu, Xue Shouru, Ma Linqing

机构信息

Department of Neurology, The People's Hospital of Suzhou New District, Suzhou, Jiangsu, China.

Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

出版信息

Biochem Biophys Rep. 2025 Jul 30;43:102184. doi: 10.1016/j.bbrep.2025.102184. eCollection 2025 Sep.

Abstract

Acute ischemic stroke is a serious global health burden which has high disability and mortality rates. Remote ischemic conditioning, a non-intrusive treatment method, triggers a series of biochemical reactions and enhances the brain's resilience to ischemia-reperfusion injury by applying brief, reversible ischemic stimuli to the limbs. Remote ischemic conditioning offers neuroprotection by lowering oxidative stress, deterring neuronal apoptosis, inhibiting inflammation, protecting mitochondrial function, and preserving the blood-brain barrier. Clinical studies have confirmed that remote ischemic conditioning improves neurological recovery, reduces infarct volume, and enhances prognosis. However, the type of remote ischemic conditioning, intensity, frequency, duration, location, and equipment types vary considerably. Furthermore, the clinical application of remote ischemic conditioning faces some challenges, such as developing standardized treatment plans, evaluating long-term effects and safety, and exploring personalized and optimized treatments. However, the precise mechanisms of remote ischemic conditioning remain complex, requiring further research. Further study should concentrate upon elaborating the peculiar molecular and cellular mechanisms of remote ischemic conditioning, developing an optimal, evidence-based standardized treatment plan, and evaluating its clinical feasibility through extensive, longstanding follow-up trials. In the future, remote ischemic conditioning may play a greater role in the treatment of acute ischemic stroke, optimize patient prognosis, and enhance living quality.

摘要

急性缺血性中风是一项严重的全球健康负担,其致残率和死亡率都很高。远程缺血预处理作为一种非侵入性治疗方法,通过对肢体施加短暂、可逆的缺血刺激,引发一系列生化反应,增强大脑对缺血再灌注损伤的耐受性。远程缺血预处理通过降低氧化应激、阻止神经元凋亡、抑制炎症、保护线粒体功能以及维持血脑屏障来提供神经保护作用。临床研究证实,远程缺血预处理可改善神经功能恢复、减小梗死体积并改善预后。然而,远程缺血预处理的类型、强度、频率、持续时间、部位和设备类型差异很大。此外,远程缺血预处理的临床应用面临一些挑战,如制定标准化治疗方案、评估长期效果和安全性以及探索个性化和优化治疗。然而,远程缺血预处理的确切机制仍然复杂,需要进一步研究。进一步的研究应集中于阐明远程缺血预处理独特的分子和细胞机制,制定最佳的、基于证据的标准化治疗方案,并通过广泛、长期的随访试验评估其临床可行性。未来,远程缺血预处理可能在急性缺血性中风的治疗中发挥更大作用,优化患者预后并提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6104/12335975/936f5eca2c8c/ga1.jpg

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