Effect of remote post-ischemic conditioning on the prognosis of elderly patients with acute cerebral infarction

Objective To observe the effect of remote post-ischemic conditioning(RPIOC)on the cerebral blood flow, neural function and prognosis of patients with acute cerebral infarction and the risk factors for short-term prognosis. Methods 133 patients with acute cerebral infarction in the Second Hospital of Beijing from January 2016 to December 2017 were selected, and randomly divided into the RIPOC group(66 cases, with RPIOC)and the control group(67 cases, without RIPOC). In the first day after hospital, patients in the RIPOC group were given RIPOC, which was tightening the left aim with a tonometer bandage for 5 minutes per time and 2 times a day at an interval of 5 minutes.All patients were provided routine treatment.All patients' cerebral blood flow, neural function and survival data were recorded.Recovery was assessed by modified Rankin Scale(mRS)180 d after stroke.Logistic regression was used to evaluate the risk factors for prognosis. Results Of the 133 patients enrolled, there were 67 males.The mean age was(73.1±10.1)year.Basic clinical characteristics, neural function and cerebral blood flow were similar between groups(P>0.05). After 10 d treatment, cerebral blood flow and neural function was significantly increased(P<0.05)in the RIPOC group.After 180 d follow-up, the RIPOC group had significantly higher rate of adverse cerebrovascular events(P<0.05). Logistic regression analyses demonstrated that advanced age(P=0.003), hypertension(P=0.03)and high NIHSS score(P=0.005)were all risk factors for prognosis. Conclusions RIPOC can enhance the cerebral blood flow, activities of daily living, limb function and prognosis.However, it does not reduce the risk of mortality.Advanced age, hypertension and high NIHSS score are risk factors for short-term prognosis. Key words: Ischemic post conditioning; Brain infarction; Neuroprotective agents; Prognosis