Volume 20 Issue 8
Aug.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(8): 1328-1331
YUAN Hai-jun, HUANG Xiao-xia, LAN Zhi-jian, FU Li, PENG Wen-yong. Effects of different phase remote ischemic preconditioning on postoperative cognitive function and brain injury in patients with carotid endarterectomy[J]. Chinese Journal of General Practice, 2022, 20(8): 1328-1331. doi: 10.16766/j.cnki.issn.1674-4152.002588
Citation: YUAN Hai-jun, HUANG Xiao-xia, LAN Zhi-jian, FU Li, PENG Wen-yong. Effects of different phase remote ischemic preconditioning on postoperative cognitive function and brain injury in patients with carotid endarterectomy[J]. Chinese Journal of General Practice, 2022, 20(8): 1328-1331. doi: 10.16766/j.cnki.issn.1674-4152.002588
shu

Effects of different phase remote ischemic preconditioning on postoperative cognitive function and brain injury in patients with carotid endarterectomy

doi: 10.16766/j.cnki.issn.1674-4152.002588

  • Department of Anesthesiology, Jinhua Central Hospital, Jinhua, Zhejiang 321000, China

Funds:

 2020KY345

 2021-4-006

  • Received Date: 2022-04-06
    Available Online: 2022-09-26
    Abstract
  •   Objective  To investigate the effects of different phases of remote ischemic preconditioning (RIPC) on cognitive function and brain injury after carotid endarterectomy (CEA).  Methods  Sixty patients with severe carotid stenosis treated in Jinhua Central Hospital from June 2020 to July 2021 were randomly divided into group A (RIPC scheme 1 h before operation) and group B (RIPC scheme 24 h before operation), with 30 patients in each group. The neurological and cognitive functions and serum central nerve specific protein (S100) of the two groups were compared, including brain-derived neurotrophic factor (BDNF), inflammatory factors, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (map), heart rate (HR) and complications.  Results  Significant differences were noted in the interaction between the two groups at each time point, between groups and between groups and time (F=3.302, 4.321, 8.717, all P < 0.05). One month after operation, the MMSE score of group B [(28.54±1.44) points] was significantly better than that of group A [(27.35±1.31) points, P < 0.05]. The level of BDNF in group B [(4.92±0.51) ng/mL] was higher than that in group A [(3.56±0.13) ng/mL, P < 0.05]. At 24 h after operation, the levels of IL-6 and hsCRP in the two groups were higher than those at 1 day before operation (all P < 0.05). Significant differences were found in the interaction of SBP, DBP, map and HR between groups, groups and time between the two groups (all P < 0.05). The incidence of cognitive impairment was 16.67% in group A and 10.00% in group B. The difference between the two groups was not significant (P>0.05).  Conclusion  The implementation of RIPC 24 h before operation can effectively alleviate brain injury after CEA and improve the neurocognitive function of patients.

     

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