Clinical application of limbs ischemic precondition in non-cardiac ischemic stroke patients for secondary prevention

Objective To investigate the clinical efficacy of limb ischemic preconditioning(LIPreC) in non-cardiac ischemic stroke patients for secondary prevention. Methods A total of 360 patients with non-cardiac ischemic stroke confirmed by clinic and imaging from June,2011 to May,2014 were recruited and randomized divided by 1:1 into LIPreC group and control group(CON group).Accordance with the medication of China ischemic stroke and TIA secondary prevention guidelines 2010,both groups were treated to control the risk factors before or after recruitment.LIPreC group was given limb ischemic precondition training after the recruitment for one year.The ischemic lesions in head were analyzed by 3.0 T MR.NIHSS and MMSE were used to evaluate the clinical symptoms,recovery degree and cognitive function.The neurological improvement and re-infarction rate of patients were observed. Results ①The recurrence rate of cerebral infarction in LIPreC group(4.4%,8 cases) was lower than that in CON group(10.6%,19 cases),P=0.044.②The incidence of increasing intracranial lacunar infarct in LIPerC group(13.3%,24 cases) was lower than that in CON group(23.9%,43 cases),P=0.014.③MRI examination showed that the recurrent infarct volume in LIPreC group[(3.6±1.7) ml] was smaller than that in CON group[(5.4±1.3) ml],P=0.004.④The increased lacunar lesions count per capita in LIPreC group(1.6±0.2) was less than CON group(1.7±0.1),P=0.015.⑤The improvement rate of neurological deficit symptoms in LIPreC group(90.6%,163 cases) was higher than that in CON group(82.8%,149 cases),P=0.043.⑥The improvement rate of cognition in LIPreC group(88.6%,31 cases) was significantly higher than that in CON group(64.9%,24 cases),P=0.026. Conclusion LIPreC can reduce the recurrence rate of acute ischemic stroke,infarct volume of recurrence,number of new lacunar infarct and severity of secondary stroke,and so physical and cognitive dysfunction of non-cardiac ischemic stroke patients.LIPreC has a wide application prospect in the area of non-cardiac ischemic stroke secondary prevention.