机构：[1]Cerebral Vascular Diseases Research Institute (China-America Institute of Neuroscience), Xuanwu Hospital, and Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China神经内科中美神经科学研究所首都医科大学宣武医院首都医科大学•脑血管病研究所[2]Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston[3]Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI[4]Department of Biochemistry & Molecular Biology,Complex Carbohydrate Research Center, University of Georgia, Athens.
Objective: This study aims to evaluate protective effects of brief repetitive bilateral arm ischemic preconditioning (BAIPC) on stroke recurrence in patients with symptomatic atherosclerotic intracranial arterial stenosis (IAS). Methods: A total of 68 consecutive cases with symptomatic IAS, diagnosed by imaging, were enrolled in this prospective and randomized study. All patients received standard medical management. Patients in the BAIPC group (n = 38) underwent 5 brief cycles consisting of bilateral upper limb ischemia followed by reperfusion. The BAIPC procedure was performed twice daily over 300 consecutive days. Incidence of recurrent stroke and cerebral perfusion status in BAIPC-treated patients were compared with the untreated control group (n = 30). Results: In the control group, incidence of recurrent stroke at 90 and 300 days were 23.3% and 26.7%, respectively. In the BAIPC group, incidence of recurrent stroke was reduced to 5% and 7.9% at 90 and 300 days (p < 0.01), respectively. The average time to recovery (modified Rankin Scale score 0-1) was also shortened by BAIPC. Cerebral perfusion status, measured by SPECT and transcranial Doppler sonography, improved remarkably in BAIPC-treated brain than in control (p < 0.01). Conclusion: This study provides a proof-of-concept that BAIPC may be an effective way to improve cerebral perfusion and reduce recurrent strokes in patients with IAS. Further investigation of this therapeutic approach is warranted as some patients were excluded after randomization. Neurology (R) 2012; 79: 1853-1861
基金：
the National Natural Science Foundation (30870854 and 30770741, China)
the Foundation of the Beijing High Level Health Systems Talented Technical Personnel Program (2009–03-02, China)
第一作者机构：[1]Cerebral Vascular Diseases Research Institute (China-America Institute of Neuroscience), Xuanwu Hospital, and Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China[2]Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
通讯作者：
通讯机构：[1]Cerebral Vascular Diseases Research Institute (China-America Institute of Neuroscience), Xuanwu Hospital, and Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Ran Meng,Karam Asmaro,Lu Meng,et al.Upper limb ischemic preconditioning prevents recurrent stroke in intracranial arterial stenosis[J].NEUROLOGY.2012,79(18):1853-1861.doi:10.1212/WNL.0b013e318271f76a.
APA：
Ran Meng,Karam Asmaro,Lu Meng,Yu Liu,Chun Ma...&Xunming Ji.(2012).Upper limb ischemic preconditioning prevents recurrent stroke in intracranial arterial stenosis.NEUROLOGY,79,(18)
MLA：
Ran Meng,et al."Upper limb ischemic preconditioning prevents recurrent stroke in intracranial arterial stenosis".NEUROLOGY 79..18(2012):1853-1861
医学