远程缺血预处理对血管内支架植入患者脑血流调节的疗效：一项随机对照试验
Efficacy of remote ischemic conditioning on cerebral blood flow regulation in patients with endovascular stenting: a randomized controlled trial.
摘要(中文译文)
术后中风会破坏血管内支架治疗脑血管狭窄的益处。该试验调查了辅助远程缺血预处理（RIC）是否改善了脑血流（CBF）调节并降低了术后卒中的风险。共有104名接受血管内支架置入术的颅内或颅外脑血管狭窄患者被纳入研究，并随机接受RIC或假RIC（1:1）。术后连续7天每天进行两次干预。在基线、第7天或出院时，使用自发血压和CBF振荡的传递函数分析对CBF调节进行双侧评估。主要结局是相位差（PD）和增益，而次要结局是90天卒中发生率和安全性。RIC组受影响侧的PD值明显高于假RIC组（40.67°[26.76°-58.28°]对20.51°[10.90°-41.73°]，P < 0.001) 未受影响的一侧（36.04°[21.66°-54.53°]对26.80°[11.94°-44.83°]，P = 0.022),表明CBF调节得到改善。组内比较显示，RIC组从基线到第7天或出院时PD有显著改善（受影响侧：20.57°[8.70°-34.24°]对40.67°[26.76°-58.28°]，P < 0.001;未受影响的一侧：26.06°[8.70°-44.37°]对36.04°[27.66°-54.53°]，P = 0.001). RIC组90天卒中发生率显著降低（0.00%比9.62%，P = 0.022). 辅助RIC安全地增强了脑血管支架植入术后患者的CBF调节，并大大减少了术后卒中，这表明这是一种有前景的非药物策略来改善预后。该试验已在ClinicalTrials.gov（NCT05970653）上注册。
Abstract
Postoperative stroke can undermine the benefits of endovascular stenting for cerebrovascular stenosis. This trial investigated whether adjunctive remote ischemic conditioning (RIC) improves cerebral blood flow (CBF) regulation and reduces the risk of postoperative stroke. A total of 104 patients with intracranial or extracranial cerebrovascular stenosis who underwent endovascular stenting were enrolled and randomized to receive either RIC or sham-RIC (1:1). The intervention was administered twice daily for 7 consecutive days postoperatively. CBF regulation was assessed bilaterally using transfer function analysis of spontaneous blood pressure and CBF oscillations at baseline and on day 7 or at discharge. The primary outcomes were phase difference (PD) and gain, whereas the secondary outcomes were 90-day stroke incidence and safety. Significantly higher PD values were observed in the RIC group than in the sham-RIC group on the affected side (40.67° [26.76°-58.28°] vs. 20.51° [10.90°-41.73°], P < 0.001) and the unaffected side (36.04° [21.66°-54.53°] vs. 26.80° [11.94°-44.83°], P = 0.022), indicating improved CBF regulation. Intragroup comparisons revealed significant PD improvement from baseline to day 7 or discharge in the RIC group (affected side: 20.57° [8.70°-34.24°] vs. 40.67° [26.76°-58.28°], P < 0.001; unaffected side: 26.06° [8.70°-44.37°] vs. 36.04° [27.66°-54.53°], P = 0.001). The 90-day stroke incidence was significantly lower in the RIC group (0.00% vs. 9.62%, P = 0.022). Adjunctive RIC safely enhanced CBF regulation and substantially reduced postoperative stroke in patients after cerebrovascular stenting, suggesting a promising non-pharmacological strategy to improve outcomes. This trial was registered at ClinicalTrials.gov (NCT05970653).
如何引用
AMA
Yi-Ting Hou, Bao-Feng Xu, Huai-Mei Zhang, Peng Zhang, Qian-Yan He, Yang Qu, et al. Efficacy of remote ischemic conditioning on cerebral blood flow regulation in patients with endovascular stenting: a randomized controlled trial.. BMC medicine. 2026; doi:10.1186/s12916-026-05038-w.
APA
Yi-Ting Hou, Bao-Feng Xu, Huai-Mei Zhang, Peng Zhang, Qian-Yan He, Yang Qu, et al (2026). Efficacy of remote ischemic conditioning on cerebral blood flow regulation in patients with endovascular stenting: a randomized controlled trial.. BMC medicine. https://doi.org/10.1186/s12916-026-05038-w
GB/T 7714
Yi-Ting Hou, Bao-Feng Xu, Huai-Mei Zhang, Peng Zhang, Qian-Yan He, Yang Qu, et al. Efficacy of remote ischemic conditioning on cerebral blood flow regulation in patients with endovascular stenting: a randomized controlled trial.[J]. BMC medicine, 2026 doi:10.1186/s12916-026-05038-w.
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