医学
神经保护
临床试验
冲程(发动机)
缺血
缺血性中风
蛛网膜下腔出血
机制(生物学)
神经科学
重症监护医学
心脏病学
麻醉
内科学
哲学
工程类
认识论
生物
机械工程
作者
David C. Hess,Rolf Ankerlund Blauenfeldt,Grethe Andersen,Kristina Dupont Hougaard,Md Nasrul Hoda,Yuchuan Ding,Xunming Ji
标识
DOI:10.1038/nrneurol.2015.223
摘要
Remote ischaemic conditioning (RIC) triggers endogenous protective pathways in distant organs such as the kidney, heart and brain, and represents an exciting new paradigm in neuroprotection. RIC involves repetitive inflation and deflation of a blood pressure cuff on the limb, and is safe and feasible. The exact mechanism of signal transmission from the periphery to the brain is not known, but both humoral factors and an intact nervous system seem to have critical roles. Early-phase clinical trials have already been conducted to test RIC in the prehospital setting in acute ischaemic stroke, and in subarachnoid haemorrhage for the prevention of delayed cerebral ischaemia. Furthermore, two small randomized clinical trials in patients with symptomatic intracranial atherosclerosis have shown that RIC can reduce recurrence of stroke and have neuroprotective activity. RIC represents a highly practical and translatable therapy for acute, subacute, and chronic neurological diseases with an ischaemic or inflammatory basis. In this Review, we consider the principles and mechanisms of RIC, evidence from preclinical models and clinical trials that RIC is beneficial in neurological disease, and how the procedure might be used in the future in disorders such as vascular cognitive impairment and traumatic brain injury.
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