摘要： 研究背景 肢体远隔缺血期适应已成为脑缺血-再灌注损伤中的一项治疗策略，然而目前应用的缺血期适应方法为有创性操作技术，限制了其长期应用的可能性，更难实现基础研究向临床应用的转化。鉴于此，若能使无创性肢体远隔缺血期适应与有创性肢体远隔缺血期适应具有同样的脑保护效果，则更有利于临床推广。方法 采用线栓法建立大鼠大脑中动脉缺血-再灌注损伤模型，分别于缺血开始通过肢体远端气囊加压法或远隔肢体动脉夹闭（缺血）10min-再灌注10min（共3 个循环）方法，制备无创和有创缺血期适应动物模型。根据12分评分法进行神经功能评分、TTC 染色测定脑梗死体积和脑水肿程度。结果 与单纯缺血-再灌注损伤组相比，无创和有创缺血期适应组大鼠神经功能评分改善（P = 0.041，0.035）、脑水肿体积（P = 0.040，0.028）和梗死灶体积缩小（P = 0.001，0.019），但两缺血期适应组之间缺血-再灌注后神经功能评分、脑水肿程度和梗死灶体积差异无统计学意义（P = 0.754，0.946，0.667）。 结论 无论是有创或无创肢体远隔缺血期适应对脑缺血-再灌注损伤动物模型均具有保护作用，而两种缺血期适应方法的脑保护作用无明显差异。

关键词: 脑缺血, 再灌注损伤, 四肢, 远隔缺血期适应（非MeSH词）, 疾病模型, 动物

Abstract: Background  Limb remote ischemic per-conditioning (LRPC) has been recognized as an applicable strategy in protecting against cerebral ischemia- reperfusion injury. However, widely used invasive limb remote ischemic per-conditioning (LRPC-I) is traumatic, limiting the possibility of long-term application and making it more difficult to achieve the conversion from basic research to clinical practice. Because of this, if non-invasive limb remote ischemic per-conditioning (LRPC-N) has the same effect of brain protection as LRPC-I, it may be more beneficial to clinical practice. Methods  The middle cerebral artery occlusion (MCAO) ischemia-reperfusion injury model was established by the suture method in mice. In the beginning of the ischemia, the LRPC-I and LRPC-N were respectively carried out by three cycles of 10 min distal airbag pressurization or clamping the distant limb artery (ischemia) /10min reperfusion. Neurological functional deficits after procedure were evaluated, and the cerebral infarct volumes and the degree of cerebral edema were quantified by TTC staining. Results  Compared with the control group, the neurological functional outcomes of LRPC-N group and LRPC-I group were improved significantly ( P = 0.041, 0.035); the edema volumes were much smaller ( P = 0.040, 0.028); the infarct volumes reduced significantly ( P = 0.001, 0.019). However, there were no significant differences between LRPC-N group and LRPC-I group on the functional neurological outcomes, edema volumes and the infarct volumes (P = 0.754, 0.946, 0.667). Conclusion  Both the LRPC-N and LRPC-I have protective effects on animal models of cerebral ischemia-reperfusion injury, and there is no obvious difference between each other.

Key words: Brain ischemia, Reperfusion injury, Extremities, Remote ischemic per-conditioning (not in MeSH), Disease models, animal