Клиникопатогенетические особенности ишемического инсульта у лиц молодого возраста и оптимизация тактики его лечения

Аннотация

Subjects of research: 200 patients with ischemic stroke (150 - young and 70 -older), 200 adult male rats. Purpose of work: comprehensive study of clinical and pathogenetic features of ischemic stroke at young age on the basis of biochemical, immunohistochemical parameters with predicting outcome and subsequent optimization of therapeutic tactics. Methods of research: clinical, paraclinical, experimental, biochemical, immunohistochemical, and statistical methods of investigation. The results obtained and their novelty. For the first time it has been identified the relative risk of ischemic stroke in young adults compared to older age groups that allowed design the table of predictive risk of ischemic stroke in young people. The basic mechanisms of disease pathogenesis and new data on the representation of different pathogenetic subtypes of ischemic stroke in young patients were established, as well as the clinical features and variants of stroke course in the young were identified. Along with the study of the phospholipid spectrum of brain neurocytes membranes, for the first time was investigated the sphingomyelin cycle in dynamics of ischemic stroke in experiment with an early assessment of neuroprotection including cmoxipinum and ccrcbrolysin. Individual sensitivity of antiapoptosis protein Bel-2 and proapoptosis protein P53 to the use of various types of drug therapy in ischemic stroke was noted. Clinical studies have confirmed the efficacy of the earlier inclusion of ccrcbrolysin and emoxipinum in comprehensive therapy of ischemic stroke in young people, especially their combined application. Practical value. The developed predictive table will enhance the quality of diagnosis, treatment and prevention of ischemic stroke. The role of membranedestructive process and apoptosis factors that determine the pattern of the pathogenesis and course of ischemic stroke should be considered for improvement of therapeutic and diagnostic activities. The proposed scheme of treatment of stroke in acutest stage allows for an earlier restoration of impaired functions, shorten hospitalizations, and facilitate the subsequent management of patients at stages of rehabilitation. Degree of embed and economic effectivity. Results of the research have been introduced into medical-diagnostic practice of departments of neurology and intensive care Tashkent Medical Academy and Republic clinical hospital, students study process of Tashkent Medical Academy, masters degree of departments of neurology. Field of application: medicine, neurology, intensive care, resuscitation.