Особенности ведения пациентов с хронической ишемией головного мозга в период пандемии COVID-19
https://doi.org/10.14412/2074-2711-2021-3-4-11
Аннотация
Отражены современные представления о роли артериальной гипертензии и сахарного диабета 2-го типа в развитии хронической ишемии головного мозга (ХИГМ). Развитие ХИГМ опосредовано церебральной микроангиопатией, основными патогенетическими звеньями формирования которой служат: ремоделирование артерий, повышение артериальной жесткости, эндотелиальная дисфункция, нарушение цереброваскулярной реактивности и воспаление, что в итоге приводит к поражению белого вещества головного мозга с развитием когнитивных нарушений. Ведущим патоморфологическим процессом, поражающим преимущественно перфорирующие артерии и артериолы, является артериолосклероз. Показано, что пандемия COVID-19 может модифицировать течение ХИГМ в силу наличия смежных патогенетических аспектов. В частности, COVID-ассоциированная коагулопатия способна инициировать формирование как бессимптомных, так и клинически манифестных лакунарных инфарктов. Рассмотрены особенности лечения пациентов с ХИГМ в период пандемии COVID-19. Сделан вывод, что особое внимание у данной группы пациентов следует уделять вопросам первичной и вторичной кардиоваскулярной профилактики, важным элементом которой является применение дипиридамола, поскольку он обладает плейотропным эффектом.
Об авторе
А. А. Кулеш
ФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера» Минздрава России
Россия
Россия
Алексей Александрович Кулеш
Кафедра неврологии и медицинской генетики
614590, Пермь, ул. Петропавловская, 26
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Рецензия
Для цитирования:
Кулеш АА. Особенности ведения пациентов с хронической ишемией головного мозга в период пандемии COVID-19. Неврология, нейропсихиатрия, психосоматика. 2021;13(3):4-11. https://doi.org/10.14412/2074-2711-2021-3-4-11
For citation:
Kulesh AA. Management tactics in patients with chronic cerebral ischemia during COVID-19 pandemic. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(3):4-11. https://doi.org/10.14412/2074-2711-2021-3-4-11
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