Effect of mexidol on lipid-phospholipid profile changes in elderly patients with stroke
https://doi.org/10.14412/2074-2711-2018-2-68-75
Abstract
Objective: to evaluate the efficiency of incorporating of mexidol into combination drug therapy for elderly patients with acute ischemic and hemorrhagic stroke (IS and HS).
Patients and methods. Sixty patients aged 60 to 74 years with new-onset hemispheric stroke were examined. 34 patients of them were diagnosed with IS; 26 patients had intracerebral bleeding (ICB). A study group consisted of 31 patients who had taken mexidol in addition to therapy in accordance with the standards adopted in the Russian Federation. A comparison group included 29 patients who used only the standard therapy. Indicators were assessed using the National Institutes of Health Stroke Scale (NIHSS), the Riverbed mobility index, the modified Rankin scale, and the Barthel index before and during intravenous dropwise infusion of mexidol 500 mg for 10 days. The percentage absorption of lipidphospholipid complexes was also examined in the infrared spectrum of blood serum. A control group compromised 20 healthy individuals.
Results and discussion. The time course of changes in the serum lipid-phospholipid complexes was found to correlate with the type of stroke. The incorporation of mexidol into combination drug therapy for elderly patients with the acute period of IS and ICB contributed to the regression of focal neurological deficit and to the improvement of daily activity and functional independence. Mexidol also exerted a positive effect on the level of neuronal membrane phospholipids.
Conclusion. Mexidol was noted to have a positive effect on serum phospholipid levels. It is concluded that the incorporation of the drug into the combination therapy is effective in patients with acute IS and HS, in elderly people in particular.
About the Author
Yu. V. Abramenko
Tver State Medical University, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Competing Interests:
Contact: Yulia Vyacheslavovna Abramenko
4, Sovetskaya St., Tver 170100
References
1. Stakhovskaya LV, Kotova SV, editors. Insul't: Rukovodstvo dlya vrachei [Stroke: a guide for doctors]. Moscow: MIA; 2013.
2. Gusev EB, Konovalov AN, Nikiforov AS. Klinicheskaya nevrologiya [Clinical neurology]. Moscow: GEOTAR-Media; 2014.
3. Shmonin AA, Panov IYu, Simanenkova AV, et al. Endogenous neuroprotection in cerebral ischemia: erythropoietin, preand postconditioning. Eksperimental'naya nevrologiya. 2010; 4(3):29-35. (In Russ.).
4. Kadykov AS, Shakhparonova NV. Lechenie i reabilitatsiya bol'nykh v vosstanovitel'nom i rezidual'nom periodakh insul'ta. Metodicheskie rekomendatsii [Treatment and rehabilitation of patients in the recovery and residual periods of stroke. Methodical recommendations]. Moscow: Nauchnyi tsentr nevrologii RAMN; 2014.
5. Stakhovskaya LV, Meshkova KS, Dadasheva MN, et al. Multicenter randomized prospective double blind placebo controlled study of safety and efficacy of Cortexin in acute and early recovery period of hemispheric ischemic stroke. Vestnik rossiiskoi voennomeditsinskoi akademii. 2012;(1):238-44. (In Russ.).
6. Saver JL, Starkman S, Eckstein M, et al; FAST-MAG Investigators and Coordinators. Prehospital use of magnesium sulfate as neuroprotection in acute stroke. N Engl J Med. 2015 Feb 5;372(6):528-36. doi: 10.1056/NEJMoa1408827.
7. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis. 2008;25(5):457-507. doi: 10.1159/000131083. Epub 2008 May 6.
8. Powers WJ, Rabinstein AA, Ackerson T, et al; on behalf of the American Heart Association Stroke Council. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018 Mar;49(3):e46-e110. doi: 10.1161/STR.0000000000000158. Epub 2018 Jan 24.
9. Torshin IYu, Gromova OA, Sardaryan IS, et al. Comparative chemoreactome analysis of mexidol. Farmakokinetika i farmokodinamika. 2016;(4):19-30. (In Russ.).
10. Piradov MA, Tanashyan MM, Domashenko MA, Maksimova MYu. Neuroprotection in cerebrovascular diseases. Medicamente. 2016;(1):4-13. (In Russ.).
11. Khasanova DR, Gavrilov IA, Prokof'eva YuV, Kamalov IR. Experience of introduction of multilevel system of rendering medical care to patients with stroke in the Republic of Tatarstan. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2014;114(2): 74-9. (In Russ.).
12. Stakhovskaya LV, Tyutyumova EA, Fedin AI. Modern approaches to neuroprotective therapy of ischemic stroke. Zhurnal nevrologii i psikhiatrii im. S. S. Korsakova. 2017;117(2):75-80. (In Russ.).
13. Piradov MA, Tanashyan MM, Domashenko MA, et al. Neuroprotection in cerebrovascular diseases: the search for life on Mars or promising direction of treatment? Part 1. Acute disorders of cerebral circulation. Annaly klinicheskoi i eksperimental'noi nevrologii. 2015;9(1):41-50. (In Russ.).
14. Novikova LB, Sharafutdinova LR, Sharapova KM. The use of Mexidol in the acute period of ischemic stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2013;113(9):83-5. (In Russ.).
15. Shchepankevich LA, Nikolaev YuA, Dolgova NA. Optimization of lipid lowering therapy in patients with ischemic stroke and diabetes mellitus of the 2nd type. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;116(2):42-5. (In Russ.).
16. Tanashyan MM, Lagoda OV, Antonova KV. Vascular diseases of the brain: the perspective of pathogenetic metabolic hemangiocorrection. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2015;115(9): 78-83. (In Russ.).
17. Yanishevskii SN, Tsygan NV, Golokhvastov SYu, et al. Modern protection strategies in hypoxic-ischemic brain damage. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2017;117(12):78-86. (In Russ.).
18. Abramenko YuV. Evaluation of clinical efficacy, vasoactive and metabolic effects of Mexidol in elderly patients with dyscirculatory encephalopathy. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2011;111(11)35-41. (In Russ.).
19. Chukanova EI, Chukanova AS, Mamaev KhI. Results of the study of the efficacy and safety of Mexidol in patients with chronic cerebral ischemia. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2015;115(2):71-4. (In Russ.)
20. Antipenko EA, Deryugina AV, Gustov AV. Systemic stress limiting effect of Mexidol in chronic cerebral ischemia. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;116(4): 28-31. (In Russ.).
21. Zhivolupov SA, Samartsev IN, Ivanova KV. Evolution of optimization of stroke treatment. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2012;112(8):49-58. (In Russ.).
22. Chefranova ZhYu, Makotrova TA, Udachin VA, Koledintsev EV. Evaluation of the effectiveness of Mexidol in combination with thrombolytic therapy in patients with ischemic stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2012;112(4): 49-52. (In Russ.).
23. Odinak MM, Yanishevskii SN, Tsygan NV, et al. Application of succinate to correct metabolic disorders in the area of ischemic penumbra in patients with stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2013;113(12): 12-7. (In Russ.).
24. Skvortsova VI, Stakhovskaya LV, Nartsissov YaR, et al. Randomized double blind placebo-controlled study of the efficacy and safety of Mexidol in the complex treatment of ischemic stroke in the acute period. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2006;106(18):47-54. (In Russ.).
25. Stakhovskaya LV, Shamalov NA, Khasanova DR, et al. The results of a randomized double-blind multicenter, placebo-controlled, parallel-group study of the efficacy and safety of Mexidol during long-term sequential therapy in patients in the acute and early recovery periods of hemispheric ischemic stroke (EPICA). Zhurnal nevrologii i psikhiatri im. S.S. Korsakova. 2017;117(3):55-65. (In Russ.).
26. Voronina TA. Pioneer of antioxidant neuroprotection. 20 years in clinical practice. Russkii meditsinskii zhurnal. 2016;24(7):434-8. (In Russ.).
27. Fedin AI. Klinicheskie aspekty patogeneticheskoi terapii ishemii golovnogo mozga. Minimizatsiya negativnogo prognoza [Clinical aspects of pathogenetic therapy of cerebral ischemia. Minimization of negative prognosis]. Moscow: AST; 2016.
28. Shmidt EV. Classification of vascular lesions of the brain and spinal cord. Zhurnal nevropatologii i psikhiatrii im. S.S. Korsakova. 1985;85(9):1281-8. (In Russ.).
29. Ermolova SN, Shpak LV, Zubareva GM. Effect of Mexidol on changes in lipid-phospholipid profile and water component of blood serum in acute coronary syndrome. Kardiologiya i serdechno-sosudistaya khirurgiya. 2015;(6): 58-66. (In Russ.).
30. Solov'eva EYu, Farrakhova KI, Karneev AN, Chipova DT. The role of phospholipids in ischemic brain damage. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;116(1):104-12. (In Russ.).
Review
For citations:
Abramenko Yu.V. Effect of mexidol on lipid-phospholipid profile changes in elderly patients with stroke. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):68-75. (In Russ.) https://doi.org/10.14412/2074-2711-2018-2-68-75
Views: 666
Email this article 