Sergeev D V, Domashenko M A, Piradov M A
Research Center of Neurology, Moscow, Russia.
Botkin Moscow City Clinical Hospital, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(4):86-91. doi: 10.17116/jnevro20171174186-91.
Despite recent advances in acute stroke care, clinical armamentarium against stroke remains limited. Furthermore, highly effective approaches to stroke treatment, such as systemic reperfusion and mechanical thrombectomy, cannot be performed in the majority of patients. Neuroprotective strategies, i.e. prevention of irreversible cell damage due to the ischemia, may improve stroke outcomes. However, only few pharmacological agents demonstrated clinical efficacy. Citicoline is an endogenous mononucleotide with neuroprotective effect and established clinical safety and tolerability, which effectiveness in acute stroke was studied in several large, well-controlled trials. Recent meta-analysis confirmed benefit of citicoline treatment in terms of increase of chance for better recovery of functional independence compared to placebo. Maximal effect of citicoline is seen when it is administered as soon as possible after stroke onset in patients who are not eligible for reperfusion therapy.
尽管急性中风治疗最近取得了进展，但针对中风的临床手段仍然有限。此外，大多数患者无法采用诸如全身再灌注和机械取栓等高效的中风治疗方法。神经保护策略，即预防因缺血导致的不可逆细胞损伤，可能会改善中风预后。然而，只有少数药物显示出临床疗效。胞磷胆碱是一种具有神经保护作用且临床安全性和耐受性已得到确立的内源性单核苷酸，其在急性中风中的有效性已在多项大型、严格对照试验中进行了研究。最近的荟萃分析证实，与安慰剂相比，胞磷胆碱治疗在提高功能独立性更好恢复的几率方面具有益处。对于不符合再灌注治疗条件的患者，在中风发作后尽快给予胞磷胆碱可获得最大效果。
