Silina Ekaterina V, Rumyantceva Sofia A, Stupin Victor A, Parfenov Vladimir A, Bolevich Sergey B
Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str, 8, Moscow, 119991, Russia.
Department of Nervous Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str, 8, Moscow, 119991, Russia.
Can J Physiol Pharmacol. 2021 Jan;99(1):72-79. doi: 10.1139/cjpp-2020-0277. Epub 2020 Sep 10.
Examination of the patterns of free-radical processes (FRP) and changes of the early screening markers to predict the course of hemorrhagic stroke (HS) and applied pathophysiologically based therapy can be of great practical importance. This study aimed to determine early changes in the parameters of oxidative stress and routine biochemistry blood tests in patients with HS and to assess their relationship with clinical outcome. The effects of early applied cytoflavin were also investigated. The prospective study included 151 patients with HS. Forty-eight percent of patients in the standard conservative therapy were given cytoflavin antioxidant energy therapy from the first day of hospitalization. The neurological status, neuroimaging, biochemical blood tests and FRP were assessed on days 1, 5, 10, and 20 of hospitalization. In patients with HS, an imbalance of all stages of FRP was detected proportionately to the severity of HS. The malondialdehyde concentration above 5.3 μmol/L, the number of leukocytes above 15 800, glucose above 11.9 mmol/L, lactate dehydrogenase above 574 IU/L, and lactate above 2.5 mmol/L, detected on the first day, predetermined a high risk of death. Additional cytoflavin treatment allowed stabilizing the clinical laboratory picture of HS, improved the treatment results, and reduced hospital mortality rate.
研究自由基过程(FRP)模式以及早期筛查标志物的变化,以预测出血性中风(HS)的病程并应用基于病理生理学的治疗方法,可能具有重要的实际意义。本研究旨在确定HS患者氧化应激参数和常规血液生化检查的早期变化,并评估它们与临床结局的关系。还研究了早期应用细胞黄素的效果。这项前瞻性研究纳入了151例HS患者。48%接受标准保守治疗的患者从住院第一天起接受细胞黄素抗氧化能量治疗。在住院第1天、第5天、第10天和第20天评估神经状态、神经影像学、血液生化检查和FRP。在HS患者中,检测到FRP各阶段的失衡与HS的严重程度成比例。第1天检测到丙二醛浓度高于5.3μmol/L、白细胞数量高于15800、血糖高于11.9mmol/L、乳酸脱氢酶高于574IU/L以及乳酸高于2.5mmol/L,预示着高死亡风险。额外的细胞黄素治疗可使HS的临床实验室情况稳定,改善治疗效果,并降低医院死亡率。