Index of SMK: 616.831-005.1-056:616.12-008.331

B.K.Duyssembayev, A.Sh.Oradova.

ANTIOXIGEN THERAPY OF THE ISCHEMIC STROKE

In recently quite a number of studies is dedicated to searching for of hereditary factors, predisposing to development of vascular diseases of brain. In this review, we have systematized the results of the influence emoxipin on clinical neurological, biohimich indicators and cerebral hemodynamic in patients with ischemic stroke.

Key words: "genes-candidates", cardiovascular diseases.

Relevance. In the neurological department of Clinical Hospital № 7 Almaty emoksipin was first used in the treatment of patients with transient ischemic stroke by type of transient ischemic attacks and dyscirculatory encephalopathy with episodes of recurrent ischemic CVD. The study showed a positive effect on emoxipine LPO, as well as the correlation between the dynamics of the clinical status of patients, a dose of medication injected and the level of LPO products. Thus, in the case of a positive clinical effect of the drug in the patients tended to deposit endogenous antioxidants and decreased ability of lipids to oxidation. The clinical effect emoxipine was presented to improve subjective well-being of patients, a decrease of headache and vestibulomozzhechkovyh disorders (dizziness, staggering when walking). Data on the pathogenetically significant increase in LP activity and decrease the level of endogenous antioxidants in the blood and serum lipoproteins in patients dyscirculatory encephalopathy with episodes of recurrent ischemic CVD served as a basis for studying the influence emoxipine on the status of these processes in ischemic stroke, depending on the mechanism for its development and the degree of neurological deficit .
Materials: This study included 32 patients with focal ischemia in the middle cerebral artery, which came to the clinic during the first days of the onset. All patients - both treated for emoksipin (16) and placebo (16) - basic therapy. The scheme of treatment was standardized. Patients of the group in the acute stage of stroke (1 to 7 days) received a dose of emoksipin 720 mg / day intravenously, and patients of the control group - a similar pattern placebo.
Methods of examination: The state of LPO was assessed by Fe2 +-induced chemiluminescence of apo-B-lipoprotein serum and spektrofluorimetricheski - in terms of products reacting with thiobarbituric acid in the blood [1].
In the study of LPO before treatment in all patients revealed a significant increase in the intensity of LPO. A comparative study of LP in patients of both groups in the 1 st day of the disease evidence of their comparability. By the end of the most acute period of treatment with emoksipin showed a decrease of H, reflecting the ability of lipids to oxidation, and increase the level of endogenous antioxidants (t) to the norm. In patients treated with placebo, all indicators were modified LPO. The content of hydroperoxides (h) and the ability of lipids to oxidation (H) were still elevated compared with the norm. Sustained reduction in the resistance of lipoproteins to the Fe2 +-induced free radical oxidation (t) indicative of depletion of endogenous antioxidant reserve.
In the overall assessment of neurological status in the whole group of patients with acute ischemic stroke in the treatment of emoksipin or placebo failed to reveal significant differences. In patients with severe disease and patients with mild stroke dynamics in the treatment of neurological deficit emoksipin did not differ significantly from the relevant parameters in the control group. At the same time, patients with moderate stroke patients receiving emoksipin achieved stabilization of neurological status compared with the placebo group, noting the increase in motor disorders.
We studied the effect emoxipine on the state of LPO in different pathogenetic mechanisms of stroke. In atherothrombotic stroke, which runs the most heavily emoksipin no significant effect on lipid parameters. In cardioembolic and lacunar stroke patients receiving emoksipin was an increase in the level of endogenous antioxidants and reduce the ability of lipids to oxidation.
Thus, emoksipin proved effective in patients with cardioembolic and lacunar stroke average severity.
The most promising of the drugs with antioxidative properties and is highly hydrophilic carnosine.
Results and discussion: As a result of carnosine metabolism in cells and tissues are formed products that have biological significance:-alanine, stimulating collagen formation, and the histidine involved in the biosynthesis of proteins and neurotransmitters. The basis of the pharmacological effect of carnosine is, apparently, a combination of antioxidant and immunomodulatory activity [2].
In 67% of animals treated with carnosine, a common condition after ischemic stroke can be assessed as light. In the control group, where instead of carnosine were administered saline, 90% of animals develop severe and moderate course of experimental cerebral ischemia.
Thus, carnosine has been effective in the correction of acute ischemic CVD: reduces the severity of local cerebral and neurological symptoms [3].

Bibliography
1. Souslin ZA, Fedorova TN, Kistenev BA, Khrapova EV, Maxi-mov MY Zh neurological and psychiatric 1999, 7: 99: 33-37.
2.Fedorova TN, Khrapova EV Medical and biological aspects of antioxidants. 2002; 61-65.
3. Fedorova TN Lipid peroxidation in cerebral ischemia and possibilities of its pharmacological correction: Abstract. Dis. ... Cand. biol. Science. M 2005.