Aim. To study features of tissue oxygenation and changes in nitroxidergic and endothelinergic mechanisms of circulation regulation in ischemic stroke and hypoxia modeling. Methods. 74 men and women with ischemic stroke were examined and experimental study on 30 outbred white male rats was conducted. All patients underwent computed tomography of the brain, neurological status was assessed and general clinical examination was performed. Tissue oxygen tension was measured percutaneuosly using polarographic method. Chronic hypoxic hypoxia was simulated in animals by daily 40-50 minutes inhalation of 10% oxygen mixture for 4 weeks. Blood oxygen tension was evaluated in patients and laboratory animals. Nitric oxide level of was assessed by determining its stable metabolites. Endothelin-1 level was determined by ELISA. Data was analyzed using «Statistica 8.0» software using non-parametric tests. Differences were considered as statistically significant at p
Aim. To study the role of nitroxidergic reactions of the circulatory system in the development of ischemic stroke. Methods. 51 patients (both males and females) with the diagnosis of ischemic stroke were examined. All patients were distributed to 3 groups according to the severity of neurological deficit. All patients underwent brain computed tomography or magnetic resonance imaging. Cerebral blood flow was examined by extra and transcranial ultrasonic dopplerography. Central hemodynamics was evaluated by echocardiography. General clinical examination, neurological and neuroophthalmological examinations were also performed. Vasomotor endothelial function was assessed using a 7 MHz linear transducer on the ultrasound unit «Medison SonoAce X8». The level of nitric oxide was assessed using its stable metabolites, nitrite and nitrate definition in serum. Neurological status was assessed according to the USA National Institutes of Health Stroke Scale. Results. Disorders of nitroxidergic mechanisms of blood vessels regulation were observed in patients with ischemic stroke. Endothelium-dependent brachial artery dilation disorders and nitric oxide persistent metabolites level decrease were related to the severity of the disease and the neurological deficit degree. Conclusion. The study of endothelium-dependent vascular tone regulation mechanisms revealed that these mechanisms are involved in the pathogenesis of ischemic stroke; the study of these mechanisms can be used to clarify the severity of neurological deficit, and possible prognosis.
This study was undertaken to determine the general regularities of hemodynamic disorders in relation to the severity of brain damage for the subsequent development of pathogenetically warranted methods for their correction in the complex of intensive care for severe brain injury. Studies were made in 67 victims, by using neurophysiological studies (electroencephalography, studies of acoustical stem evoked potentials and somatosensory stem evoked potentials), computed tomography and magnetic resonance imaging. Central hemodynamics was studied by a Sirecust 1260 moni toring system using Swan Ganz catheters and thermodilution. The overall condition of the victims was regarded as very bad. Loss of consciousness was 8 4 scores by the Glasgow coma scale. The studies have indicated that the victims in whose clinical picture the signs of compression of the cerebral hemispheres dominate over those of the latter's contu sion develop a hemodynamic reaction by the normodynamic type. The hyperdynamic type of hemodynamic disorder develops in cerebral hemispheric and diencephalic lesions with a parallel increase in oxygen transport and uptake; and in severe brain injury, lower brain stem damages are accompanied by hemodynamic disorder by the hypodynamic type with a reduction in oxygen transport and uptake. Key words: severe brain injury; hyperdynamic, hypodynamic, and normodynamic types of circulation, brain injury.
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