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In the past decade, stroke incidence in younger adults increased. Methionine synthase reductase (MTRR) A66G polymorphism is one of the risk factors for ischemic stroke (IS). However, clinical features of IS in MTRR A66G polymorphism are not yet studied.Objective: to investigate clinical features of IS in MTRR A66G polymorphism.Patients and methods. One hundred forty-one younger patients with IS, hospitalized in the neurological department of Sverdlovsk Regional Clinical Hospital №1, were included in the study. MTRR A66G polymorphism was detected by the real-time polymerase chain reaction in all participants.Results and discussion. MTRR A66G polymorphism was present in 83.7% of younger patients with IS. Participants with MTRR A66G polymorphism had a significantly higher prevalence of arterial hypertension (р=0.029). In addition, protein C level was significantly lower in patients with MTRR A66G mutation (р=0.001).Conclusion. The majority of younger patients with IS have MTRR A66G polymorphism. Therefore, the inclusion of MTRR A66G polymorphism screening in the diagnostic algorithm of stroke in young adults seems necessary.
In the past decade, stroke incidence in younger adults increased. Methionine synthase reductase (MTRR) A66G polymorphism is one of the risk factors for ischemic stroke (IS). However, clinical features of IS in MTRR A66G polymorphism are not yet studied.Objective: to investigate clinical features of IS in MTRR A66G polymorphism.Patients and methods. One hundred forty-one younger patients with IS, hospitalized in the neurological department of Sverdlovsk Regional Clinical Hospital №1, were included in the study. MTRR A66G polymorphism was detected by the real-time polymerase chain reaction in all participants.Results and discussion. MTRR A66G polymorphism was present in 83.7% of younger patients with IS. Participants with MTRR A66G polymorphism had a significantly higher prevalence of arterial hypertension (р=0.029). In addition, protein C level was significantly lower in patients with MTRR A66G mutation (р=0.001).Conclusion. The majority of younger patients with IS have MTRR A66G polymorphism. Therefore, the inclusion of MTRR A66G polymorphism screening in the diagnostic algorithm of stroke in young adults seems necessary.
Background. Inflammatory changes in the vascular wall play an important role in the progression of cerebral atherosclerosis and the occurrence of its complications, including stroke. The infl uence of transcranial direct current stimulation and methods of secondary prevention of stroke on the inflammatory changes in the blood that develop in the acute period of acute cerebral catastrophe has not been fully studied. Objective: to evaluate changes in blood parameters reflecting inflammatory changes in patients in the early recovery period of ischemic stroke against the background of complex rehabilitation measures, including transcranial direct current stimulation and secondary prevention measures. Material and methods. 78 patients in the early recovery period of ischemic stroke aged from 42 to 75 years (average age 59.50 [54.50; 64.50]) were examined. Patients are divided into 2 groups: 1 — transcranial direct current stimulation was used (46 people, 59.0 %), 2 — it was not used (32 people, 41.0 %). In all patients, before starting the rehabilitation course and after its completion, the blood levels of C-reactive protein, fibrinogen, glycoprotein sCD40L, homocysteine and uric acid were determined. Results. The level of C-reactive protein, fibrinogen and uric acid in patients during the rehabilitation course did not change signifi cantly, and the glycoprotein sCD40L exceeded the normative values before and after the course, decreasing during treatment in patients of group 1 (p = 0.027). The blood homocysteine concentration during the rehabilitation course was within the reference values, decreasing in patients of group 1 (p = 0.004). A statistical analysis revealed a dose-dependent relationship between taking atorvastatin and a decrease in the levels of uric acid, C-reactive protein and fibrinogen. Conclusion. A course of rehabilitation using transcranial direct current stimulation in patients in the early recovery period of stroke is accompanied by a decrease in the level of glycoprotein sCD40L and blood homocysteine. Aggressive treatment with statins is accompanied by improvements in blood C-reactive protein, fibrinogen and uric acid levels.
The objective of the study is review and analyze scientific publications devoted to the problems of stroke, its relationship with the most common mutations in the MTHFR gene and their individual allelic variants and serum homocysteine levels.Materials and methods. Analyzing foreign and domestic publications, the relationship of the strongest mutations in the MTHFR gene with an increase in the level of serum homocysteine, which is a predictor of the development of vascular accidents, including acute circulatory disorders of the brain, was revealed.Results. Stroke is a socially significant disease. All risk factors for acute cerebral stroke are subdivided into modifiable and non-modifiable. To a non-modifiable factor that predisposes to the development of ischemic and hemorrhagic stroke, hereditary factors, including genetic mutations in a number of genes. MTHFR is a genome carrying individual allelic variants that can affect the level of homocysteine in blood serum, causing it to increase, and hyperhomocysteinemia, according to a number of studies, is a likely predictor of diseases of the cardiovascular system, including severe cerebrovascular accidents. At the same time, a large number of studies use the services of the protective role of reducing the elevated level of serum homocysteine using various forms of folic acid and B vitamins. The authors of the article attempted to process, analyze and summarize the data of modern research issues on the topic under consideration.Conclusions. The relationship between the occurrence of ischemic and hemorrhagic stroke and the most common mutations in the MTHFR gene has been revealed. Hyperhomocysteinemia, separate and developing as a result of these mutations, is an independent risk factor for the development of acute cerebral ischemia. Normalization of elevated serum homocysteine levels is required for all patients as stroke prevention, and includes not only the use of foods enriched with folic acid, but also pharmacological correction of folates and B vitamins.
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