COMORBID PATIENT - MODERN VIEW ON THE PROBLEM. CHRONIC CEREBRAL ISCHEMIA AS AN INTERDISCIPLINARY PROBLEM (literature review)
Keywords:
сhronic cerebral ischemia (CCI), neurology, cerebrovascular diseases (CVD).Abstract
Introduction. Chronic cerebral ischemia (CCI) is the most common form of cerebrovascular disease, representing an "umbrella" diagnosis that encompasses etiologically and pathogenetically heterogeneous group of clinical conditions resulting from vascular brain damage not associated with prior strokes.
Objective. To study the modern literature data on the pathogenesis and risk factors of CCI, as well as the mechanisms of action of the ethylmethylhydroxypyridine succinate (мexidol) on various links of pathogenesis in neurological disorders in patients with CCI, including those with comorbidity.
Methods. A systematic search was conducted in electronic bibliographic databases such as PubMed, MEDLINE, Google Scholar, in the electronic resource and on Russian and English-language websites for articles on CCI and мexidol published in open access, as well as on the official websites of medical journals. Articles published from 2000 to 2022 were analyzed. Search criteria: randomized controlled trials, meta-analyses, and original studies. Exclusion criteria included studies with low reliability, retrospective studies, scientific reviews, systematic reports, and clinical cases.
Results and discussion. Mexidol (ethylmethylhydroxypyridine succinate) therapy led to a significant regression of such important manifestations of CCI as cognitive, emotional, autonomic, and motor disorders. An additional indirect sign of the effectiveness of drug therapy may be the high adherence of patients to treatment. The main advantage of the antioxidant and antihypoxic agent мexidol is its multimodal action, which contributes to its effective use in comorbid pathologies with CCI.
Conclusions. The clinical efficacy, safety, and good tolerability of мexidol allow recommending long-term sequential therapy in the form of injections, with subsequent transition to tablets for two months, for the treatment of patients with CCI, including those with comorbidity.
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