TY - JOUR AU - T. V. Cherniy PY - 2018/10/25 Y2 - 2024/03/29 TI - Improvement of diagnosis and treatment of cerebrovascular complications and premorbid conditions of arterial hypertension in patients with chronic cerebral ischemia JF - Clinical and Preventive Medicine JA - Clin. and prev. med. VL - IS - 2-3 SE - Clinical medicine DO - 10.31612/2616-4868.2-5.2018.06 UR - http://cp-medical.com/index.php/journal/article/view/21 AB - This article presents the results of one of the parts of the scientific research: "Hypertensive and non-hypertonic (atherosclerotic) dyscirculatory encephalopathy in civil servants.Studied pathogenetic mechanisms of occurrence, integral diagnostic criteria, individualized correction of medical therapy". The data of general clinical examination of 88 persons with chronic cerebral ischemia (dyscirculatory encephalopathy (DE)) of 2 degrees are presented.The first study group - patients with DE without concomitant hypertension - 28, the second - 39 people with hypertonic dyscirculatory encephalopathy (HDE), the third - 21 patients with dyscirculatory encephalopathy and history of stroke (HDE + INS). The purpose of this study was to develop a method for targeted drug correction of cognitive impairment in chronic brain ischemia. The diagnosis was confirmed by general clinical, clinical-neurological, laboratory, instrumental examination, neuropsychological examination (MMSE, DASS-21). In addition to the protocol, patients with dyscirculatory encephalopathy of all the study groups received a complex of drugs aimed at correcting neurotransmitter metabolism: in the morning 1 ml (15 mg) solution of ipidacrine hydrochloride monohydrate (paraplexin) intramuscularly 1 time per day for 14 days. 1-2 hours after administration, ipidacrine was injected sequentially with 4 ml (1000 mg) of choline alfosserate solution and 4 ml (1000 mg) solution of cytocholine intravenously drip 1 time per day for 14 days.The addition of the protocol for the treatment of patients with dyscirculatory encephalopathy in all the groups studied by a complex of drugs aimed at eliminating cholinergic insufficiency resulted in correction of cognitive impairment in chronic brain ischemia.Statistically significant manifestations of the recovery of the cognitive function (MMSE scale) after the basic complex of therapy were associated primarily with impulsiveness decrease due to increased attention. Statistically significant manifestations of reduction of anxiety and depressive disorders (on the DASS-21 scale) after the basic complex of therapy were associated primarily with anxiety reduction due to restoration of neurohumoral balance: GABA-ergic inhibitory effects, serotonin-, catecholamine-peptidergic activation systems. ER -