Indicators of Energy Metabolism in Patients during the Early Recovery Period of Ischemic Stroke under the Influence of Complex Therapy Using Neuroprotectors and Vasoactive Drugs

V. R. Gerasymchuk

Abstract


Ischemic stroke remains one of the most urgent health and social problems as well as the leading cause of disability in neurological patients.

The objective of the research was to study and evaluate the efficiency of complex therapy using choline alphoscerate and vincamine in patients during the early recovery period of ischemic stroke considering the processes of energy metabolism.

Materials and methods. The study involved 66 patients in the early recovery period of primary hemispheric ischemic stroke being randomized into 2 groups. Group 1 received basic therapy for secondary prevention of stroke. Patients of Group 2 received choline alphoscerate and vincamine for 2 months in addition to basic therapy. The evaluation of neurological deficit and functional status of patients was carried out using the NIH Stroke Scale, the Scandinavian stroke scale (SSS) and the Barthel Index; the concentration of lactic and pyruvic acid in serum was determined.

Results. After treatment the NIH Stroke Scale score decreased significantly by 17.7%, the SSS score increased by 22.7% and the Barthel Index increased by 16.2%  in Group 2 (p<0.05). There was detected a moderate correlation (r=0.34; p=0.031) between the lactate level and the NIH Stroke Scale score as well as a moderate inverse correlation between the lactate level and the SSS score (r=-0.42; p=0.032) one month after stroke. In addition, 3 months  after stroke increased initial lactate level correlated inversely with the SSS score (r=-0.41; p=0.036) and the lactate-to-pyruvate ratio correlated with the SSS score (r=-0.47; p=0.039) and the Barthel Index (r=-0.29; p=0.046).

Conclusions. Early recovery period of ischemic stroke is characterized by the disorders of energy metabolism, signs of activation of anaerobic glycolysis with increased serum levels of lactate and lactate-to-pyruvate ratio which may be predictors of unfavourable functional outcome. Complex therapy using choline alphoscerate and vincamine can contribute to the normalization of energy metabolism as well as to the reduction in clinical manifestations of neurological disorders.

Keywords


ischemic stroke; early recovery period; energy metabolism; lactate; pyruvate

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References


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