The efficacy of the anti-acidemic agent dimephosphone at the first rehabilitation stage in patients in the acute period of carotid-related ischemic stroke

Abstract

To evaluate the efficacy of the intravenous form of dimephosphon at the first stage of rehabilitation in patients with ischemic stroke in the carotid system. The article presents the results of examination of 60 patients in the acute period of ischemic stroke in the carotid system (30 patients were treated with dimephosphon and 30 patients were in the comparison group). The dynamics of the clinical picture (according to the NIHSS), functional dependence in self-service (according to the modified Rankin scale), state of autonomic response using spectral analysis of heart rate variability, cerebrovascular reactivity using functional tests were assessed during the treatment. A significant decrease in NIHSS points was recorded (on average by 60% from the initial level) in the main group, relative to the comparison group (on average by 33% from the initial points). On the 10th day of therapy, there was a significantly more improvement in cerebrovascular reactivity to hypercapnic and hypocapnic loads, the index of vasomotor reactivity, as well as the state of cerebral blood flow autoregulation in the main group compared with the comparison group. In addition, by the 10th day of therapy relative to the initial values in the main group, a statistically significant increase (by 30%) was revealed in the number of patients with adaptive sympathicotonic type of autonomic regulation with a decrease in the number of patients with hypersympathetic and asymptomatic types of autonomic regulation after orthostatic test (by 10% and 20%, respectively). By the 10th day of hospitalization, there were more patients with no or mild signs of disability (0-2 points according to the modified Rankin scale) in the main group (83%) compared with the comparison group (60%). The use of the multimodal drug dimephosphon in complex therapy in patients in the acute period of ischemic stroke in the carotid system contributes to the normalization of the regulatory mechanisms of cerebral circulation and autonomic regulation. This helps to improve functional recovery and enhance the rehabilitation potential of patients.