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Использование цитиколина у пациентов с нарушением двигательных функций после инсульта
Использование цитиколина у пациентов с нарушением двигательных функций после инсульта
Кольцова Е.А., Петрова Е.А., Стаховская Л.В.
Использование цитиколина у пациентов с нарушением двигательных функций
после инсульта. Consilium Medicum. 2018; 20 (2): 41–44. DOI:
10.26442/2075-1753_2018.2.41-44
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Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Обзор посвящен применению препарата цитиколин в комплексе лечебно-реабилитационных мероприятий у больных с острым ишемическим инсультом. Приведены результаты многочисленных экспериментальных и клинических исследований влияния цитиколина на ишемию и гипоксию мозга. Освещены основные фармакологические свойства цитиколина, обладающего комплексным нейропротекторным действием. Приводятся данные о новейших многоцентровых плацебо-контролируемых испытаниях препарата при остром инсульте. Обсуждаются базисные принципы успешной нейрореабилитации при инсульте – раннее начало, непрерывность, преемственность, мультидисциплинарный организационный подход, комбинирование реабилитационных мероприятий и медикаментозной поддержки нейропластичности.
Ключевые слова: ишемический инсульт, нейропротекция, репаративная терапия, цитиколин, реабилитация.
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The review is devoted to the use of the drug citicoline in a complex of therapeutic and rehabilitation measures in patients with acute ischemic stroke. The results of numerous experimental and clinical studies of the effect of citicoline on ischemia and brain hypoxia are also presented. The main pharmacological properties of citicoline, which has a complex neuroprotective effect, are described, just as the data on the newest multicenter placebo-controlled trials of the drug in acute stroke, that is also presented. The basic principles of successful neurorehabilitation after a stroke – early onset, continuity, continuity, multidisciplinary organizational approach, combination of rehabilitation measures and drug support of neuroplasticity are discussed as well.
Key words: ischemic stroke, neuroprotection, reparative therapy, citicoline, rehabilitation.
Полный текст
Список литературы
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1. Stakhovskaya L.V., Kotov S.V. Insul't. Rukovodstvo dlya vrachei. M.: MIA, 2014. [in Russian]
2. Kryzhanovskii G.N. Obshchaya patofiziologiya nervnoi sistemy. M.: Meditsina, 1997. [in Russian]
3. Anokhin P.K. Obshchie printsipy kompensatsii narushennykh funktsii i ikh fiziologicheskoe obosnovanie. M.: Meditsina, 1977. [in Russian]
4. Lo AC, Guarino PD, Richards LG et al. Robot-assisted therapy for long-term upper-limb impairment after stroke. N Engl J Med 2010; 362: 1772–83.
5. Álvarez-Sabín J, Román GC. The Role of Citicoline in Neuroprotection and Neurorepair in Ischemic Stroke. Brain Sci 2013; 3: 1395–414.
6. Salomon JA, Wang H, Freeman MK et al. The global burden of disease study 2010. Lancet 2013; 380: 2053–260.
7. Sahota P, Savitz SI. Investigational therapies for ischemic stroke: Neuroprotection and neurorecovery. Neurotherapeutics 2011; 8: 434–51.
8. Zapadnyuk BV, Kopchak OO. Features drug correction of vascular cognitive disorders in patients with discirculatory encephalopathy and metabolic. Pro Neuro 2010; 4: 77.
9. Adibhatla RM, Hatcher JF. Citicoline mechanisms and clinical efficacy in cerebral ischemia. J Neurosci Res 2002; 70: 133–9.
10. Bustamante A, Giralt D, Rosell A et al. Citicoline in pre-clinical animal models of stroke: A meta-analysis shows the optimal neuroprotective profile and the missing steps for jumping into a stroke clinical trial. J Neurochem 2012; 123: 217–25.
11. Hurtado O, Moro MA, Cárdenas A et al. Neuroprotection afforded by prior citicoline administration in experimental brain ischemia: Effects on glutamate transport. Neurobiol Dis 2005; 18: 336–45.
12. Saver JL. Targeting the brain: neuroprotection and neurorestoration in ischemic stroke. Pharmacotherapy 2010; 30: S62.
13. Xu F, Hongbin H, Yan J et al. Greatly improved neuroprotective efficiency of citicoline by stereotactic delivery in treatment of ischemic injury. Drug Deli 2011; 18: 461–7.
14. Hurtado O, Cárdenas A, Lizasoain I et al. A chronic treatment with CDP-choline improves functional recovery and increases neuronal plasticity after experimental stroke. Neurobiol Dis 2007; 26: 105–11.
15. Parnetti L, Mignini F, Tomassoni D et al. Cholinergic precursors in the treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation? J Neurol Sci 2007; 257: 264–9.
16. Gutiérrez-Fernández M, Rodriguez-Frutos B, Fuentes B et al. CDP-choline treatment induces brain plasticity markers expression in experimental animal stroke. Neurochem Int 2012; 60: 310–7.
17. Diederich K, Frauenknecht K, Minnerup J et al. Citicoline enhances neuroregenerative processes after experimental stroke in rats. Stroke 2012; 43: 1931–40.
18. Krupinski J, Abudawood M, Matou-Nasri S et al. Citicoline induces angiogenesis improving survival of vascular/human brain microvessel endothelial cells through pathways involving ERK1/2 and insulin receptor substrate-1. Vasc Cell 2012; 4. DOI: 10.1186/2045-824X-4-20
19. Krupinski J, Slevin M, Badimon L. Citicoline inhibits MAP kinase signalling pathways after focal cerebral ischaemia. Neurochem Res 2005; 30: 1067–73.
20. Wang LE, Fink GR, Diekhoff S et al. Noradrenergic enhancement improves motor network connectivity in stroke patients. Ann Neurol 2011; 69: 375–88.
21. Tazaki Y, Sakai F, Otomo E et al. Treatment of acute cerebral infarction with a choline. Stroke 1988; 19: 211–6.
22. Kliushnikov S.A. Neiroprotektivnye i neiroreparativnye effekty Tseraksona (tsitikolina): obzor eksperimental'nykh i klinicheskikh issledovanii. Nervnye bolezni. 2012; 3: 13–20. [in Russian]
23. Warach SJ. ECCO 2000 study of citicoline for treatment of acute ischemic stroke: Effects on infarct volumes measured by MRI. Stroke 2000; 31: 283.
24. Dávalos A, Álvarez-Sabín J, Castillo J et al. Citicoline in the treatment of acute ischaemic stroke: An international, randomised, multicentre, placebo-controlled study (ICTUS trial). Lancet 2012; 380: 349–57.
25. Vaizova O.E. i dr. Klinicheskii opyt primeneniia tsitikolina pri ishemicheskom insul'te. Eksperim. i klin. farmakologiia. 2012; 3: 7. [in Russian]
26. Gavrilova S.I. i dr. Lechenie miagkogo kognitivnogo snizheniia. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2011; 12: 16. [in Russian]
27. Martynov M.Iu., Iasamanova A.N., Shchukin I.A. Tsitoprotektivnaia i neirotroficheskaia terapiia pri tserebral'nom insul'te. Klinitsist. 2013; 7 (1): 21. [in Russian]
28. Piradov M.A. Intensivnaia terapiiainsul'ta: vzgliad na problemu. Annaly klin. i eksperim. nevrologii. 2007; 1 (1): 17–22. [in Russian]
29.Shamalov N.A., Stakhovskaia L.V., Shetova I.M. i dr. Issledovanie bezopasnosti i effektivnosti kombinirovannoi terapii tsitikolinom i Aktoveginom bol'nykh v ostrom periode ishemicheskogo insul'ta. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2010; 9 (2): 13–7. [in Russian]
30. Rus. med. zhurn.: http://www.rmj.ru/articles/nevrologiya/Primenenie_citikolina_v_lechenii_insulyta/#ixzz4lIo1fnXW [in Russian]
Авторы
Е.А.Кольцова*, Е.А.Петрова, Л.В.Стаховская
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
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E.A.Koltsova*, E.A.Petrova, L.V.Stakhovskaya
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
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