Хронические расстройства мозгового кровообращения (ХРМК) – частая причина развития когнитивных нарушений и последующей утраты способности к самообслуживанию. Развитие ХРМК связано с поражением сосудов как малого, так и крупного калибра, расстройствами микроциркуляции, нарушением системной гемодинамики. Обеспечение достаточного уровня церебрального кровотока способно замедлить прогрессирование заболевания. Рассматриваются возможности применения препарата Вазонит (пентоксифиллин) при лечении больных с ХРМК.
Chronic cerebral ischemia (CCI) is a common cause of cognitive impairment and decrease in self-sufficiency. CCI development is associated with small and large vessels damage, microcirculation disorders and systemic hemodynamic disturbances. A sufficient level of cerebral blood flow support may slow down the disease progression. The article considers the possibilities of Vasonit (pentoxifylline) use in patients with CCI treatment.
3. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 2010; 9 (7): 689–701.
4. Zhang M, Chen M, Wang Q et al. Relationship between cerebral microbleeds and cognitive function in lacunar infarct. J Int Med Res 2013; 41 (2): 347–55.
5. Жетишев Р.Р., Михайлова Н.А., Камчатнов П.Р., Иващенко Р.А. Асимптомные инфаркты головного мозга: факторы риска и когнитивные нарушения. Журн. неврологии и психиатрии им. С.С.Корсакова. Инсульт. 2014; 3 (2): 3–7. / Zhetishev R.R., Mikhailova N.A., Kamchatnov P.R., Ivashchenko R.A. Asimptomnye infarkty golovnogo mozga: faktory riska i kognitivnye narusheniia. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. Insul't. 2014; 3 (2): 3–7. [in Russian]
6. De la Torre J. Cardiovascular risk factors promote brain hypoperfusion leading to cognitive decline and dementia. Cardiovasc Psychiatry Neurol 2012; 2012.
7. Palacio S, McClure L, Benavente O et al. Lacunar strokes in patients with diabetes mellitus: risk factors, infarct location, and prognosis: the secondary prevention of small subcortical strokes study. Stroke 2014; 45 (9): 2689–94.
8. Cai Z, Wang C, He W et al. Cerebral small vessel disease and Alzheimer’s disease. Clin Interv Aging 2015; 10: 1695–704.
9. Blinder P, Tsai P, Kaufhold J et al. The cortical angiome: an interconnected vascular network with noncolumnar patterns of blood flow. Nat Neurosci 2013; 16: 889–97.
10. Nishimura N, Rosidi N, Iadecola C, Schaffer C. Limitations of collateral flow after occlusion of a single cortical penetrating arteriole. J Cereb Blood Flow Metab 2010; 30: 1914–27.
11. Sörös P, Whitehead S, Spence J, Hachinski V. Antihypertensive treatment can prevent stroke and cognitive decline. Nat Rev Neurol 2013; 9: 174–8.
12. Riba-Llena I, Nafría C, Mundet X et al. Assessment of enlarged perivascular spaces and their relation to target organ damage and mild cognitive impairment in patients with hypertension. Eur J Neurol 2016; 23: 1044–50.
13. Derosa G, Maffioli Р. A review about biomarkers for the investigation of vascular function and impairment in diabetes mellitus. Vasc Health Risk Manag 2016; 12: 415–9.
14. Kampoli A, Tousoulis D, Briasoulis A et al. Potential pathogenic inflammatory mechanisms of endothelial dysfunction induced by type 2 diabetes mellitus. Curr Pharm Des 2011; 17 (37): 4147–58.
15. Zwanenburg J, van Osch M. Targeting Cerebral Small Vessel Disease With MRI. Stroke 2017; 48: 3175–82.
16. Ding J, Sigurðsson S, Jónsson P et al. Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia. The Age, Gene/Environment Susceptibility–Reykjavik Study. JAMA Neurol 2017; 74 (9): 1105–12.
17. McLauchlan D, Malik G, Robertson N. Cerebral amyloid angiopathy: subtypes, treatment and role in cognitive impairment. J Neurol 2017; 264: 2184–6.
18. Hilal S, Mok V, Youn Y et al. Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries. J Neurol Neurosurg Psychiatr 2017; 88 (8): 45–9.
19. Iadecola C. The pathobiology of vascular dementia. Neuron 2013; 80 (4): 844–66.
20. Cooper L, Woodard T, Sigurdsson S et al. Cerebrovascular Damage Mediates Relations Between Aortic Stiffness and Memory. Hypertension 2016; 67: 176–82.
21. Nichols W, O’Rourke M. McDonalds’s blood flow in arteries: theoretical, experimental and clinical principles, 5th edn. Hodder Arnold Publishing, London. 2005.
22. Kollias A, Lagou S, Zeniodi M et al. Association of central versus brachial blood pressure with target-organ damage: systematic review and meta-analysis. Hypertension 2016; 67 (1): 183–90.
23. Barnes J, Harvey R, Zuk S et al. Aortic hemodynamics and white matter hyperintensities in normotensive postmenopausal women. J Neurol 2017; 264: 938.
24. Townsend R, Black H, Chirinos J et al. Clinical use of pulse wave analysis: proceedings from a symposium sponsored by North American artery. J Clin Hypertens (Greenwich) 2015; 17 (7): 503–13.
25. Webb A, Simoni M, Mazzucco S et al. Increased cerebral arterial pulsatility in patients with leukoaraiosis: arterial stiffness enhances transmission of aortic pulsatility. Stroke 2012; 43 (10): 2631–6.
26. Pase M, Himali J, Mitchell G et al. Association of aortic stiffness with cognition and brain aging in young and middle-aged adults: the Framingham third generation cohort study. Hypertension 2016; 67 (3): 513–9.
27. Davis K, Pearson H, Moat S et al. Acute hyperhomocysteinaemia affects pulse pressure but not microvascular vasodilator function. Br J Clin Pharmacol 2001; 52 (3): 327–32.
28. Plotnikov MF, Aliev OI, Nosarev AV et al. Relationship between arterial blood pressure and blood viscosity in spontaneously hypertensive rats treated with pentoxifylline. Biorheology 2016; 53 (2): 93–107.
29. Plotnikov MB, Aliev OI, Shamanaev AY et al. Effects of pentoxifylline on hemodynamic, hemorheological, and microcirculatory parameters in young SHRs during arterial hypertension development. Clin Exp Hypertens 2017; 39 (6): 570–8.
30. Brie D, Sahebkar A, Penson P et al. Effects of pentoxifylline on inflammatory markers and blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Hypertens 2016; 34 (12): 2318–29.
31. Banihani SA, Abu-Alhayjaa R, Amarin Z, Alzoubi K. Pentoxifylline increases the level of nitric oxide produced by human spermatozoa. Andrologia 2018; 50 (2). DOI: 10.1111/and.12859
32. Laurat E, Poirier B, Tupin E et al. In vivo dowregulation of T helper cell 1 immune responses reduces atherogenesis in apolipoprotein E-knockout mice. Circulation 2001; 104: 197–202.
33. Samardzic T, Jankovic V, Stosic-Grujicic S et al. Pentoxifylline inhibits the synthesis and IFN-gamma-inducing activity of IL-18. Clin Exp Immunol 2001; 124: 274–81.
34. Dolatabadi H, Zarrindast M, Reisi P, Nasehi M. The Effects of Pentoxifylline on Serum Levels of Interleukin 10 and Interferon Gamma and Memory Function in Lipopolysaccharide-induced Inflammation in Rats. Adv Biomed Res 2017; 6: 110–5.
35. Savas S, Delibas N, Savas C et al. Pentoxifylline reduces biochemical markers of ischemia-reperfusion induced spinal cord injury in rabbits. Spinal Cord 2002; 40: 224–9.
36. Bruno R, Marques T, Batista T et al. Pentoxifylline treatment improves neurological and neurochemical deficits in rats subjected to transient brain ischemia. Brain Res 2009 13; 1260: 55–64.
37. Movassaghi S, Nadia Sharifi Z, Soleimani M et al. Effect of Pentoxifylline on Ischemia- induced Brain Damage and Spatial Memory Impairment in Rat. Iran J Basic Med Sci 2012; 15 (5): 1083–90.
38. Sari S, Hashemi M, Mahdian R et al. The Effect of Pentoxifylline on bcl-2 Gene Expression Changes in Hippocampus after Ischemia-Reperfusion in Wistar Rats by a Quatitative RT-PCR Method. Iran J Pharm Res 2013; 12 (3): 495–501.
39. Vakili A, Mojarrad S, Akhavan M, Rashidy-Pour A. Pentoxifylline attenuates TNF-a protein levels and brain edema following temporary focal cerebral ischemia in rats. Brain Res 2011; 1377: 119–25.
40. Vakili A, Khorasani Z. Post-ischemic treatment of pentoxifylline reduces cortical not striatal infarct volume in transient model of focal cerebral ischemia in rat. Brain Res 2007; 1144: 186–91.
41. Park JH, Kim SE, Jin JJ et al. Pentoxifylline Alleviates Perinatal Hypoxic-Ischemia-Induced Short-term Memory Impairment by Suppressing Apoptosis in the Hippocampus of Rat Pups. Int Neurourol J 2016; 20 (2): 107–13.
42. Xia DY, Zhang HS, Wu LY et al. Pentoxifylline Alleviates Early Brain Injury After Experimental Subarachnoid Hemorrhage in Rats: Possibly via Inhibiting TLR 4/NF-kB Signaling Pathway. Neurochem Res 2017; 42 (4): 963–74.
43. Dong J, Yuan X, Xie W. Pentoxifylline exerts anti-inflammatory effects on cerebral ischemia reperfusion induced injury in a rat model via the p38 mitogen-activated protein kinase signaling pathway. Mol Med Rep 2018; 17 (1): 1141–7.
44. Bath PM, Bath-Hextall FJ. Pentoxifylline, propentofylline and pentifylline for acute ischaemic stroke. Cochrane Database Syst Rev 2004; 3: CD000162.
45. Sha MC, Callahan CM. The efficacy of pentoxifylline in the treatment of vascular dementia: a systematic review. Alzheimer Dis Assoc Disord 2003; 17 (1): 46–54.
46. Бойко А.Н., Камчатнов П.Р., Чугунов А.В. и др. Патогенетический подход к лечению больных с вертебрально-базилярной недостаточностью. Врач. 2005; 11: 7–13. / Boiko A.N., Kamchatnov P.R., Chugunov A.V. i dr. Patogeneticheskii podkhod k lecheniiu bol'nykh s vertebral'no-baziliarnoi nedostatochnost'iu. Vrach. 2005; 11: 7–13. [in Russian]
47. Roman G. Perspectives in the treatment of vascular dementia. Drugs Today (Barc) 2000; 36 (9): 641–53.
48. McCarty M, O'Keefe J, Di Nicolantonio J. Pentoxifylline for vascular health: a brief review of the literature. Open Heart 2016; 3 (1): e000365.
49. Teruya R, Fagundes D, Oshima C et al. effects of pentoxifylline into the kidneys of rats in a model of unilateral hindlimb ischemia/reperfusion injury. Acta Cir Bras 2008; 23 (1): 29–35.
50. Inal M, Kanbak G. Prevention of ischemia-reperfusion-induced oxidative injury in liver by allopurinol and pentoxifylline. Transplantationsmedizin 2006; 18: 29–32.
51. Banfi C, Sironi L, De Simoni G et al. Pentoxifylline prevents spontaneous brain ischemia in stroke-prone rats. J Pharmacol Exp Ther 2004; 310 (3): 890–5.
52. Rodriguez-Moran M, Guerrero-Romero F. Pentoxifylline is as effective as captopril in the reduction of microalbuminuria in non-hypertensive type 2 diabetic patients – a randomized, equivalent trial. Clin Nephrol 2005; 64 (2): 91–7.
53. Liu D, Wang L, Li H et al. Pentoxifylline plus ACEIs/ARBs for proteinuria and kidney function in chronic kidney disease: a meta-analysis. J Int Med Res 2017; 45 (2): 383–98.
54. Jiang X, Zhou S, Yao J et al. Effect of pentoxifylline in proteinuric chronic kidney disease: a systematic review and meta-analysis. J Nephrol 2016; 29 (5): 653–62.
55. Incandela L, Cesarone MR, Belcaro G et al. Treatment of vascular inner ear disease with pentoxifylline: a 4-week, controlled, randomized trial. Angiology 2002; 53 (Suppl. 1): S19–22.
56. Kiris M, Cankaya H, Icli M, Kutluhan A. Retrospective analysis of our cases with sudden hearing loss. J Otolaryngol 2003; 32 (6): 384–7.
57. Gouveris H, Mewes T, Maurer J, Mann W. Steroid and vasoactive treatment for acute deafness after attempted hearing preservation acoustic neuroma surgery. ORL J Otorhinolaryngol Relat Spec 2005; 67 (1): 30–3.
58. De Barros F, Penido N, Ramos H et al. Audiological evaluation of twenty patients receiving pentoxifylline and prednisone after sudden deafness: prospective study. Int Tinnitus J 2003; 9 (1): 17–22.
59. Echarri RM, Rivera T, Mate MA, Cobeta I. Sudden deafness: efficacy of a therapeutic protocol. Acta Otorrinolaringol Esp 2000; 51 (6): 490–4.
60. Ueno M, Ferreiro J, Tomasello S et al. Impact of pentoxifylline on platelet function profiles in patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy with aspirin and clopidogrel. JACC Cardiovasc Int 2011; 4 (8): 905–12.
3. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 2010; 9 (7): 689–701.
4. Zhang M, Chen M, Wang Q et al. Relationship between cerebral microbleeds and cognitive function in lacunar infarct. J Int Med Res 2013; 41 (2): 347–55.
6. De la Torre J. Cardiovascular risk factors promote brain hypoperfusion leading to cognitive decline and dementia. Cardiovasc Psychiatry Neurol 2012; 2012.
7. Palacio S, McClure L, Benavente O et al. Lacunar strokes in patients with diabetes mellitus: risk factors, infarct location, and prognosis: the secondary prevention of small subcortical strokes study. Stroke 2014; 45 (9): 2689–94.
8. Cai Z, Wang C, He W et al. Cerebral small vessel disease and Alzheimer’s disease. Clin Interv Aging 2015; 10: 1695–704.
9. Blinder P, Tsai P, Kaufhold J et al. The cortical angiome: an interconnected vascular network with noncolumnar patterns of blood flow. Nat Neurosci 2013; 16: 889–97.
10. Nishimura N, Rosidi N, Iadecola C, Schaffer C. Limitations of collateral flow after occlusion of a single cortical penetrating arteriole. J Cereb Blood Flow Metab 2010; 30: 1914–27.
11. Sörös P, Whitehead S, Spence J, Hachinski V. Antihypertensive treatment can prevent stroke and cognitive decline. Nat Rev Neurol 2013; 9: 174–8.
12. Riba-Llena I, Nafría C, Mundet X et al. Assessment of enlarged perivascular spaces and their relation to target organ damage and mild cognitive impairment in patients with hypertension. Eur J Neurol 2016; 23: 1044–50.
13. Derosa G, Maffioli Р. A review about biomarkers for the investigation of vascular function and impairment in diabetes mellitus. Vasc Health Risk Manag 2016; 12: 415–9.
14. Kampoli A, Tousoulis D, Briasoulis A et al. Potential pathogenic inflammatory mechanisms of endothelial dysfunction induced by type 2 diabetes mellitus. Curr Pharm Des 2011; 17 (37): 4147–58.
15. Zwanenburg J, van Osch M. Targeting Cerebral Small Vessel Disease With MRI. Stroke 2017; 48: 3175–82.
16. Ding J, Sigurðsson S, Jónsson P et al. Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia. The Age, Gene/Environment Susceptibility–Reykjavik Study. JAMA Neurol 2017; 74 (9): 1105–12.
17. McLauchlan D, Malik G, Robertson N. Cerebral amyloid angiopathy: subtypes, treatment and role in cognitive impairment. J Neurol 2017; 264: 2184–6.
18. Hilal S, Mok V, Youn Y et al. Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries. J Neurol Neurosurg Psychiatr 2017; 88 (8): 45–9.
19. Iadecola C. The pathobiology of vascular dementia. Neuron 2013; 80 (4): 844–66.
20. Cooper L, Woodard T, Sigurdsson S et al. Cerebrovascular Damage Mediates Relations Between Aortic Stiffness and Memory. Hypertension 2016; 67: 176–82.
21. Nichols W, O’Rourke M. McDonalds’s blood flow in arteries: theoretical, experimental and clinical principles, 5th edn. Hodder Arnold Publishing, London. 2005.
22. Kollias A, Lagou S, Zeniodi M et al. Association of central versus brachial blood pressure with target-organ damage: systematic review and meta-analysis. Hypertension 2016; 67 (1): 183–90.
23. Barnes J, Harvey R, Zuk S et al. Aortic hemodynamics and white matter hyperintensities in normotensive postmenopausal women. J Neurol 2017; 264: 938.
24. Townsend R, Black H, Chirinos J et al. Clinical use of pulse wave analysis: proceedings from a symposium sponsored by North American artery. J Clin Hypertens (Greenwich) 2015; 17 (7): 503–13.
25. Webb A, Simoni M, Mazzucco S et al. Increased cerebral arterial pulsatility in patients with leukoaraiosis: arterial stiffness enhances transmission of aortic pulsatility. Stroke 2012; 43 (10): 2631–6.
26. Pase M, Himali J, Mitchell G et al. Association of aortic stiffness with cognition and brain aging in young and middle-aged adults: the Framingham third generation cohort study. Hypertension 2016; 67 (3): 513–9.
27. Davis K, Pearson H, Moat S et al. Acute hyperhomocysteinaemia affects pulse pressure but not microvascular vasodilator function. Br J Clin Pharmacol 2001; 52 (3): 327–32.
28. Plotnikov MF, Aliev OI, Nosarev AV et al. Relationship between arterial blood pressure and blood viscosity in spontaneously hypertensive rats treated with pentoxifylline. Biorheology 2016; 53 (2): 93–107.
29. Plotnikov MB, Aliev OI, Shamanaev AY et al. Effects of pentoxifylline on hemodynamic, hemorheological, and microcirculatory parameters in young SHRs during arterial hypertension development. Clin Exp Hypertens 2017; 39 (6): 570–8.
30. Brie D, Sahebkar A, Penson P et al. Effects of pentoxifylline on inflammatory markers and blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Hypertens 2016; 34 (12): 2318–29.
31. Banihani SA, Abu-Alhayjaa R, Amarin Z, Alzoubi K. Pentoxifylline increases the level of nitric oxide produced by human spermatozoa. Andrologia 2018; 50 (2). DOI: 10.1111/and.12859
32. Laurat E, Poirier B, Tupin E et al. In vivo dowregulation of T helper cell 1 immune responses reduces atherogenesis in apolipoprotein E-knockout mice. Circulation 2001; 104: 197–202.
33. Samardzic T, Jankovic V, Stosic-Grujicic S et al. Pentoxifylline inhibits the synthesis and IFN-gamma-inducing activity of IL-18. Clin Exp Immunol 2001; 124: 274–81.
34. Dolatabadi H, Zarrindast M, Reisi P, Nasehi M. The Effects of Pentoxifylline on Serum Levels of Interleukin 10 and Interferon Gamma and Memory Function in Lipopolysaccharide-induced Inflammation in Rats. Adv Biomed Res 2017; 6: 110–5.
35. Savas S, Delibas N, Savas C et al. Pentoxifylline reduces biochemical markers of ischemia-reperfusion induced spinal cord injury in rabbits. Spinal Cord 2002; 40: 224–9.
36. Bruno R, Marques T, Batista T et al. Pentoxifylline treatment improves neurological and neurochemical deficits in rats subjected to transient brain ischemia. Brain Res 2009 13; 1260: 55–64.
37. Movassaghi S, Nadia Sharifi Z, Soleimani M et al. Effect of Pentoxifylline on Ischemia- induced Brain Damage and Spatial Memory Impairment in Rat. Iran J Basic Med Sci 2012; 15 (5): 1083–90.
38. Sari S, Hashemi M, Mahdian R et al. The Effect of Pentoxifylline on bcl-2 Gene Expression Changes in Hippocampus after Ischemia-Reperfusion in Wistar Rats by a Quatitative RT-PCR Method. Iran J Pharm Res 2013; 12 (3): 495–501.
39. Vakili A, Mojarrad S, Akhavan M, Rashidy-Pour A. Pentoxifylline attenuates TNF-a protein levels and brain edema following temporary focal cerebral ischemia in rats. Brain Res 2011; 1377: 119–25.
40. Vakili A, Khorasani Z. Post-ischemic treatment of pentoxifylline reduces cortical not striatal infarct volume in transient model of focal cerebral ischemia in rat. Brain Res 2007; 1144: 186–91.
41. Park JH, Kim SE, Jin JJ et al. Pentoxifylline Alleviates Perinatal Hypoxic-Ischemia-Induced Short-term Memory Impairment by Suppressing Apoptosis in the Hippocampus of Rat Pups. Int Neurourol J 2016; 20 (2): 107–13.
42. Xia DY, Zhang HS, Wu LY et al. Pentoxifylline Alleviates Early Brain Injury After Experimental Subarachnoid Hemorrhage in Rats: Possibly via Inhibiting TLR 4/NF-kB Signaling Pathway. Neurochem Res 2017; 42 (4): 963–74.
43. Dong J, Yuan X, Xie W. Pentoxifylline exerts anti-inflammatory effects on cerebral ischemia reperfusion induced injury in a rat model via the p38 mitogen-activated protein kinase signaling pathway. Mol Med Rep 2018; 17 (1): 1141–7.
44. Bath PM, Bath-Hextall FJ. Pentoxifylline, propentofylline and pentifylline for acute ischaemic stroke. Cochrane Database Syst Rev 2004; 3: CD000162.
45. Sha MC, Callahan CM. The efficacy of pentoxifylline in the treatment of vascular dementia: a systematic review. Alzheimer Dis Assoc Disord 2003; 17 (1): 46–54.
46. Boiko A.N., Kamchatnov P.R., Chugunov A.V. i dr. Patogeneticheskii podkhod k lecheniiu bol'nykh s vertebral'no-baziliarnoi nedostatochnost'iu. Vrach. 2005; 11: 7–13. [in Russian]
47. Roman G. Perspectives in the treatment of vascular dementia. Drugs Today (Barc) 2000; 36 (9): 641–53.
48. McCarty M, O'Keefe J, Di Nicolantonio J. Pentoxifylline for vascular health: a brief review of the literature. Open Heart 2016; 3 (1): e000365.
49. Teruya R, Fagundes D, Oshima C et al. effects of pentoxifylline into the kidneys of rats in a model of unilateral hindlimb ischemia/reperfusion injury. Acta Cir Bras 2008; 23 (1): 29–35.
50. Inal M, Kanbak G. Prevention of ischemia-reperfusion-induced oxidative injury in liver by allopurinol and pentoxifylline. Transplantationsmedizin 2006; 18: 29–32.
51. Banfi C, Sironi L, De Simoni G et al. Pentoxifylline prevents spontaneous brain ischemia in stroke-prone rats. J Pharmacol Exp Ther 2004; 310 (3): 890–5.
52. Rodriguez-Moran M, Guerrero-Romero F. Pentoxifylline is as effective as captopril in the reduction of microalbuminuria in non-hypertensive type 2 diabetic patients – a randomized, equivalent trial. Clin Nephrol 2005; 64 (2): 91–7.
53. Liu D, Wang L, Li H et al. Pentoxifylline plus ACEIs/ARBs for proteinuria and kidney function in chronic kidney disease: a meta-analysis. J Int Med Res 2017; 45 (2): 383–98.
54. Jiang X, Zhou S, Yao J et al. Effect of pentoxifylline in proteinuric chronic kidney disease: a systematic review and meta-analysis. J Nephrol 2016; 29 (5): 653–62.
55. Incandela L, Cesarone MR, Belcaro G et al. Treatment of vascular inner ear disease with pentoxifylline: a 4-week, controlled, randomized trial. Angiology 2002; 53 (Suppl. 1): S19–22.
56. Kiris M, Cankaya H, Icli M, Kutluhan A. Retrospective analysis of our cases with sudden hearing loss. J Otolaryngol 2003; 32 (6): 384–7.
57. Gouveris H, Mewes T, Maurer J, Mann W. Steroid and vasoactive treatment for acute deafness after attempted hearing preservation acoustic neuroma surgery. ORL J Otorhinolaryngol Relat Spec 2005; 67 (1): 30–3.
58. De Barros F, Penido N, Ramos H et al. Audiological evaluation of twenty patients receiving pentoxifylline and prednisone after sudden deafness: prospective study. Int Tinnitus J 2003; 9 (1): 17–22.
59. Echarri RM, Rivera T, Mate MA, Cobeta I. Sudden deafness: efficacy of a therapeutic protocol. Acta Otorrinolaringol Esp 2000; 51 (6): 490–4.
60. Ueno M, Ferreiro J, Tomasello S et al. Impact of pentoxifylline on platelet function profiles in patients with type 2 diabetes mellitus and coronary artery disease on dual antiplatelet therapy with aspirin and clopidogrel. JACC Cardiovasc Int 2011; 4 (8): 905–12.
1 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;
2 The Scientific Medical Center of Professor Umarova Kh.Ya. 364001, Russian Federation, Grozny, ul. Avtorkhanova, d. 40/60