Изменение показателей серотонинергической и нитроксидергической систем на стадиях развития общего адаптационного синдрома у больных с ишемическим инсультом

Abstract

В роботі була досліджена динаміка змін показників серотонінергічної та нітроксидергічної систем на стадіях розвитку загального адаптаційного синдрома, у хворих на ішемічний інсульт, під час проведення інтенсивної терапії. Інтенсивна терапія у критичних хворих з ішемічним інсультом може вважатися ефективною, якщо на 3-тю добу захворювання досягнута стадія резистентності загального адаптаційного синдрому. Зменшення показників серотонінергічної та нітрокcидергічної систем, характеризує ефективність інтенсивної терапії. Abstract. The general adaptation syndrome that occurs in patients with ischemic stroke in response to hypoxic damage to neurons of the brain is characterized by a combination of stereotyped reactions that provides the body to the victims not only stability to the stressor agent, but also to other damaging factors. It is now known that the serotoninergic system participates in the central stress-limiting mechanisms, while the nitroxidergic system limits stress reactions, affecting both the central and peripheral links. The aim of the study was to study the dynamics of changes in serotoninergic system and nitroxidergic system, at the stages of general adaptation syndrome development, in patients with ischemic stroke, during intensive therapy. 16 critical patients with ischemic stroke were involved in the research (average age was 62,5±2,8 years) under conditions of neuroreanimation. Among these patients 10 (62,5%) are of average age (64,6±4,1) years; among them women included 6 (37,5%) of the average age (59,0±2,3) years. The control group is represented by 14 volunteers (average age 35,1±2,7 years), among them 8 (57,2%) presented middle age (38,5±4,1); there were 6 (43,7%) women. The average age was (42,8 ± 3,6) years. The severity of ischemic stroke, assessed by the stroke scale of the National Institutes of Health Stroke Scale, coincided to a moderate cerebral stroke (9,3±0,5 points). When assessing the degree of neurological deficiency on the 3-rd day after hospitalization, against the background of the intensive therapy conducted, a significant positive dynamics was revealed in 10 patients. Four patients had no positive dynamics on intensive therapy. Two patients died earlier 3 days after admission (1 man and 1 woman), mortality was 12,5% of all hospitalized. Against the background of the intensive therapy level of serotonin, was within the limits of normal values, but on the 1st day of hospital stay in the department of neuroreanimation exceeded the values of the control group. In 2 days later, there was a decrease in the level of serotonin, due to the onset of a resistant stage of resistance. The nitroxidergic system, with the exception of NO2 (μmol×Lˉ¹), was lower than the control group, although it didn’t go beyond the norm. However, from 2 days onwards, there was a decrease in the nitroxidergic system (NO2, μmol×Lˉ¹ and NO2 + NO3, μmol×Lˉ¹) values, which was statistically significant (p <0,05) and is characterized by the development of the stage of stable adaptation. Thus, intensive therapy in patients with ischemic stroke can be considered effective if on the 3-rd day of the disease a stable stage of adaptability is achieved. The decrease in serotoninergic and nitroxidergic systems, at the stages of development of the general adaptation syndrome is characterized by the efficiency of intensive therapy in patients with ischemic stroke.