DOI: https://doi.org/10.22141/2224-0713.1.95.2018.127411

Efficacy, safety and tolerability of combination of electrolytes and citicoline (Neurocitin®) in comprehensive treatment of patients with acute ischemic stroke

V.A. Grib, I.I. Titov

Abstract


The article presents the results of the study evaluating the efficacy, safety and tolerability of one of the most well-known cerebroprotectors (citicoline) combined with electrolytes (Neurocitin®) in the comprehensive treatment of patients with acute ischemic stroke (IS). Materials and methods. 55 patients with acute IS aged 40 to 75 years were examined. They were randomized into 2 groups: in the control group (CG), patients received standard therapy, in the main group (MG) — Neurocitin® in addition to standard therapy. All patients underwent general clinical and clinical-neurological examination. IS was verified using neuroimaging methods. The degree of neurologic deficit and the functional state of patients was determined using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) on days 1 and 14 of the IS. The degree of neuronal damage was assessed by the level of neuron-specific enolase (NPE). The bioelectrical activity of the cerebral cortex was determined using bispectral index. The level of blood oxygenation was evaluated by means of cerebral oximetry. Results. On day 14 of treatment, on the background of Neurocitin® therapy (MG), bispectral index increased by 84.0 % from baseline (p < 0.01) and was 49.1 % higher than that of CG (p < 0.05). A similar trend was observed according to the data of cerebral oximetry: in MG from the third day of treatment, this index significantly exceeded the initial parameters — by 31.1 % (p < 0.05), from day 5 — by 57.8 % (p < 0.01), and was 44.9 % higher than the same figure in the CG (p < 0.05). In both groups, there was a decrease in NPE in the blood, but these changes were significantly more pronounced only in patients from MG, who received Neurocitin® therapy. The neurologic deficit in MG patients on day 14 was 59.7 % (p < 0.01) lower than baseline and 36.6 % — than the same parameter in CG (p < 0.05) according to NIHSS. When observing the dynamics of the functional state of patients 1.5 months after the IS, the mRS score in patients treated with Neurocitin® significantly decreased compared to the baseline (p < 0.05), whereas in the CG, such changes did not reach statistically significant values (p > 0.05). Conclusions. Neurocitin® accelerates recovery after acute IS due to the neuroprotective effect of citicoline on the background of adequate support of the fluid and electrolyte balance.


Keywords


citicoline; Neurocitin®; acute ischemic stroke

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