Brovchenko M. Disorders of neurologic and cytokino-immune statues in patients with consequences caused by ischemic stroke in the period of rehabilitation.

The dissertation contain theoretical and practical generalization of the study results on peculiarities of cytokine and immune state in 100 convalescents after ischemic stroke during rehabilitation treatment, based on the investigation of main lymphocyte subpopulations, lymphocyte apoptotic antigens as well as levels of tumor necrosis factor (TNF), interleukin (IL)-1, IL-4 and IL-6, with the aim to offer a new solution of the actual scientific task - optimization of diagnostics, treatment and rehabilitation in patients with ischemic stroke.For the first time a dissociation was revealed between indices of the cellular immune response and synthesis of proinflammation cytokines in patients with the right hemisphere lesions, that may be considered as a specific clinical-immunological feature of the strokes of such a localization. It was also revealed, that substantial abnormalities in the neurological status of the patients are accompanied by more pronounced inflammation features - increased serum levels of IL-1?, TNF-? and IL-6, decreased immune-regulatory index, high percentage of СD95+ lymphocytes. Simvastatin add-on to the complex treatment during different rehabilitation periods in patients with the ischemic stroke consequences was characterized by the increase of immune-regulatory index, the decrease of the immunocompetent cell adhesion and migration processes to atherosclerotic plagues, the reduction of activated lymphocytes with CD95+ phenotype, and the normalization of the serum proinflammatory cytokines content. Based on the cytokine-immune status abnormalities, a prognostic criteria for the lost functions restoration in patients with the ischemic stroke consequences are elaborated, which include: indices of the unfavorable prognosis (significant reduction of immune-regulatory index, high percentage of CD95 lymphocytes, increased level of IL-6) as well as indices of the favorable prognosis (normal levels of TNF, IL-1, IL-6, and increased level of IL-4).