But O. Clinico-immunological features of the current of the acute period brain ischemic stroke and treatment optimization. Thesis for the degree of medical sciences, specialty 14.01.15 - nervous disease

Constitute the basis of data analysis and clinical and instrumental examination of 167 patients (including 115 with brain ischemic stroke (BIS) and 52 with discirculatory encephalopathy (DEP)). Revealed that in patients with BIS from the first days of the disease the concentration of neurospecifis proteins increased in blood serum compared with patients with DEP indicated the express damage of the various types of the nervous cells - neuron and glia, followed by an autoimmune reaction. It is established that increase of the level NSE, MBP, S-100 protein can be isolated or in combination, positive correlating with the severity of the neurological deficiency measured by the NIHSS and negative correlating with clinical recovery of neurological function by 17 -21 days of the BIS. Shown that the most sensitive marker of the dynamics of pathological process in BIS is a change in blood concentration of MBP in the most acute stage of BIS. Found that elevated circulating levels of proinflammatory cytokine TNF-?, which indicates increased activity immunoinflammatory processes have occurred in patients with BIS compared with DEP statistically significant correlates associated with the severity and course of BIS and the forecast. It is established that TNF-? is an effective marker of the degree of damage to nerve tissue at BIS. For severe disease and unfavorable prognosis BIS cytokine status of patients BIS is characterized by a pronounced increase in TNF-? level in serum. Proved that the BIS observed pronounced disbalance between the activity of generation of free radicals and their elimination under the influence of endogenous antioxidant systems, characterized significant prevalence of active formation of free radicals and the formation of oxidative stress, which is one of the major pathogenetic mechanisms that determine metabolism and bioavailability nitric oxide in patients of BIS. Found that increasing serum levels of intracellular enzymes in the CNS BIS significantly associated processes and determined expression of oxidative modification protein molecules. Immunofan prescription in complex therapia of the patients with BIS support more rapid recovery of neurological function and is accompanied by positive dynamics of the NSB, especially in the level of MBP and is accompanied by decrease immunoinflammatory activation process and contributes to adequately reduce the generation of free radicals, which creates favorable conditions for functional recovery of vascular endothelium to the BIS. Key words: cerebral ischemic stroke, neurospecific protein, cytokine status, oxidative modification protein, "Immunofan".