Filimonov D. The role of hyperhomocysteinemia and disturbance of lactate-pyruvate metabolism in the development of ischemic stroke in young adults

The dissertation is devoted to studying the role of homocysteine metabolism disorders, lactate and pyruvate in acute ischemic stroke in young adults with a view to improving the efficiency of the therapy and prophylaxis of ischemic stroke in young adults. A comprehensive clinical neurological, laboratory and instrumental examination of 50 young patients (18-45 years) and 40 elderly patients (51-74 years) with ischemic mainly thrombotic and lacunar stroke in the acute period. It was shown that in young patients acute ischemic is associated with increased lactate (median of 4.66 mmol / L; 95% CI 2,52 - 5,67 mmol / l) and lactate-pyruvate ratio (median, 42.41 mmol / l ; 95% CI 27,21 - 48,23 mol / L). In the acute phase of ischemic stroke homocysteine levels significantly correlated with the ratio of lactate: pyruvate (rho = 0,619; p = 0,041), the activity of antithrombin-III (rho = -0,833; p = 0,0102), ADP platelet aggregation (rho = 0,667; p = 0,0450). Therapy scheme aimed to reduce homocysteine and lactate levels in the acute phase of ischemic stroke was developed. This scheme include B vitamins, folic acid and quercetin. The effectiveness of the scheme had been confirmed clinically.