Baranova E. Features of cytokine-enzymatic balance in patients with different types of cerebral strokes and optimization of their treatment tactics

Thesis is devoted to the improvement of diagnostics and optimization of therapeutic measures in patients with different types of brain strokes. On the basis of summarizing the results of a comprehensive survey of 141 patients with ischemic stroke, hemorrhagic stroke and ischemic stroke with hemorrhagic transformation, clinical - neurological, neuroimaging and cytokine-enzyme features in acute period of these types of strokes have been identified. The characteristics of changes of pro- and anti-inflammatory IL-6 and IL-10 and proteolytic enzyme MMP-9 have been presented, the dynamics of changes in these indicators and their impact on the course of the various types of cerebral strokes have been studied. The associated participation of these factors and their significant role in the development of primary and secondary hemorrhagic processes in patients with CS have been revealed. A shortened method of determination of MMP-9 for early treatment and timely correction of the risk of hemorrhagic complications during the IS for minimization of their occurrence during thrombolytic therapy has been developed. Based on the obtained results, the pathogenetically grounded recommendations for improvement of diagnosis and optimization of treatment in patients with CS, as well as for reducing the risk of bleeding complications in IS have been developed.