Characteristics and clinical significance of magnetic resonance imaging manifestations of cerebral small vessel disease in acute period of ischemic stroke

Aim. To characterize magnetic-resonance imaging manifestations of cerebral small vessel disease in patients in acute period of ischemic stroke and to study their clinical significance. Methods. 56 patients in acute period of ischemic stroke and 10 subjects without stroke and cognitive impairment were examined. Magnetic-resonance tomography of the brain was performed to all patients and healthy subjects to assess the quantity of lacunes, perivascular spaces, leukoaraiosis and cerebral microbleeds. Based on analysis of 4 neurovisual markers of cerebral small vessel disease, an integral scale was developed. The obtained results were evaluated in association with a wide spectrum of clinical data. Results. Patients in acute period of ischemic stroke are characterized by higher quantitative expression of certain markers of cerebral small vessel disease in comparison with healthy age-matched subjects. A correlation between neuroimaging markers of cerebral small vessel disease and patients` age, severity and etiology of the stroke was observed. Total expression of cerebral small vessel disease, assessed using the integral score turned out to be higher in the group of stroke than in healthy elderly persons. High rates of certain markers of cerebral small vessel disease and integral scale score are associated with low mobility of patients, neurological deficiency and dependence in daily activities on discharge. Conclusion. In patients in acute period of ischemic stroke, higher expression of certain markers of cerebral small vessel disease and their total evidence were revealed in comparison with healthy people; total indicator of cerebral small vessel disease expression is associated with neurological and functional outcome of acute period of stroke

Взаимосвязь динамики сывороточных концентраций интерлейкина-1β, интерлейкина-6 и интерлейкина-10 с клиническими данными в остром периоде ишемического инсульта в зависимости от стратегии реперфузионной терапии

Aim. To study the relationship between the dynamics of serum concentrations of interleukin-1β, interleukin-6 and interleukin-10 with clinical data in the acute period of ischemic stroke, and the strategy of reperfusion therapy.Materials and methods. In 28 patients with acute ischemic stroke, half of whom underwent intravenous thrombolysis, the concentration of interleukin-1β, interleukin-6 and interleukin-10 was assessed at admission, on the 3rd and 10th day of the disease.Results. The concentration of interleukin-1β and interleukin-6 decreases during the acute period of stroke. The concentration of interleukin-10 remains unchanged for the first 10 days since the development of stroke. When thrombolysis is performed, there is a more significant decrease in interleukin-1β concentration in the hyperacute period of stroke, whereas in patients without reperfusion there is a decrease in interleukin-6 concentration from 1 to 10 days. The concentration of cytokines is associated with age, lipid spectrum, severity of carotid atherosclerosis, myocardial hypertrophy and injection fraction of the heart. Only in the subgroup of thrombolysis, correlations of cytokine concentrations with systolic blood pressure at admission, hemoglobin concentration, total cholesterol and high-density lipoproteins, hematocrit, degree of stenosis of the contralateral carotid artery, injection fraction and the number of antihypertensive drugs prescribed in the hospital were recorded. The concentration of interleukin-6 at day 10 is associated with the severity of stroke at admission, and the level of IL-10 on day 3 of the disease, with the mobility of patients at discharge.Conclusions. In the hyperacute period of stroke, there is a decrease in the pro-inflammatory activity of blood serum, more pronounced in patients undergoing systemic thrombolysis. Concentrations of interleukin1β, interleukin-6 and interleukin-10 are associated with a wide range of parameters characterizing the cardiovascular and functional status, and the pattern of these associations differs depending on the reperfusion therapy strategy. Цель. Изучить взаимосвязь динамики сывороточных концентраций интерлейкина-1β, интерлейкина-6 и интерлейкина-10 с клиническими данными в остром периоде ишемического инсульта в зависимости от стратегии реперфузионной терапии.Материалы и методы. В исследование включены 28 пациентов в возрасте от 47 до 87 (64 ± 13) лет, в том числе 21 мужчина и 7 женщин. У всех пациентов в остром периоде ишемического инсульта, 14 из которых проводилась внутривенная тромболитическая терапия, оценена концентрация интерлейкина-1β, интерлейкина-6 и интерлейкина-10 при поступлении, на 3-и и 10-е сут заболевания. Результаты. Концентрация интерлейкина-1β и интерлейкина-6 снижается в течение острейшего периода инсульта. Концентрация интерлейкина-10 остается неизменной на протяжении первых 10 сут с момента развития мозговой катастрофы. При проведении тромболизиса отмечается более значимое снижение концентрации интерлейкина-1β в острейшем периоде инсульта, тогда как у пациентов без реперфузии наблюдается снижение концентрации интерлейкина-6 с 1-го по 10-е сут заболевания. Концентрация цитокинов ассоциирована с возрастом, параметрами липидного спектра, выраженностью каротидного атеросклероза, гипертрофией миокарда и насосной функцией сердца. Лишь в подгруппе тромболизиса зафиксированы корреляции концентрации цитокинов с величиной систолического артериального давления при поступлении, концентрацией гемоглобина, общего холестерина и липопротеинов высокой плотности, гематокритом, степенью стенозирования контралатеральной сонной артерии, фракцией выброса сердца и количеством антигипертензивных препаратов, назначенных в стационаре. Концентрация интерлейкина-6 на 10-е сут связана с тяжестью инсульта при поступлении в стационар, а уровень интерлейкина-10 на 3-и сут заболевания − с мобильностью пациентов при выписке.Выводы. В острейшем периоде инсульта происходит снижение провоспалительной активности сыворотки крови, более выраженное у пациентов, которым проведен системный тромболизис. Концентрация интерлейкина-1β, интерлейкина-6 и интерлейкина-10 ассоциирована с широким спектром параметров, характеризующих сердечно-сосудистый и функциональный статус, причем паттерн данных ассоциаций отличается в зависимости от стратегии реперфузионной терапии

Interrelation of the dynamics of serum concentrations of interleukin-1β, interleukin-6 and interleukin-10 with clinical data in acute ischemic stroke and the strategy of reperfusion therapy

Aim. To study the relationship between the dynamics of serum concentrations of interleukin-1β, interleukin-6 and interleukin-10 with clinical data in the acute period of ischemic stroke, and the strategy of reperfusion therapy.Materials and methods. In 28 patients with acute ischemic stroke, half of whom underwent intravenous thrombolysis, the concentration of interleukin-1β, interleukin-6 and interleukin-10 was assessed at admission, on the 3rd and 10th day of the disease.Results. The concentration of interleukin-1β and interleukin-6 decreases during the acute period of stroke. The concentration of interleukin-10 remains unchanged for the first 10 days since the development of stroke. When thrombolysis is performed, there is a more significant decrease in interleukin-1β concentration in the hyperacute period of stroke, whereas in patients without reperfusion there is a decrease in interleukin-6 concentration from 1 to 10 days. The concentration of cytokines is associated with age, lipid spectrum, severity of carotid atherosclerosis, myocardial hypertrophy and injection fraction of the heart. Only in the subgroup of thrombolysis, correlations of cytokine concentrations with systolic blood pressure at admission, hemoglobin concentration, total cholesterol and high-density lipoproteins, hematocrit, degree of stenosis of the contralateral carotid artery, injection fraction and the number of antihypertensive drugs prescribed in the hospital were recorded. The concentration of interleukin-6 at day 10 is associated with the severity of stroke at admission, and the level of IL-10 on day 3 of the disease, with the mobility of patients at discharge.Conclusions. In the hyperacute period of stroke, there is a decrease in the pro-inflammatory activity of blood serum, more pronounced in patients undergoing systemic thrombolysis. Concentrations of interleukin1β, interleukin-6 and interleukin-10 are associated with a wide range of parameters characterizing the cardiovascular and functional status, and the pattern of these associations differs depending on the reperfusion therapy strategy