Assessment of rheological indicators of blood in patients with acute ischemic stroke when using the drug Mexidol

Authors:

D.M. Plotnikov ¹ , M.N. Stegmeier ¹ , O.I. Aliyev ²

¹ Department of Neurology and Neurosurgery of the Federal State Budgetary Institution “Siberian State Medical University” of the Ministry of Health of Russia, Tomsk, Russia;
² research institute pharmacology and regenerative therapy named after E.D. Goldberg Tomsk Nimets of the Russian Academy of Sciences, Tomsk, Russia

Place of publication:
special release of the journal of neurology and psychiatry named after S.S. Korsakov Stroke No. 3.2/2019

Summary:
Purpose of the study. To study in dynamics the rheological properties of blood in patients with acute ischemic stroke (AI) when Mexidol is included in complex therapy. Material and methods. 60 patients with acute AI examined. Mexidol (500 mg/day intravenously within 20 days) received 32 patients, 28 patients received magnesium sulfate (2000 mg/day intravenously for 20 days). The control group included 20 patients without a history of cardiovascular pathology. Assessment of rheological indicators of blood (whole blood viscosity, plasma viscosity, hematocrit, aggregation and deformability of red blood cells, the level of fibrinogen in plasma) was carried out in patients three times: during the first 12 hours, on the 3-5th day and on the 18-20th day and on the 18th-20th day After hospitalization. Results. All patients with a stroke observed a high viscosity syndrome. A statistically significant decrease in blood viscosity was detected in patients receiving Mexidol, by the 3-5th day of the disease at low shift speeds and by the 18-20 days at the speed of the shift from 3-100 S1. By the 18-20th day of the disease, reliable differences in the value of hematocrit (p = 0.026) and the content of fibrinogen (p = 0.017) were revealed in groups of patients receiving various therapy. A reliable increase in the erythrocyte deformability index in patients who received the therapy with Mexidol by the 3-5th day at the shift speeds of 90 and 890 S-1, by the 18-20th day at the shift speeds 90–360 S-1, was recorded. Conclusion. The study shows the effect of Mexol's drug on blood fluidity in the dynamics of acute cerebral ischemia and its effectiveness is proved in reducing blood viscosity by reducing the level of hematocrit and fibrinogen, as well as an improvement in the deformation ability of red blood cells. Keywords: acute ischemic stroke, rheological indicators of blood, blood viscosity, erythrocyte deformability, Mexidol (2-ethyl-6-methyl-3-hydroxypirinate), treatment of brain ischemia.