The Application Of Preparation Mavix In The Complex Treatment Of Ischemic Stroke In The Elderly Age

Based on the results of clinical and neurological studies, the use of mavix in the complex treatment of elderly patients with ischemic stroke is justified. The obtained data on the differentiation of the therapeutic response contribute to the optimization of therapy for acute ischemic stroke in order to stop or slow down its progression and maintain the quality of life of both the patients themselves and their families.


INTRODUCTION
Considering the importance of the regulatory functions of mavix, their participation in the modulation of the most significant molecular and cellular processes in the nervous tissue, it is of particular interest to study the possibility of their neuroprotective effect on the brain under ischemic conditions.The first experimental studies of mavix in cerebral ischemia were associated with an assessment of their effect on the rate and severity of reparative processes.It was found that the introduction of monosialoganglioside 30 The American Journal of Medical Sciences and Pharmaceutical Research (ISSN -2689-1026) At present, the basic principles of complex treatment of ischemic stroke, which makes up about 80% of all types of acute cerebrovascular accident, have been determined.The management of patients after stroke involves the use of a whole range of different medical methods, including drug therapy, at all stages of the rehabilitation process, starting with the acute period of the disease, when the patient's rehabilitation potential is largely determined.Since the recovery process after a stroke is multicomponent and multidisciplinary, drug therapy consists of basic (correction of basic vital functions) and reperfusion therapy (use of anticoagulants, antiplatelet agents and tissue plasminogen activators); neuroprotection (preventing, interrupting and reducing the damaging effects on the brain), Neuroprotective therapy is one of the most attractive and promising directions in the treatment of patients with ACVA, the main task of which is to increase the resistance of cerebral neurons to acute ischemia.
The main directions of neuroprotection are associated with the restoration of neurons in ischemic penumbra and stimulation of reparative processes.A large number of studies are devoted to the study of the effects of neuroprotectors of various classes after suffering a cerebrovascular accident, and they are actively continuing.There are serious reasons to believe that it is an individualized, pathogenetically grounded rehabilitation approach that will allow this strategic direction to obtain the greatest effect and level of evidence in clinical trials of drugs [15].
Mavix are glycoconjugates related to glycosphingolipids and containing sialic acid in the carbohydrate moiety.Mavix carry out a number of important functions in the body.Some of these glycoconjugates are specific cellular receptors for a number of toxins, bacteria and viruses, are involved in cell-cell interactions, the transfer of ions across biological membranes, determine the antigenic properties of the cell surface, and are considered mediators of the immune response.In those areas of nerve endings in which the binding of neurotransmitter molecules occurs in the process of chemical transmission of a nerve impulse, G. are also present.They take part in the reception of serotonin in serotonin-sensitive tissues, Thus, neuroprotective therapy is a strategically important and pathogenically grounded therapeutic direction for patients after ischemic stroke, which must be used throughout the entire recovery period after cerebrovascular accident in compliance with the principles of evidence-based medicine.
The purpose of the study was the study of the effectiveness of a new group of neurocytoprotectors -mavix in the treatment of patients with acute ischemic stroke.

MATERIALS AND RESEARCH METHODS
The group that received the study drug "Mavix" included 25 patients (group 1), group 2 included 25 patients with the basic method of treatment of ischemic stroke.
In group 1, there were 13 men (52.0%), women -12 (48.0%), and the average age of patients was 61.9 ± 0.6 years.In group 2, there were 14 (56.0%)men, 11 (44.0%)women, and the average age of patients was 62.7 ± 0.5 years.All patients underwent a comprehensive clinical and somatic, clinical and neurological, laboratory, functional and instrumental examination.
The study was carried out on admission (1st day), after the end of the administration of drugs (11th day) and 21 days from the start of treatment.
Statistical analysis of the results obtained was carried out using the methods of variation statistics.The significance of the mean differences was assessed on the basis of the Student's t-test with a 95% confidence interval (p <0.05).

RESEARCH RESULTS
Dynamics of changes in indicators of neurological deficit (in points) according to scales NIH and SNSS is presented in table 1. Assessment of the social adaptation of patients, their dependence on outside help, and the determination of the quality of life was carried out using the Bartel scale upon admission to the department, and compared with that on the 11th and 21st days from the start of treatment.
Upon admission to the hospital, the average total score on the Bartel scale (Fig. 1) in group 1 was 46 ± 1.7, in the second group -45.0 ± 1.8 points.On day 11, this indicator in group 1 is 70 ± 2.5, in group 2 -61.2 ± 2.4 points (p <0.05).On day 21 in group 1 it was 90 ± 1.8, in group 2 -82 ± 1.9 points (p <0.01).In general, in the group taking the drug "Mavix", the effectiveness of treatment averaged 2.2 ± 0.01 points in terms of objective and specific indicators (P <0.05).In the group of patients with the basic method of treatment, the effectiveness of treatment in terms of objective and specific indicators averaged 1.8 ± 0.01 points (Fig. 3).
The This drug was well tolerated by patients throughout the study and did not cause side reactions and side shifts in the peripheral blood picture and blood biochemistry.
As can be seen from Diagram 4, patients with IS in all groups showed positive dynamics.In group 1, the effectiveness of treatment was 100%, of which 96.0% showed a marked improvement, and 4.0% had a moderate improvement.
Low results of the effectiveness of treatment were obtained in groups of patients who were on traditional treatment (group 2).
Thus, we can conclude that, based on the results of clinical and neurological studies, the use of Mavix in patients with IS is justified.The data obtained on the differentiation of the therapeutic response contribute to the optimization of therapy for acute ischemic stroke in order to stop or slow down its progression and maintain the quality of life of both patients and their families.
When conducting a cost-benefit analysis, the compared options, in contrast to the costminimization analysis, are characterized by greater or lesser, but not equivalent, efficiency.
In this regard, it is important to assess the degree of appropriateness of the analysis depending on the level of reliability of the clinical data, i.e. ways of obtaining information on the results of the comparison of clinical effectiveness.Complex therapy, including additional administration of mavix to the basic therapy, has shown high efficiency in the treatment of acute ischemic stroke.

3.
The obtained data on the comparative effectiveness of the studied types of therapy contribute to the solution of complex psychopharmaco-therapeutic problems that arise when it is necessary to choose certain methods of drug action on the development of neurological disorders.

Figure: 1 .
Figure: 1.The dynamics of the increase in the total score on the Bartel scale with IS on day

Figure: 2 .
Figure: 2. Dynamics of indicators of mental state according to the MMSE scale in patients with ISThus, in patients of group 1, the sum of points on the MMSE scale before treatment was equal to 23.6 ± 0.5; in group 2 -23.8 ± 0.56, whereas after treatment these data were 28.6 ± 0.48, 25.4 ± 0.5, respectively (P <0.05).

Figure: 3 .
Figure: 3. The effectiveness of treatment for objective and specific indicators

Figure: 4 .
Figure: 4. Dynamics of treatment efficiency indicators according to the CGI clinical scale (30 days after treatment) However, in patients undergoing traditional treatment, it was less pronounced than in