Журнал неврологии и нейрохирургических исследований / Journal of Neurology and Neurosurgical Research Volume 7 Issue 5 (2026)
ISCHEMIC-REPERFUSION INJURY AFTER THROMBOLYTIC THERAPY FOR ISCHEMIC STROKE
Ярашев Акмал Рустамович, Сабиров Джурабой Марифбаевич, Эшонов Олим Шойимкулович, Нариманова Хамидабону Анваровна
Abstract
A prospective study of 67 patients with ischemic stroke who underwent systemic thrombolytic therapy (ТLT) was conducted. Depending on the course of the post-reperfusion period, the patients were divided into two groups: the first group consisted of 48 patients who did not develop reperfusion syndrome, and the second group consisted of 19 patients with clinical manifestations of ischemia-reperfusion injury (IRI). In patients without IRI, a significant improvement in neurological status was observed already 24 hours after TLT: the level of consciousness according to the GCS increased from 10.3±1.2 to 13.8±1.2 points, reaching 14.1±0.9 points by the 7th day (p<0.005), while the NIHSS index decreased from 14.2±1.8 to 6.3±1.5 points after 24 hours and to 5.2±2.1 points by the 7th day (p<0.005). In contrast, patients with IRI experienced early clinical deterioration, accompanied by hyperthermia, worsening neurological deficits, impaired consciousness, seizures, and hemodynamic and respiratory distress. The GCS decreased from 10.6±2.4 to 9.3±3.5 points after 24 hours and was 10.1±4.5 points on day 7, while the NIHSS increased from 14.9±3.5 to 18.3±4.1 points after 24 hours and remained high (16.1±4.5 points) on day 7. The development of IRI after systemic TLT is associated with early neurological deterioration and unfavorable dynamics of clinical indicators, reflecting the progression of IRI of the brain.
ишемический инсульт; системная внутривенная тромболитическая терапия; реперфузионный синдром, неврологический дефицитischemic stroke; systemic intravenous thrombolytic therapy; reperfusion syndrome, neurological deficitishemik insult; tizimli vena ichiga trombolitik terapiya; reperfuziya sindromi, nevrologik defitsit
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