THE USE OF CHOLINE ALFOSCERATE FOR THE PREVENTION AND CORRECTION OF COGNITIVE IMPAIRMENT IN COMBAT TRAUMA

Krishtafor A. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The aim of the study was to determine the efficacy of Gliatilin as a drug that reduces the severity of cognitive impairments caused by combat trauma. 44 injured, divided into the main (24) and control (20) groups were examined. Patients from both groups received standard intensive care. In the main group, additionally, Gliatilin was applied according to the scheme: 1 g once a day intramuscularly and switching to ingestion 400 mg twice a day for up to 10 days. Cognitive functions (CFQ and MMSE scales) and stress response (IES-R scale) were studied. The severity of injury and somatic status was assessed using ISS, EmTraS, SAPS II scales. The level of cognitive functions that preceded trauma was assessed retrospectively on the CFQ scale. The same scale was used to study the state of cognitive functions 3 months after the injury. The MMSE scale was used on the 2nd day with complete recovery of consciousness, before transfer from the ICU and before discharge from the hospital. The IES-R scale was used before transfer from the ICU and 3 months after discharge. Results.It was noted that combat trauma causes a decrease in cognitive functions by more than 10% (by 12.7% lower in the control group and 11.4% in the main group), which corresponds to the level of dysfunction. By the end of the hospital period, cognitive functions were partially restored in both groups, but in the control group after 3 months there was a repeated deterioration (12.1% below the baseline level), while in the main group, cognitive functions continued to recover (by 5.7% below the baseline level). The reaction to stress in the wounded in the ATO zone is gradually increasing from the minimum and low at the time of discharge to low after 3 months. Conclusion. Combat trauma causes a decrease in the quality of brain function, manifested by cognitive dysfunction. Gliatilin helps to accelerate the recovery of the quality of brain function and less progression of stress reaction.

cognitive impairment, combat trauma, choline alfoscerate

1. Volkov AO, Klygunenko EN, Vetoshka IA. Kak otsenit` kognitivnye funktsii pered kesarevym secheniem? 2014;3. Dostupno: https://science-education.ru/ru/article/view?id=13474[in Russiаn]. 
2. Golohvastov SYu, Tsygan NV. Mnogotsentrovoje (pilotnoe) issledovanije effektivnosti gliatilina pri ostrom ishemcheskom insul`te. Klinicheskaje nevrologija. 2010;4(1):20-7. [in Russiаn]. 
3. Zaharov VV, Yahno NN. Kognitivnyie rasstroystva v pozhilom i starcheskom vozraste: Metodicheskoe posobie dlya vrachey. М.; 2005. 71 s. Dostupno: http://www.moscowuniversityclub.ru/article/files/13498_63020093.pdf[in Russiаn].
4. Kostenko EV, Petrova LV, Ganzhula PA, Ismailov AM, Lisenker LN, Otcheskaya OV. Kompleksnaya reabilitatsiya patsientov s posttravmaticheskoy entsefalopatiey s primeneniem Tserepro v ambulatornyih usloviyah. Lechebnoe delo. 2013;2. Dostupno: http://cyberleninka.ru/article/n/kompleksnaya-reabilitatsiya-patsientov-s-posttravmaticheskoy-entsefalopatiey-s-primeneniem-tserepro-v-ambulatornyh-usloviyah[in Russiаn].
5. Krishtafor AA. Kognitivnyie narusheniya, obuslovlennyie kriticheskimi sostoyaniyami, kak proyavlenie tserebralnoy nedostatochnosti. Meditsina neotlozhnyih sostoyaniy. 2015;2(65). Dostupno: http://cyberleninka.ru/article/n/kognitivnye-narusheniya-obuslovlennyekriticheskimi-sostoyaniyami-kak-proyavlenie-tserebralnoy-nedostatochnosti [in Russiаn]. 
6. Krishtafor AA, Usenko LV, Tyutyunnik AG, Krishtafor DA, Perederiy MN. Effektivnost primeneniya reamberina s tselyu korrektsii kognitivnyih funktsiy v ostrom periode politravmyi. Ukrainskiy zhurnal meditsini, bIologii ta sportu. 2017;4(6):76-81. DOI: 10/26693/jmbs02.04.075 [in Russiаn]. 
7. Lesnoy II, Belka KYu, Klimchuk LV, Vorobeva LI, Kabanchuk YuV, Katrichenko MO, i dr. Posleoperatsionnaya kognitivnaya disfunktsiya u zhenschin srednego vozrasta: intsidentnost i metodyi profilaktiki. Novosti meditsinyi i farmatsii. 2013;474. Dostupno: http://www.mifua.com/archive/article/37274[in Russiаn]. 
8. Melnitskaya TB, Havyilo AV, Belyih TV. Shkala otsenki vliyaniya travmaticheskogo sobyitiya (IES-R) primenitelno k radiatsionnomu faktoru [Internet]. Psihologicheskie issledovaniya: elektronnyiy nauchnyiy zhurnal. 2011;5(19). Dostupno: http://psystudy.ru/index.php/num/2011n5-19/546-melnitskaya-et-al-19.html [in Russiаn].
9. Nikonov VV, Savitskaya IB. Vozmozhnosti primeneniya holina alfostserata dlya lecheniya postgipoksicheskoy entsefalopatii. Meditsina neotlozhnyih sostoyaniy. 2011;1-2(32-33). Dostupno: http://www.mif-ua.com/archive/article/16262[in Russiаn].
10. Odinak MM, Voznyuk IA, Piradov MA, Rumyantseva SA, Kuznetsov AN, Yanishevskiy SN, i dr. Mnogotsentrovoe (pilotnoe) issledovanie effektivnosti gliatilina pri ostrom ishemicheskom insulte. Annalyi klinicheskoy i eksperimentalnoy nevrologii. 2010;1. Dostupno: http://cyberleninka.ru/article/n/mnogotsentrovoe-pilotnoe-issledovanie-effektivnosti-gliatilina-pri-ostrom-ishemicheskom-insulte[in Russiаn].
11. Rumyantseva SA. Nevrologicheskie rasstroystva pri sindrome poliorgannoy nedostatochnosti. Nervnyie bolezni. 2003;2:2-8.[in Russiаn].
12. Tarabrina NV. Praktikum po psihologii posttravmaticheskogo stressa. SPb: Piter; 2001. 272 s. [in Russiаn].
13. Usenko LV, Krishtafor AA, Polinchuk IS, Tyutyunnik AG, Usenko AA, Petrashenok EV. Posleoperatsionnyie kognitivnyie rasstroystva kak oslozhnenie obschey anestezii. Znachenie ranney fаrmakologicheskoy neyroprotektsii. Meditsina neotlozhnyih sostoyaniy. 2015;2(65). Dostupno: http://cyberleninka.ru/article/n/posleoperatsionnye-kognitivnye-rasstroystva-kak-oslozhnenie-obschey-anestezii-znachenieranney-farmakologicheskoy-neyroprotektsii [in Russiаn].
14. Usenko LV, Rizk ESh, Krishtafor AA. Posleoperatsionnaya kognitivnaya disfunktsiya kak anesteziologicheskaya problema i puti ee resheniya. Bil`, znebolyuvannya i intensiv. terapiya. 2008;4:14-20. [in Russiаn].

«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 135-139 pages, index UDK 616.89-008.44/.48:616-001.3/.4

10.29254/2077-4214-2018-1-1-142-135-139