Clinical and immunobiochemical study of efficacy and stress-protective properties of thyroliberin at the acute stage of carotid ischemic stroke
Skvortsova, V.I.; Platonova, I.A.; Shamalov, N.A.; Polepchuk, A.N.; Maslak, A.A.; Arsen'eva, E.L.; Grivennikov, I.A.
Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova Suppl 16: 51-59
2006
ISSN/ISBN: 1997-7298 PMID: 18196636 Document Number: 596981
Stress-promoting system is known to be involved in course and outcome of acute stage of ischemic stroke. An important predictor of an unfavorable course of stroke is so-called "low T3-syndrome". Therapy with drugs increasing T3 level on the background of reduced reaction of oxidative stress is one of a perspective direction of neuroprotection. The study aimed at investigating thyroliberin influence on a clinical course and an outcome of ischemic atherothrombotic stroke as well as on thyroid hormones level in 46 patients (27 women and 19 men) aged 55-75 years admitted to the hospital at the first 24 hours of the disease. Twenty-one patients were switched to thyroliberin in dosage 500 mcg twice a day during 5 days. A control group included 25 patients. Neurological status of the patients was evaluated on days 1, 3, 7 and 21 using the Orgogozo scale and functional recovery was assessed on day 21 with the Bartel scale. Radioimmunoassay of TTH level, cT3 and free thyroxine (cT4) in blood plasma was conducted on days 1, 2, 3 and 7 using test-kit IRMA TTG CT (Belorus). Atherosclerotic changes of MAG were measured with USDG on day 1. All the patients underwent MRI of the brain on days 1, 7 and 21 using tomograph Ellips (Russia) 0.15 Tesla. The dynamics of regress of neurological disturbances in patients receiving thyroliberin appeared as the higher total score on the Orgogozo scale on days 3, 7 and 21 especially in a severe course of the diseases compared to the control group (p<0,007 on day 7). The T3 level in these patients was significantly higher (p<0,05) on days 2, 3 and 7 and the thyroxine level was increased significantly on the 3rd day of stroke (p<0,005) as compared to the control group. In patients with moderate severity of the disease, the TTH level was significantly higher on the 2nd day of stroke (p=0,0004). However, in patients with a severe course TTH and T4 concentrations did not differ in both groups. The results of the study suggest that the use of thyroliberin in an acute stage of ischemic stroke prevents development of "low T3 syndrome" that promotes more rapid and essential regress of neurological disturbances.