Ke ho?ololi nei ka ho?onohonoho ?ana o Citicoline i kahi loli ko?iko?i, e ulu mālie ana mai kahi "lā?au lapa?au adjuvant" ku?una i kahi "?ano neuroprotective agent". ?A?ole kumu kumu ?ole kēia ho?ololi, akā ma muli o ka hō?ili?ili mau ?ana o nā hō?ike lā?au lapa?au e pili ana i nā hō?ike, kahi ?ike hohonu o kāna ?ano hana multi-target o ka hana, a me ka ?ike ko?iko?i o ka "window window" i ka mālama ?ana i ka ?eha a?alolo. Eia nā kumu nui a me nā loiloi e kāko?o ana i kēia ho?ololi:

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1、 Ka ikaika ho?okele kumu: Nā hō?ike ikaika mai ka mīkini a hiki i ka hana lapa?au

Nānā hou i ke ?ano o ka hana (ma waho a?e o ke 'kōkua'):

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Membrane phospholipid repair core: ?O Cytophosphatidylcholine kahi mea mua no ka synthesis o nā phospholipid membrane cell, e like me ka phosphatidylcholine. ?O ka ho?oha?aha?a ?ana i ka membrane phospholipid kahi hanana hō?eha ko?iko?i ma hope o ka neuronal ischemia/hypoxia. Hiki i ka Phosphatidylcholine ke ho?opili pololei i nā mea synthesis phospholipid endogenous, e ho?oikaika i ka ho?oponopono ?ana o ka membrane cell nerve a me ka pa?a, ?o ia ke kumu kumu o ka neuroprotection.

?O nā hopena neuroprotective lehulehu:

E hō?emi i ka excitotoxicity: kaohi i ka ho?oku?u nui a me ka ?ona o ka glutamate.

Antioxidant stress: ho?onui i ka pae glutathione a ho?oma?ema?e i nā radical manuahi.

Ho?omaika?i i ka hana mitochondrial: mālama i ka metabolism ikehu a ho?emi i ka apoptosis cell.

Ho?onui i ka synthesis neurotransmitter: ho?onui i nā pae o ka acetylcholine, dopamine, etc.

E ho'ēmi i ka neuroinflammation: pale i ka ho?oku?u?ana o nā cytokines pro-inflammatory.

Ho?oholo ka mīkini ?o ia ke kuleana ko?iko?i o "ka hana mua a me ka pale ikaika", ?a?ole he mea kōkua wale no ka hō?olu?olu o nā hō?ailona. ?

?O ka hō?ili?ili ?ana o nā hō?ike hō?ike ki?eki?e ki?eki?e (e uha?i i ka mana?o o "auxiliary"):

?O ka ma?i ma?i ischemic acute (AIS):

Ha?awina ICTUS (2012): ?Oiai ?a?ole maika?i ka hopena mua, ?o nā pū?ulu i koho mua ?ia (ka ma?i ma?i a i ka ma?i ko?iko?i, ka mālama mua ?ana) ua hō?ike i nā pōmaika?i ko?iko?i, e hō?ike ana he mea ko?iko?i ka manawa mālama a me ke koho ?ana o ka heluna kanaka.

Ha?awina ECCO 2 (2023): RCT nui i alaka?i ?ia ma ka heluna kanaka Kina (3947 mau ma?i AIS i komo). Ua hō?ike ?ia nā hopena ma ke kumu o ka thrombolysis intravenous a me / a i ?ole ka mālama ?ana i ka endovascular, i ka wā mua (i loko o 24 mau hola ma hope o ka ho?omaka ?ana) ho?ohana intravenous o phosphatidylcholine no nā lā 14 i ho?onui nui i ka māhele o 90 lā hana kū?oko?a (mRS 0-1) (43.5% vs 40.0%), a maika?i ka palekana. E hō?oia i kona hopena synergistic ma ke kumu o ka ma?amau reperfusion therapy. ?

Nui nā meta-analyses: kāko?o i kona pono i ka ho?omaika?i ?ana i nā hopena neurological a me nā hiki ke ola i kēlā me kēia lā, ?oi aku ka ho?omaka ?ana i ka mālama ?ana i ka wā mua o ka ho?omaka ?ana (

?Eha Loko Traumatic (TBI):

Ke a?o COBRIT: He ho?opa?apa?a nā hopena, akā hō?ike ka ho?opa?a ?ana ma hope e loa?a i nā pū?ulu kiko?ī kiko?ī (ma?alahi a ko?iko?i TBI).

Ka noi?i honua maoli a me ka meta-analysis: Ua hō?ike ?ia nā ha?awina lehulehu e hiki ke ho?omaika?i i nā hopena neurological a me ka ho?iho?i ?ana i ka ?ike i nā ma?i TBI.

Nā ma?i neurodegenerative (ma lalo o ka ?imi ?ana):

?O ka hō?ino ?ana i ka na?au (VCI)/dementia vascular (VaD): Ua hō?ike nā ha?awina e hiki ke ho?omaika?i i ka hana no?ono?o (nānā, ho?okō, ho?omana?o).

?O ka ma?i o Alzheimer (AD)/Parkinson's ma?i (PD): Ma ke ?ano he mau mea ho?ololi ma?i hiki ke ho?ololi ?ia, hō?ike kekahi mau ha?awina li?ili?i i ka ho?omaika?i ?ana i ka no?ono?o a me ke ?ano.

?O ka noi?i ?ana i nā ?ano ?ē a?e e like me ka glaucoma a me ka ?eha spinal cord i hō?ike pū kekahi i ka hiki ke neuroprotective.

2、 ?O ke kumu nui o ka ho?ololi ?ana i ke kūlana: mai ka "auxiliary" a i ka "core"

Ke ne?e nei i ka manawa o ka lapa?au ?ana i mua (ka hana ko?iko?i o ka "puka manawa gula"):

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?O ke kī i ka neuroprotection aia i ka 'mua'. Ma hope o ka ?eha o ka lolo (e like me ka hahau ?ana, TBI), ho?omaka ?ia kahi pane ?eha cascade i kekahi mau minuke a i kekahi mau hola ma hope.

Ho?oholo ke ?ano o ka hana o ka phosphatidylcholine e ho?ohana ?ia i ka wā mua loa o ka hopena cascade hō?eha (e like me i loko o 24 mau hola ma hope o ka ho?omaka ?ana o ka hahau ?ana, ?oi aku ka maika?i ma mua) e ālai i ke ala ?eha a pale i nā ?i?o neural pō?ino i ka nui loa. He ?oko?a loa kēia mai ke kūlana ku?una o "lā?au lapa?au adjuvant rehabilitation".

Ho?okumu ?ia ka kūle?a o ka noi?i ECCO 2 ma ka ho?olālā ?ana i nā protocols administration intravenous mua.

?O ke kūlana kumu o ka ho?olālā lapa?au (i hui pū ?ia me ka reperfusion therapy):

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?O ka hana hou i ke ?ano o ka mālama ?ana i ka ma?i ischemic stroke: ?O ka ho?oma?ama?a ma?amau he vascular recanalization (thrombolysis, thrombectomy), akā ?o ka hapa nui o nā mea ma?i e loa?a mau ana ka maika?i ?ole ma hope o ka recanalization (reperfusion injury, no reflow phenomenon, etc.).

Hiki i ke ?ano neuroprotective o phosphatidylcholine (stabilizing cell membrane, antioxidant, anti apoptotic) ke ho?ohui a synergize me ka reperfusion therapy, e hō?emi ana i ka hō?eha reperfusion a me ka pale ?ana i ka lolo ma hope o ka reperfusion.

Ua hō?oia ka noi?i ECCO 2 i kona waiwai ma ke ?ano he ?āpana neuroprotective ko?iko?i i ka ho?olālā "vascular recanalization +", ?a?ole ia he ho?ohui kōkua koho.

Ho?onui i nā ala ho?okele (e hahai ana i ka bioavailability):

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?O ka phosphatidylcholine waha he ha?aha?a bioavailability (

Hiki ke hā?awi i ka ho?okele intravenous i ka bioavailability ki?eki?e, e ho?okō koke i ka ho?opa?a ?ana i ka lā?au lapa?au koko pono, a ho?okō i nā pono o ka neuroprotection wikiwiki i ka pae ko?iko?i.

?O ka ne?e ?ana i ke kūlana "core" e hele pū ?ia me ka ?ōlelo a?oa?o o nā ?ano ?ano intravenous no ka ho?ohana ?ana i ka pae ko?iko?i.

3、 Ho?ohou i nā alaka?i/consensus (e hō?ike ana i kahi ho?ololi i ke kūlana)

Kina:

Ua hō?ike ?ia ka "Guidelines for the Prevention and Treatment of Stroke in China" a me nā palapala ?ē a?e i kona hopena neuroprotective.

Ma muli o nā hopena holomua o ka noi?i ECCO 2, ua mana?o ?ia e ho?omaika?i maika?i ?ia ka pae ?ōlelo a me ka ho?onohonoho ?ana o ka phosphatidylcholine (?oi aku ka intravenous formulations i ho?ohana ?ia i ka manawa acute) i nā alaka?i Kina i ka wā e hiki mai ana. ?

International:

?A?ole i kuhikuhi ?ia nā alaka?i AHA / ASA ma ?Amelika Hui Pū ?Ia, akā ua wehe lākou i ka noi?i ?ana i nā mea hana neuroprotective.

?O kekahi mau alaka?i ?āina ?Eulopa he loiloi maika?i a?e o ka phosphatidylcholine (e like me Sepania, Pokukala).

4、 ?O ke ko?iko?i o ka ho?ololi ?ana i ke kūlana ho?oma?ama?a

Hō?ano hou i ka mana?o lapa?au: ?O ka Neuroprotection he pou like ko?iko?i i ka mālama ?ana i ka hō?eha lolo e like me ka ho?oponopono hou ?ana i ka vascular.

Ho?onui i ka ho?olālā lapa?au: Ho?oikaika i ka lā?au ho?ohui kumu o ka phosphatidylcholine (intravenous) e like me ka mālama ma?amau (e like me ka thrombolysis/thrombectomy) i ka manawa hyperacute/acute o ka hahau ?ana/TBI a me nā ma?i ?ē a?e.

Ho?omaika?i i ka wānana o ka ma?i: Ma o ka neuroprotection mua a me ka maika?i, mana?o ?ia e ho?omaika?i hou i ka helu ola a me ka pae ho?ōla hana o nā ma?i me ka ?eha lolo, a e hō?emi i ke kīnā.

Ho?oikaika i ka noi?i a me ka ho?omohala ?ana: Ho?olaha i nā ha?awina hau?oli ki?eki?e a e ?imi i nā regimens lawe lā?au hou no ka neuroprotection acute.

Hō?ulu?ulu mana?o a me Outlook

?O ka ho?ololi ?ana o ka phosphatidylcholine mai kahi "adjuvant drug" i kahi "core neuroprotective agent" ?o ia ka hopena o ka ho?onui ?ana i ka noi?i kumu, nā holomua i nā hō?ike lapa?au (?oi aku ka noi?i ECCO 2), a me nā mana?o lapa?au hou. Aia kona kumu ma:

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Ho?omaka mua: E ho?oikaika i ka lā?au lapa?au i ka puka aniani manawa gula (?āpana acute/subacute early stage) ke ho?omaka ?ia ka hopena cascade o ka ?eha a?alolo.

?O ka mea nui i loko o ka intravenous: I ka manawa ko?iko?i kahi e koi ?ia ai ka hana wikiwiki, ?o ka ho?okele intravenous ke ala nui e ho?okō ai i nā hopena pale.

Ka ho?onui ?ana i ka pono hui: Ma ke ?ano he mea ko?iko?i ko?iko?i o ka neuroprotection ma ke kumu o ka vascular recanalization therapy (stroke) a i ?ole ka mālama piha ?ana (TBI), ?a?ole ia he bonus ho?ohui.

Hō?ike kēia ho?ololi i ka ?ike hou ?ana a me ka ho?onui ?ana i ka waiwai o ka phosphatidylcholine i ka mālama ?ana i nā ma?i neurological, ?oi aku ho?i i ke ?ano o ka mālama ?ana i ka ma?i ischemic stroke. Ma ke ?ano he ?āpana ko?iko?i o ka ho?olālā "standard reperfusion therapy+core neuroprotection", ke loa?a nei ia i ke kāko?o e pili ana i nā hō?ike a me ka ?ike lapa?au. I ka wā e hiki mai ana, me ka ho?omohala ?ana i nā noi?i ki?eki?e a me nā mea hou i nā alaka?i, e ho?ohui hou ?ia kona kūlana kumu.