Qhov chaw kho mob ntawm Citicoline tau dhau los ua qhov tseem ceeb ntawm kev hloov pauv, maj mam hloov zuj zus los ntawm cov tshuaj "adjuvant" mus rau "tus neeg sawv cev tseem ceeb neuroprotective". Qhov kev hloov pauv no tsis yog qhov tsis muaj tseeb, tab sis raws li qhov txuas ntxiv ntawm cov pov thawj tshuaj raws li cov pov thawj, kev nkag siab tob txog nws cov phiaj xwm ntau yam ntawm kev ua, thiab kev lees paub tseem ceeb ntawm "lub sijhawm lub qhov rais" hauv kev kho mob ntawm cov hlab ntsha raug mob. Cov hauv qab no yog lub hauv paus tseem ceeb thiab kev tshuaj xyuas uas txhawb nqa qhov kev hloov pauv no:

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1, Lub zog tsav tsheb: Cov pov thawj muaj zog los ntawm cov txheej txheem rau kev kho mob

Rov ntsuam xyuas cov txheej txheem ntawm kev nqis tes ua (tshaj 'kev pab'):

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Membrane phospholipid kho core: Cytophosphatidylcholine yog ib qho ncaj qha precursor rau kev sib txuas ntawm cell membrane phospholipids, xws li phosphatidylcholine. Membrane phospholipid degradation yog qhov kev raug mob tseem ceeb thaum ntxov tom qab neuronal ischemia / hypoxia. Phosphatidylcholine tuaj yeem ncaj qha ntxiv endogenous phospholipid synthesis cov ntaub ntawv, txhawb kev puas hlwb cell membrane kho thiab stability, uas yog lub hauv paus ntawm neuroprotection.

Ntau lub hom phiaj neuroprotective teebmeem:

Txo excitotoxicity: inhibit ntau tso tawm thiab toxicity ntawm glutamate.

Antioxidant kev nyuaj siab: nce glutathione ntau ntau thiab tshem tawm cov dawb radicals.

Txhim kho mitochondrial muaj nuj nqi: tswj lub zog metabolism thiab txo cov cell apoptosis.

Txhawb nqa neurotransmitter synthesis: nce qib ntawm acetylcholine, dopamine, thiab lwm yam, txhim kho cov paj hlwb.

Txo neuroinflamation: inhibit qhov tso tawm ntawm pro-inflammatory cytokines.

Lub tshuab txiav txim siab tias nws yuav tsum yog lub luag haujlwm tseem ceeb ntawm "kev cuam tshuam thaum ntxov thiab kev tiv thaiv nquag", es tsis yog ib qho kev pabcuam rau cov tsos mob. cov

Kev sib sau ua ke ntawm cov ntaub ntawv pov thawj zoo-raws li cov pov thawj (ua txhaum los ntawm qhov kev xav ntawm "cov koom haum"):

Mob stroke ischemic stroke (AIS):

ICTUS txoj kev tshawb fawb (2012): Txawm hais tias thawj qhov kawg yog qhov tsis zoo, cov pab pawg ua ntej tau txiav txim siab (mob rau mob stroke, kev kho mob thaum ntxov) tau pom cov txiaj ntsig tseem ceeb, qhia tias lub sijhawm kho mob thiab kev xaiv pej xeem yog qhov tseem ceeb.

ECCO 2 txoj kev tshawb fawb (2023): RCT loj ua nyob rau hauv Suav pej xeem (3947 cov neeg mob AIS suav nrog). Cov txiaj ntsig tau pom tias raws li kev kho mob hauv cov hlab ntsha thiab / lossis kev kho mob endovascular, thaum ntxov (hauv 24 teev tom qab pib) kev siv cov tshuaj phosphatidylcholine rau 14 hnub tau nce qhov feem ntawm 90 hnub ua haujlwm ywj pheej (mRS 0-1) (43.5% vs 40.0%), thiab kev nyab xeeb yog qhov zoo. Paub meej tias nws cov nyhuv synergistic raws li kev kho tus qauv reperfusion. cov

Ntau qhov kev ntsuam xyuas meta: txhawb nqa nws cov txiaj ntsig hauv kev txhim kho cov txiaj ntsig ntawm lub paj hlwb thiab lub peev xwm ua neej nyob txhua hnub, tshwj xeeb tshaj yog pib kho thaum ntxov ntawm qhov pib (

Traumatic Brain Injury (TBI):

Kev tshawb fawb COBRIT: Cov txiaj ntsig tau muaj kev tsis sib haum xeeb, tab sis kev tshuaj ntsuam tom qab qhia tias cov pab pawg tshwj xeeb (nruab nrab mus rau TBI hnyav) tau txais txiaj ntsig.

Kev tshawb fawb hauv ntiaj teb tiag tiag & kev ntsuas ntsuas: Ntau qhov kev tshawb fawb tau pom tias nws tuaj yeem txhim kho cov txiaj ntsig ntawm lub paj hlwb thiab kev nco qab rov qab los ntawm cov neeg mob TBI.

Cov kab mob neurodegenerative (hauv kev tshawb nrhiav):

Vascular cognitive impairment (VCI) / vascular dementia (VaD): Cov kev tshawb fawb tau pom tias nws tuaj yeem txhim kho kev txawj ntse (kev saib xyuas, ua tiav, nco).

Alzheimer's disease (AD) / Parkinson's disease (PD): Raws li cov kab mob hloov pauv cov neeg ua haujlwm, qee qhov kev tshawb fawb me qhia txog kev txawj ntse thiab kev coj cwj pwm.

Kev tshawb fawb hauv lwm qhov chaw xws li glaucoma thiab txha caj qaum raug mob kuj tau pom tias muaj peev xwm tiv thaiv kab mob.

2, Lub ntsiab lus tseem ceeb ntawm kev hloov pauv hloov pauv: los ntawm "cov koom haum" mus rau "core"

Tsiv lub sijhawm ntawm kev kho mob rau pem hauv ntej (qhov kev cuam tshuam tseem ceeb ntawm "lub sijhawm golden"):

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Tus yuam sij rau neuroprotection yog nyob rau hauv 'thaum ntxov'. Tom qab raug mob lub hlwb (xws li mob stroke, TBI), qhov kev raug mob cascade teb tau pib ob peb feeb mus rau ob peb teev tom qab.

Cov txheej txheem ntawm kev txiav txim ntawm phosphatidylcholine txiav txim siab tias nws yuav tsum tau siv nyob rau hauv cov theem ntxov ntawm kev raug mob cascade cov tshuaj tiv thaiv (xws li nyob rau hauv 24 teev tom qab mob stroke pib, qhov ua ntej tshaj qhov zoo dua) los thaiv txoj kev raug mob thiab tiv thaiv cov ntaub so ntswg endangered mus rau qhov loj tshaj plaws. Qhov no yog txawv kiag li los ntawm cov tsoos positioning ntawm "rehabilitation adjuvant tshuaj".

Kev ua tiav ntawm ECCO 2 kev tshawb fawb yog ua raws li kev tsim cov txheej txheem kev tswj hwm kev noj qab haus huv thaum ntxov.

Lub luag haujlwm tseem ceeb ntawm txoj kev kho mob (ua ke nrog kev kho reperfusion):

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Kev tsim kho tshiab hauv kev kho mob ntawm tus mob ischemic stroke: Cov txheej txheem kho yog vascular recanalization (thrombolysis, thrombectomy), tab sis feem ntau ntawm cov neeg mob tseem muaj qhov tsis zoo tom qab recanalization (reperfusion raug mob, tsis muaj qhov tshwm sim reflow, thiab lwm yam).

Cov txheej txheem tiv thaiv neuroprotective ntawm phosphatidylcholine (stabilizing cell membrane, antioxidant, anti apoptotic) tuaj yeem ntxiv thiab sib koom ua ke nrog kev kho reperfusion, txo cov kev raug mob reperfusion thiab tiv thaiv lub hlwb tom qab reperfusion.

ECCO 2 kev tshawb fawb tau lees paub nws tus nqi raws li cov tseem ceeb neuroprotective tivthaiv hauv "vascular recanalization +" lub tswv yim, tsis yog ib qho kev xaiv ntxiv ntxiv.

Optimization ntawm txoj kev tswj hwm (nrhiav bioavailability):

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Qhov ncauj phosphatidylcholine muaj tsawg bioavailability (

Intravenous txhaj tshuaj tuaj yeem muab bioavailability siab, ua tiav cov tshuaj ntshav siab sai, thiab ua tau raws li cov kev xav tau ntawm kev tiv thaiv neuroprotection sai hauv theem mob.

Kev hloov mus rau qhov "core" positioning yuav inevitably nrog los ntawm kev pom zoo ntawm intravenous dosage forms rau siv nyob rau hauv lub mob theem.

3 、 Hloov tshiab ntawm cov lus qhia / kev pom zoo (xav txog kev hloov pauv hauv qhov chaw)

Tuam Tshoj:

Cov "Cov Lus Qhia rau Kev Tiv Thaiv thiab Kev Kho Mob Stroke hauv Suav Teb" thiab lwm cov ntaub ntawv tau pom nws cov txiaj ntsig neuroprotective.

Raws li cov txiaj ntsig ntawm kev tshawb fawb ECCO 2, nws xav tias qib kev pom zoo thiab qhov chaw ntawm phosphatidylcholine (tshwj xeeb tshaj yog cov tshuaj txhaj tshuaj siv nyob rau theem mob hnyav) hauv Suav cov lus qhia yuav ua tau zoo dua yav tom ntej. cov

International:

AHA/ASA cov lus qhia hauv Tebchaws Meskas tseem tsis tau pom zoo, tab sis lawv qhib rau kev tshawb fawb txog cov tshuaj tiv thaiv neuroprotective.

Qee lub tebchaws nyob sab Europe cov lus qhia muaj kev soj ntsuam zoo dua ntawm phosphatidylcholine (xws li Spain, Portugal).

4 、 Qhov tseem ceeb ntawm qhov chaw kho mob hloov pauv

Hloov kho cov tswv yim kho mob: Neuroprotection yog ib qho tseem ceeb sib npaug hauv kev kho mob ntawm lub hlwb raug mob raws li vascular recanalization.

Txhim kho txoj kev kho mob kom zoo: Txhawb txoj kev kho mob tseem ceeb ntawm phosphatidylcholine (txhaj tshuaj) raws li cov qauv kev kho mob (xws li thrombolysis / thrombectomy) nyob rau hauv hyperacute / mob stroke / TBI thiab lwm yam kab mob.

Kev txhim kho tus neeg mob qhov kev mob tshwm sim: Los ntawm kev tiv thaiv kev tiv thaiv ntxov ntxov thiab muaj txiaj ntsig zoo, nws xav tias yuav txhim kho kev ciaj sia thiab kev ua haujlwm zoo ntawm cov neeg mob uas mob hlwb raug mob, thiab txo qis kev tsis taus.

Txhawb kev tshawb fawb thiab kev txhim kho kev taw qhia: Txhawb nqa ntau qhov kev tshawb fawb soj ntsuam zoo thiab tshawb nrhiav cov tshuaj noj tshiab rau kev tiv thaiv mob hlwb.

Summary thiab Outlook

Kev hloov pauv ntawm phosphatidylcholine los ntawm ib qho "adjuvant drug" mus rau "core neuroprotective agent" yog qhov tshwm sim ntawm kev tshawb fawb tob zuj zus, kev ua txhaum ntawm cov pov thawj kho mob (tshwj xeeb yog ECCO 2 kev tshawb fawb), thiab kho cov tswv yim kho tshiab. Nws lub ntsiab yog nyob rau hauv:

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Kev cuam tshuam thaum ntxov: Qhia tshuaj noj thaum lub sij hawm kub lub qhov rais (mob theem / subacute thaum ntxov) thaum cov tshuaj tiv thaiv cascade ntawm paj hlwb pib.

Intravenous precisely: Nyob rau theem mob uas yuav tsum tau ua sai sai, kev tswj cov hlab ntsha yog txoj hauv kev tseem ceeb rau kev tiv thaiv tseem ceeb.

Kev txhim kho kev sib koom ua ke: Raws li qhov tseem ceeb ntawm kev tiv thaiv neuroprotection ntawm vascular recanalization therapy (stroke) lossis kev kho mob dav dav (TBI), nws tsis yog ib qho ntxiv lawm.

Qhov kev hloov pauv no ua rau muaj kev lees paub tshiab thiab txhim kho tus nqi ntawm phosphatidylcholine hauv kev kho mob ntawm cov kab mob neurological, tshwj xeeb tshaj yog nyob rau hauv cov qauv kev kho mob ntawm tus mob ischemic stroke. Raws li ib feem tseem ceeb ntawm "tus qauv reperfusion therapy + core neuroprotection" lub tswv yim, nws tau txais cov ntaub ntawv pov thawj los ntawm kev txhawb nqa thiab kev paub txog kev kho mob. Nyob rau hauv lub neej yav tom ntej, nrog rau kev loj hlob ntawm ntau high-zoo kev tshawb fawb thiab hloov tshiab rau cov kev taw qhia, nws lub luag hauj lwm tseem ceeb yuav muab ntxiv consolidated.