Ikibanza cya Citicoline kigenda gihinduka cyane, kigenda gihinduka kuva "imiti isanzwe" ihinduka "intangangabo ya neuroprotective agent". Iri hinduka ntabwo rifite ishingiro, ahubwo rishingiye ku guhora gukusanya ibimenyetso bishingiye ku buvuzi bushingiye ku bimenyetso, gusobanukirwa byimazeyo uburyo bukoreshwa mu bikorwa byinshi, ndetse no kumenya "idirishya ryigihe" mu kuvura ibikomere bikabije. Ibikurikira nurufatiro rwingenzi nisesengura bishyigikira iri hinduka:

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1 force Imbaraga zikomeye zo gutwara: Ibimenyetso bifatika kuva muburyo bukoreshwa mubuvuzi

Ongera usuzume uburyo bwibikorwa (birenze 'ubufasha'):

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Membrane fosifolipide yo gusana intandaro: Cytophosphatidylcholine ni intangiriro itaziguye yo guhuza ingirabuzimafatizo ya fosifolipide, nka fosifatidylcholine. Kwangirika kwa Membrane fosifolipide ni ikintu cyakomeretse hakiri kare nyuma ya ischemia neuronal / hypoxia. Fosifatiqueylcholine irashobora kuzuza mu buryo butaziguye ibikoresho bya synthesis ya endogenous fosifolipide, bigateza imbere ibyangiritse byangiza ingirabuzimafatizo no gusana, bikaba aribyo shingiro rya neuroprotection.

Ingaruka nyinshi za neuroprotective ingaruka:

Mugabanye excitotoxicity: kubuza kurekurwa gukabije nuburozi bwa glutamate.

Antioxidant stress: yongera glutathione kandi ikuraho radicals yubusa.

Kunoza imikorere ya mitochondrial: kubungabunga ingufu za metabolism no kugabanya apoptose selile.

Guteza imbere synthesis ya neurotransmitter: kongera urwego rwa acetylcholine, dopamine, nibindi, kunoza imitsi.

Mugabanye neuroinflammation: kubuza irekurwa rya cytokine.

Uburyo bugena ko bugomba kuba uruhare rwibanze rwo "gutabara hakiri kare no kurinda ibikorwa", aho kuba umufasha gusa wo kugabanya ibimenyetso. ?

Gukusanya ibimenyetso byujuje ubuziranenge bishingiye ku bimenyetso (guca ukubiri n "" umufasha "):

Indwara ya ischemic stroke (AIS):

Ubushakashatsi bwa ICTUS (2012): Nubwo iherezo ryibanze ryari ribi, amatsinda mato yateganijwe (ubwonko bukabije cyangwa bukabije, kuvura hakiri kare) yerekanye inyungu zikomeye, byerekana ko igihe cyo kuvura no gutoranya abaturage ari ngombwa.

Ubushakashatsi bwa ECCO 2 (2023): RCT nini yakorewe mubushinwa (abarwayi 3947 AIS barimo). Ibisubizo byerekanye ko hashingiwe ku kuvura imitsi ya trombolysis no / cyangwa kuvura endovaskulaire, hakiri kare (mu masaha 24 nyuma yo gutangira) gukoresha imitsi ya fosifatiqueyloline muminsi 14 byongereye cyane igipimo cyubwigenge bwiminsi 90 (mRS 0-1) (43.5% vs 40.0%), kandi umutekano wari mwiza. Emeza ingaruka zayo zifatika hashingiwe kubuvuzi busanzwe bwa reperfusion. ?

Isesengura ryinshi rya meta-gusesengura: shyigikira imikorere yaryo mugutezimbere imitekerereze yubuzima nubushobozi bwa buri munsi, cyane cyane gutangira kuvura mugihe cyambere cyo gutangira (

Gukomeretsa Ubwonko (TBI):

Ubushakashatsi bwa COBRIT: Ibisubizo ntibivugwaho rumwe, ariko isesengura ryakurikiyeho ryerekana ko amatsinda mato (TBI aringaniye kandi akomeye) yunguka.

Ubushakashatsi nyabwo ku isi & meta-gusesengura: Ubushakashatsi bwinshi bwerekanye ko bushobora guteza imbere imitekerereze y’imitsi no gukira ubwenge ku barwayi ba TBI.

Indwara zifata ubwonko (mu bushakashatsi):

Ubumuga bwo kutamenya kwamaraso (VCI) / guta umutwe (VaD): Ubushakashatsi bwerekanye ko bushobora kunoza imikorere yubwenge (kwitondera, gukora, kwibuka).

Indwara ya Alzheimer (AD) / Indwara ya Parkinson (PD): Nka miti ishobora guhindura indwara, ubushakashatsi bumwe na bumwe buto bwerekana ko imyumvire igenda itera imbere.

Ubushakashatsi mu zindi nzego nka glaucoma no gukomeretsa umugongo nabwo bwerekanye ubushobozi bwa neuroprotective.

2 point Ingingo y'ingenzi yo guhindura imyanya: kuva "umufasha" kugeza "intangiriro"

Kwimura igihe cyo kuvura imbere (intangiriro yibanze ya "zahabu yigihe idirishya"):

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Urufunguzo rwa neuroprotection ruri muri 'kare'. Nyuma yo gukomeretsa ubwonko (nka stroke, TBI), igisubizo cyimvune ya casade gitangizwa muminota mike kugeza amasaha menshi.

Uburyo bwibikorwa bya phosphatidylcholine bugena ko bugomba gukoreshwa mugihe cyambere cyane cyimvune ya cascade (nko mumasaha 24 nyuma yubwonko butangiye, hakiri kare ibyiza) kugirango bahagarike inzira yimvune kandi barinde ingirabuzimafatizo zangirika kuburyo bushoboka bwose. Ibi bitandukanye cyane nu myanya gakondo y "imiti igabanya ubukana".

Intsinzi yubushakashatsi bwa ECCO 2 ishingiye ku gishushanyo mbonera cya protocole yubuyobozi bwinjira mbere.

Umwanya wibanze wingamba zo kuvura (uhujwe nubuvuzi bwa reperfusion):

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Guhanga udushya muburyo bwo kuvura indwara ya ischemic stroke: Ubuvuzi busanzwe ni recanalisation y'amaraso (trombolysis, trombectomy), ariko umubare munini w'abarwayi baracyafite prognoza mbi nyuma yo kwisubiraho (gukomeretsa reperfusion, nta kintu cyerekana, nibindi).

Uburyo bwa neuroprotective of phosphatidylcholine (stabilizing membrane selile, antioxidant, anti apoptotic) burashobora kuzuzanya no guhuza hamwe nubuvuzi bwa reperfusion, kugabanya imvune no kurinda ubwonko nyuma yo kwisubiraho.

Ubushakashatsi bwa ECCO 2 bwemeje agaciro kayo nkibice byingenzi bigize neuroprotective muri stratégies "vascular recanalisation +", ntibikiri inyongera yubufasha gusa.

Gukwirakwiza inzira z'ubuyobozi (gukurikirana bioavailability):

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Fosifatidylcholine yo mu kanwa ifite bioavailable nkeya (

Gutera inshinge birashobora gutanga bioavailable nyinshi, bigahita bigera kumiti yibiyobyabwenge mumaraso, kandi bigahuza ibikenewe byihuse bya neuroprotection mugice gikaze.

Guhinduranya kuri "core" imyanya byanze bikunze bizajyana no gusaba impapuro zifata imitsi kugirango ikoreshwe mugice gikaze.

3 Kuvugurura umurongo ngenderwaho / ubwumvikane (byerekana ihinduka ryumwanya)

Ubushinwa:

"Amabwiriza yo gukumira no kuvura indwara y’imitsi mu Bushinwa" hamwe n’izindi nyandiko byagaragaje ingaruka zayo zo mu mutwe.

Hashingiwe ku bisubizo byagaragaye mu bushakashatsi bwa ECCO 2, biteganijwe ko urwego rusabwa hamwe n’umwanya wa fosifatidylcholine (cyane cyane imitsi itwara imitsi ikoreshwa mu cyiciro gikaze) mu mabwiriza y’Ubushinwa bizanozwa cyane mu bihe biri imbere. ?

Mpuzamahanga:

Amabwiriza ya AHA / ASA muri Reta zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe z 'Reta zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe zunzubumwe z' Reta zunzubumwe zamerika.

Amabwiriza amwe y’ibihugu by’i Burayi afite isuzuma ryiza rya fosifatiqueylcholine (nka Espagne, Porutugali).

4 、 Akamaro ko guhindura imyanya yubuvuzi

Kuvugurura igitekerezo cyo kuvura: Neuroprotection ninkingi yingirakamaro kimwe mukuvura ibikomere bikabije byubwonko nko kuvura imitsi.

Hindura gahunda yo kuvura: Teza imbere ubuvuzi bwibanze bwa fosifatidylcholine (imitsi) nkubuvuzi busanzwe (nka trombolysis / thrombectomy) muri hyperacute / acute acute ya stroke / TBI nizindi ndwara.

Kunoza imenyekanisha ry'abarwayi: Binyuze mu bwonko kandi bukora neza, biteganijwe ko bizarushaho kunoza ubuzima no kurwego rwo gukira kw'abarwayi bafite ibikomere bikabije mu bwonko, kandi bikagabanya ubumuga.

Guteza imbere ubushakashatsi nicyerekezo cyiterambere: Guteza imbere ubushakashatsi bwubuvuzi bufite ireme kandi ushakishe uburyo bushya bwo gutanga imiti ya neuroprotection ikaze.

Incamake na Outlook

Guhindura fosifatidylcholine kuva "ibiyobyabwenge byongera imiti" bigahinduka "intandaro yo mu bwoko bwa neuroprotective agent" ni ibisubizo byimbitse zubushakashatsi bwibanze, intambwe igaragara mubimenyetso byubuvuzi (cyane cyane ubushakashatsi bwa ECCO 2), hamwe nuburyo bwo kuvura. Intego yacyo iri:

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Kwitabira hakiri kare: Shimangira imiti mugihe cyizuba rya zahabu (acute phase / subacute hakiri kare) mugihe cascade reaction yo gukomeretsa imitsi itangiye.

Ibyingenzi byinjira: Mubyiciro bikaze aho bisabwa ibikorwa byihuse, ubuyobozi bwimitsi ninzira yingenzi yo gukora ingaruka zingenzi zo kurinda.

Gutezimbere hamwe: Nkibintu byingenzi byingenzi bigize neuroprotection hashingiwe ku kuvura imitsi yo kuvura imitsi (stroke) cyangwa kuvura byuzuye (TBI), ntabwo ari bonus yongeyeho.

Ihinduka ryerekana kumenyekanisha no kongera agaciro ka fosifatiidiloline mu kuvura indwara zifata ubwonko, cyane cyane mu buryo bwo kuvura indwara y’indwara ikaze. Nkigice cyingenzi cyingamba za "reperfusion therapy + core neuroprotection", igenda irushaho gushyigikirwa n’ibimenyetso bifatika no kumenyekana kwa muganga. Mu bihe biri imbere, hamwe niterambere ryubushakashatsi bwujuje ubuziranenge no kuvugurura umurongo ngenderwaho, umwanya wacyo uzarushaho gushimangirwa.