18 -6 (92) 2026 - B.I. Dzhumaev, S.N. Rakhmatova - CLINICAL AND BIOCHEMICAL INDICATORS AFTER STROKE IN YOUNG PATIENTS

CLINICAL AND BIOCHEMICAL INDICATORS AFTER STROKE IN YOUNG PATIENTS

B.I. Dzhumaev - Bukhara branch of the Republican Scientific Center for Emergency Medical Care Uzbekistan

S.N. Rakhmatova - Bukhara State Medical Institute named after Abu Ali ibn Sina

Resume

Ischemic stroke in young patients continues to be one of the leading causes of disability. In a study of 179 patients, it was shown that the recovery of functional abilities depends not only on clinical factors but also on social conditions. In the early stages, young patients exhibited pronounced neurological deficits and cognitive impairments. Hemostasis alterations, elevated levels of inflammatory markers (sICAM-1, MPO, sE-selectin), and increased platelet adhesion were identified, which increased the risk of recurrence. The use of a combination of acetylsalicylic acid and clopidogrel reduced the likelihood of recurrent stroke, while the addition of transcranial magnetic stimulation (TMS) and cholin-alfoscerate increased the effectiveness of outpatient rehabilitation by 1.5 times. Secondary prevention in young patients included risk factor correction and lifestyle modification. Objective: Clinical and biochemical parameters after stroke in young patients. Materials and Methods: The study was conducted on 116 young patients during the recovery period after mild to moderate atherothrombotic and lacunar stroke. To assess inflammatory processes associated with endothelial dysfunction, levels of MPO, sICAM-1, and sE-selectin were measured. Rehabilitation included individualized application of TMS and cholin-alfoscerate to correct cognitive impairments and prevent recurrence. Results: The severity of neurological deficits was assessed using the NIHSS, and the level of adaptation was measured by the Barthel Index, which in the 3rd subgroup of young patients was 1.5 times higher (p<0.01). Cognitive function improved in young patients according to ACE-R (81.3→90.9), while scores decreased in middle-aged and elderly patients. Initially, levels of sICAM-1, MPO, and sE-selectin in young patients decreased but increased during the decompensation phase; in the 3rd subgroup, levels rose 2.3 times (p<0.001). The highest sICAM-1 values were observed in the comparative group of adult patients. Conclusions: In young patients, functional recovery in both early and late rehabilitation periods was 1.5 times higher (p<0.05). Major risk factors for recurrent stroke include type 2 diabetes mellitus, grade 3 arterial hypertension, metabolic syndrome, endothelial dysfunction, and increased platelet adhesion. Platelet activity persisted in 32.1% of young patients on ASA, whereas combination therapy with clopidogrel reduced the risk of recurrent stroke by 1.5 times (p<0.05). Increased platelet adhesion was observed in 66% of patients in the early period, 56% in the late period, and 71% in recurrent stroke, indicating the need for individualized antiplatelet therapy. Application of TMS and cholin-alfoscerate increased the effectiveness of rehabilitation in young patients by 1.5 times, and prevention included risk factor correction and lifestyle modification.

Keywords: MPO, sICAM-1, sE-selectin, TMS, stroke in young patients

First page

102

Last page

116

For citation:B.I. Dzhumaev, S.N. Rakhmatova - CLINICAL AND BIOCHEMICAL INDICATORS AFTER STROKE IN YOUNG PATIENTS//New Day in Medicine 6(92)2026 102-116 https://newdayworldmedicine.com/en/new_day_medicine/6-92-2026

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