medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-19-41-48medsovet-6529Research ArticleЦЕРЕБРОВАСКУЛЯРНЫЕ ЗАБОЛЕВАНИЯCEREBROVASCULAR DISEASESЭффекты дипиридамола и его применение в неврологииEffects of dipyridamole and its use in neurologyhttps://orcid.org/0000-0002-7465-0677ПизоваН. В.PizovaN. V.

Пизова Наталия Вячеславовна, д.м.н., профессор, профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией

150000, Россия, Ярославль, ул. Революционная, д. 5

Natalia V. Pizova, Dr. Sci. (Med.), Professor, Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery

5, Revolutsionnaya St., Yaroslavl, 150000, Russia

pizova@yandex.ruЯрославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian Federation2021301120210194148Copyright © Пизова Н.В., 20212021Пизова Н.В.Pizova N.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6529

Дипиридамол на фармацевтическом рынке присутствует с 1959 г. и, являясь пиримиди-пиримидиновым соединением, обладает разнообразными механизмами действия. Самым первым действием дипиридамола был его антиангинальный эффект. В последующие годы обратили внимание на антитромбоцитарные свойства дипиридамола, которые связаны с ингибированием фосфодиэстеразы тромбоцитов, а также с блокированием транспорта аденозина. Другим важным свойством дипиридамола служит влияние на деформируемость эритроцитов, тем самым улучшается микроциркуляция. Дипиридамол оказывает влияние на изменение динамики тромбоцитарной активности и васкулярной реактивности, вызывает улучшение церебральной перфузии. Благодаря выраженным антитромбоцитарным свойствам препарат широко исследовался в целях профилактики ишемических инсультов и транзиторных ишемических атак как в качестве монотерапии, так и в комбинации с другими лекарственными средствами. В отличие от других тромбоцитарных антиагрегантов дипиридамол не оказывает повреждающего действия на слизистые оболочки. Его антиагрегантное действие не сопровождается подавлением активности циклооксигеназы и уменьшением синтеза простациклина. В терапии нарушений мозгового кровообращения при использовании дипиридамола имеется возможность управления антитромботическим эффектом путем подбора оптимальных доз этого препарата. Дипиридамол обладает антиоксидантными свойствами, способствует усилению NO-опосредованных путей, может оказывать как непрямые противовоспалительные эффекты через аденозин и простагландин-2, так и прямые противовоспалительные эффекты и ряд других эффектов. Дипиридамол считается безопасным препаратом на основании десятилетий клинического опыта. Его побочные эффекты обычно ограничены и преходящи. Учитывая разнообразные эффекты дипиридамола, данный препарат может использоваться для широкого спектра патологий, помимо профилактики тромбозов. Представлены данные об эффективности и безопасности дипиридамола при различных заболеваниях неврологического спектра.

Dipyridamole has been on the pharmaceutical market since 1959 and, as a pyrimidyl-pyrimidine compound, has a variety of mechanisms of action. The very first action of dipyridamole was its antianginal effect. In subsequent years, attention was drawn to the antiplatelet properties of dipyridamole, which are related to inhibition of platelet phosphodiesterase as well as to blocking adenosine transport. Another important property of dipyridamole is its effect on the deformability of red blood cells, thereby improving microcirculation. Dipyridamole affects changes in the dynamics of platelet activity and vascular reactivity and causes improvement of cerebral perfusion. Due to its pronounced antiplatelet properties, the drug has been widely studied for the prevention of ischemic strokes and transient ischemic attacks, both as monotherapy and in combination with other drugs. Unlike other platelet antiaggregants, dipyridamole does not have a damaging effect on mucous membranes. Its antiplatelet effect is not accompanied with inhibition of cyclooxygenase activity and reduction of prostacyclin synthesis. In the treatment of cerebral circulation disorders, dipyridamole can be used to control the antithrombotic effect by selecting the optimal dose of the drug. Dipyridamole has antioxidant properties, enhances NO-mediated pathways, has indirect anti-inflammatory effects via adenosine and prostaglandin-2 as well as direct anti-inflammatory effects and several other effects. Dipyridamole is considered a safe drug based on decades of clinical experience. Its side effects are usually limited and transient. Given the diverse effects of dipyridamole, it can be used for a wide range of pathologies other than thrombosis prevention. Data on the efficacy and safety of dipyridamole in various diseases of the neurological spectrum are presented.

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The authors declare that there are no conflicts of interest present.