ГоловнаArchive of numbers2021Volume 29, issue 3 (108)On the importance of nonionic osmotically active substances of the blood for the pathogenesis of severe alcoholic delirium
Title of the article On the importance of nonionic osmotically active substances of the blood for the pathogenesis of severe alcoholic delirium
Authors Zadorozhnyi Volodymyr
In the section DIAGNOSTICS AND THERAPY OF MENTAL AND NARCOLOGICAL DISORDERS
Year 2021 Issue Volume 29, issue 3 (108) Pages 37-42
Type of article Scientific article Index UDK 616.853.-008.441.13-06 Index BBK -
Abstract DOI : https://doi.org/10.36927/2079-0325-V29-is3-2021-7

The main non-ionic osmotically active substances in blood serum are glucose and urea. The aim of the study was to study the changes in the water-osmotic state caused by non-ionic (organic) substances in patients with delirium tremens (DT) and in a state of alcohol withdrawal, and to assess their influence on the blood leukocyte composition and the clinical manifestations of the disease. A total of 747 men were examined in a state of alcohol withdrawal; of these, 450 people had manifestations of severe DT (F10.43), 213 — “classic” DT (F10.4), 84 patients had signs of alcohol withdrawal with somatic and vegetative manifestations (F10.3). To quantitatively describe the composition of leukocytes, an index equal to the neutrophil to lymphocyte ratio (NL-R) was used. We were able to mathematically describe a previously unknown quantitative relationship between the osmolarity level due to non-ionic osmotically active substances in blood serum and the NL-R values. It is expressed by the following formula: G + U = 1 mmol/L (log2 NL-R + 9.5), where G — concentration of glucose in blood serum, mmol/l; U is the concentration of urea in the blood serum, mmol/l; NL-R — neutrophil-lymphocyte index, units; 1 mmol/l — coefficient providing the required dimension of the result; log2 — logarithm with base 2; 9.5 is a constant whose size depends on the selected system of units. It was found that regular changes in blood osmolarity in patients with alcohol withdrawal and DT, both at the stage of initiation of psychosis and during the progression of the disease and the formation of severe DT, occur mainly, and maybe completely, due to non-ionic osmotically active substances. Glucose and urea have their unique role in the formation of homeostasis disorders during the development of the disease in individuals with uncomplicated alcohol withdrawal, as well as DT of varying severity.
Key words nonionic osmotically active substances of blood serum, blood glucose, blood urea, neutrophilic-lymphocyte index, assessment of clinical manifestations of delirium tremens
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