RU2086980C1 - Method of alcoholism diagnosis - Google Patents

Abstract

FIELD: medicine, narcology. SUBSTANCE: method involves examination of thrombocytolytic action of patient blood serum in the presence of complement and tetrahydroisoquinoline at dose 0.5 x 10^-4 mmole as hapten. EFFECT: increased precision of diagnosis at early stage of alcoholism, simplified method. 4 tbl

Description

 The invention relates to medicine, namely to addiction.

 The aim of the invention is to improve the accuracy of diagnosis, including at the initial stage of alcoholism, removing the time limitations of its implementation, regardless of the timing of alcohol consumption.

This goal is achieved by the fact that when determining the thrombocytolytic effect of the patient's blood serum, tetrahydroisoquinoline in a dose of 0.5 • 10 ^-4 mmol is used as a hapten.

 The method is as follows.

To 0.15 ml of the patient’s serum, whole and serial dilutions, add 0.15 ml of platelet mass obtained from donor blood of group 0, 0.05 ml of guinea pig complement at a dilution of 1 30 and 0.05 ml of 0.04 an aqueous solution of 1,2,3,4-tetrahydro-1-methyl-6,7-isoquinolinediol (TIH). After thorough mixing, 16 μl of the mixture was taken to calculate the initial platelet count. The remaining mixture was incubated in closed vessels at 37 ^° C for 1 h, after which 16 μl of the mixture was again taken for post-incubation counting of platelet counts. The result is considered positive if the platelet count after incubation in the experimental samples is reduced by at least 20 25 from the original, with a constant platelet count in the control samples. Each study includes 3 control samples in which the patient’s serum is replaced with healthy human serum (1st control sample), or complement (2nd control sample) or SIL (3rd control sample) are excluded from the incubation medium.

Example 1. Patient K., b. 1962 Medical history N 27182. Diagnosis at admission: cyclothymia, with a possible complication of alcoholism. He entered the psychiatric hospital for the first time. The department is lethargic, inhibited, depressed mood, at the same time restless, anxious. Somatic and neurological disorders were not detected. Intelligence and memory are normal. Since 1986, occasionally, with large interruptions up to 20 30 days, he drinks strong alcohol. Alcohol withdrawal syndrome is mild, short-lived. A patient was examined on 19.02.90 (on the 35th day of abstinence from alcohol). 1 ml of patient’s blood was taken, serum was obtained, serial dilutions from 1 2 to 1 128 were prepared. Serum, whole and serial dilutions, platelet mass from donor blood of group 0, complement of guinea pig and SIL in the ratio of 3 3 1 1, respectively, were added. In all samples, 16 μl were taken from the resulting mixture to calculate the initial platelet count. The calculation was carried out on an electronic counter of microparticles "Picoskel PS-4" (Medicor, Budapest). After a 1-h incubation at 37 ^° C, 16 μl samples were taken again for post-incubation platelet counts. The total study time is 1 h 40 min. The results of the analysis are shown in table. one.

 Based on a decrease in the number of platelets in experimental samples, starting from whole serum and before dilution of 1: 4, by 20 29 after incubation compared to that which took place before incubation, with a constant number of platelets in control samples (fluctuations within the experimental error), it was concluded the presence of alcoholism in the patient, which is confirmed by the corresponding clinical picture of the disease. Clarified diagnosis made at patient’s discharge: stage I alcoholism with the development of astheno-neurotic disorders on its background. Thus, the proposed method allowed to diagnose the initial stage of alcoholism after 35 days of abstinence from alcohol.

 Example 2. Patient G. born in 1967 Case history No. 27367. Received with complaints of epileptic seizures of the polymorphic type. Attacks are sometimes confined to a hangover after drinking. I started drinking from the age of 16. He drinks alcohol occasionally, with intervals of 2 to 3 weeks. There is a hereditary burden of alcoholism on the part of the father. Preliminary diagnosis: epilepsy of alcoholic origin. 03/26/90 the patient underwent a diagnostic study (on the 15th day of abstinence from alcohol). The results are shown in table. 2. Based on the absence of thrombocytolytic action of the patient's serum (all fluctuations in the number of platelets are within the experimental error), a conclusion is drawn from the patient’s absence of alcoholism. Upon further investigation, the patient was found to have an inflammatory process in the subarachnoid region. The final diagnosis: epilepsy of infectious origin.

Example 3. In an experiment on white outbred rats treated with the 15th solution of ethanol instead of drinking water, a study was made of the thrombocytolytic SIL-dependent action of blood serum in a male aged 3 months with a duration of alcoholization of 19 days. Serial dilutions from 1 2 to 1 8392 ¹ were prepared from the blood serum of the experimental rat. Platelets isolated from the blood of an intact, non-alcoholized rat of the same age were used as a target for serum thrombocytolytic action. The results of the study are given in table. 3.

 As can be seen from the table. 3, the serum of a rat, which had been forced alcoholization for 19 days, showed a clear TI-dependent thrombocytolytic effect in high titer, up to dilution of 1,024, on the basis of which it was concluded that experimental rats were formed in the rat. This conclusion was confirmed by a subsequent enzymatic study of the liver and brain of a rat on autopsy material on the activation of ethanol-metabolizing enzymes: alcohol dehydrogenase, microsomal ethanol-oxidizing system and aldehyde dehydrogenase, characteristic of the initial stage of alcoholism. Thus, the proposed method allowed for in vivo diagnosis of the initial stage of experimental alcoholism.

 The proposed method for the diagnosis of alcoholism is applied to 12 healthy donors, 34 patients with alcoholism, 21 patients with epilepsy, 19 patients with schizophrenia, cyclotemia and manic-depressive psychosis, not complicated by alcoholism.

 Additional confirmation of the higher sensitivity of the proposed method for the diagnosis of alcoholism as applied to various stages of alcoholism was obtained in an experiment on 146 rats with different periods of experimental alcoholism. The results are presented in table. 4.

 From the table. Figure 4 shows that the SIL-specific thrombocytolytic effect of rat sera is already observed in the early stages of alcoholization (from two weeks to two months), corresponding to the initial stages of clinical alcoholism, while the prototype method exhibits significantly lower sensitivity (p <0, 5) 05). In particular, in the period of alcoholization from 2 weeks to 1 month, the frequency of positive reactions in the prototype method is practically no different from the control group of intact rats (p> 0.1). A higher frequency of positive reactions detected by the proposed method in comparison with the prototype method is maintained in the later stages of experimental alcoholism (3-12 months), although the difference in sensitivity decreases slightly during these periods.

 Thus, the proposed method has the advantages of improving the accuracy of diagnosis of alcoholism, the ability to diagnose the initial stage of this disease, the absence of time limits when it is carried out, regardless of the timing of previous alcoholization.

Claims (1)

A method for diagnosing alcoholism, including a patient’s blood test, characterized in that blood serum is obtained, donor blood platelets, complement and 0.5 • 10 ^{- 4} mmol of tetrahydroisoquinoline as a hapten are added to it, platelet count is counted, and if it is reduced, not less than 20 25% of the initial level is diagnosed with alcoholism.

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