RU2093828C1 - Method of determination of serotonin content in whole blood - Google Patents

Abstract

FIELD: medicine, analytical biochemistry. SUBSTANCE: method involves determination of the whole blood serotonin and assay of hematokrit. Serotonin concentration is calculated by the formula:

where: C_blood - serotonine level in the whole blood; I - actual blood volume sample; H_tn - hematokrit, normal value; H_tblood - hematokrit, value in examined blood sample. EFFECT: improved method of analysis.

Description

 The invention relates to medicine, to biochemical methods for the study of blood.

 There are various methods for assessing blood serotonin levels, but all of them do not have sufficient reliability, which leads to errors in the choice of treatment. These errors in determining the true level of serotonin in whole blood are due to the fact that its determination does not take into account the degree of blood concentration in various diseases accompanied by dehydration or an increase in the amount of fluid, for example, when transfusion of solutions. Serotonin is found only in the liquid part of the blood (plasma), therefore, the level of serotonin depends on the ratio of plasma and hematocrit red blood cells in whole blood.

 The purpose of the invention to obtain reliable results in assessing the level of serotonin.

где С_крови уровень серотонина в цельной крови;
Нтн гематокрит, норма в крови здоровых людей;
Нт_крови гематокрит, определенный в крови пациента.To achieve this goal, it is proposed to calculate the true level of serotonin in whole blood according to the formula, taking into account the amount of plasma using a correction factor

where With _{blood the} level of serotonin in whole blood;
NTN hematocrit, the norm in the blood of healthy people;
NT _blood hematocrit, determined in the patient’s blood.

Example 1. Patient Komarov A.V. 37 years old, delivered to the infectious ward on 04.16.91 with complaints of fever up to 39 ^o C, repeated vomiting, abdominal pain, frequent loose watery stools up to 15 times a day, convulsive contractions of the muscles of the feet and hands. Sick during the day. Upon receipt, a moderate condition. The skin is pale, dry, tissue turgor preserved. Muffled heart sounds, pulse of 92 beats per minute, blood pressure -100/70 mm Hg were revealed. The abdomen is soft, painful in the lower sections. Diagnosed with salmonellosis, gastrointestinal form, moderate course. Further, the diagnosis was confirmed by the allocation of comproculture. Salmonella interitidis from 04.16.91

Blood test upon admission: hemoglobin 180 g / l, hematocrit 61% leukocytes 6 • 10 ⁹ / l, ESR 15 mm / h. Blood serotonin 0.341 μmol / l, which with the usual evaluation method can be interpreted as significantly (p ∠ 0.05) different from the control.

 Calculation based on hematocrit revealed a significant increase (p p0.05) in blood serotonin (0.507 µmol / L).

The patient underwent rehydration therapy with Philips solution. He received chloramphenicol and antispasmodics. The condition improved, the stool returned to normal on 04/22/91. The patient was discharged in satisfactory condition. A blood test on the day of discharge: hemoglobin -140 g / l, hematocrit 46% white blood cells 5.8 • 10 ⁹ / l, ESR 8 mm / h. Blood serotonin 0.435 μmol / L; serotonin 0.467 μmol / L.

 This example shows that even with the relief of the main symptoms of the disease, the level of serotonin did not normalize, which corresponds to the absence of morphological repair of the intestinal wall.

Example 2. Patient Seredin I.A. 18 years old, delivered on 02.15.90 to the toxicology department with a diagnosis of% domestic antifreeze poisoning. Upon admission, he complained of weakness, drowsiness, nausea, repeated repeated vomiting, lower back pain, visual impairment. On examination, pallor of the skin was noted, the tones were rhythmic, loud. Pulse 96 beats per minute. Blood pressure 100/60 mm Hg Tongue dry, coated. The abdomen is soft, painless. The liver and spleen are not palpable. Palpation in the projection of the kidneys is painful on both sides. On examination by an ophthalmologist, primary partial atrophy of the optic nerve discs of both eyes was revealed. Blood test: hemoglobin blood 175 g / l, hematocrit 58% leukocytes 5.2 • 10 ⁹ / l, ESR 4 mm / h. Whole blood serotonin 0.356 μmol / L. After reduction to normal hematocrit, 0.492 μmol / L was obtained, which was significantly (p ∠ 0.05) higher than the control, indicating the liberation of serotonin from the depot and the need to include antiserotonin drugs in complex therapy.

 Example 3. Patient Shaporov D.A. 25 years old, was admitted to the infectious diseases department on 07.12.88 with complaints of nausea, repeated vomiting, headache, aching pains in the abdomen and lower back, loose stools 5 times a day, fever, lack of urine. The condition at admission is serious. The skin is pale. On the lateral surfaces of the trunk hemorrhagic rash, sometimes linear in nature. Enanthema. Rhythmic tones, muffled, pulse 88 beats per minute, weak filling and tension, blood pressure 90/60 mm Hg The tongue is covered, rather dry. Palpation of the abdomen and lumbar region is sharply painful. No urine for 14 hours. Diagnosed with hemorrhagic fever with renal syndrome, severe course, acute renal failure.

Blood test from 8/12: hemoglobin -194 g / l, hematocrit 66% leukocytes - 18.8 • 10 ⁹ / l, ESR 10 mm / h. Blood serotonin 0.368 μmol / L (reduced compared with the control), serotonin taking into account a blood concentration of 0.625 μmik / L, which is 1.55 times higher than normal and, of course, requires the inclusion of antiserotonin drugs.

 The given clinical examples illustrate the effectiveness of the proposed evaluation method. Improving the accuracy of assessing the level of serotonin in the blood allows you to correctly assess the patient's condition and prescribe adequate treatment.

 The proposed method for assessing serotonin levels in whole blood was used in the examination of 52 patients with HFRS, 16 patients with acute intestinal infections (salmonellosis, dysentery) and 7 patients with domestic antifreeze poisoning. In all cases, the method made it possible to find out the true picture of the level of serotonin in whole blood and, therefore, correct the therapy.

The positive effect of the proposed method in comparison with the known is as follows:
the method improves the reliability of assessing the true content of serotonin in the blood of patients;
as a result of using the method, it becomes possible to timely correct therapy for various pathological conditions accompanied by dehydration or blood loss;
The method allows a retrospective assessment of the obtained results of the level of serotonin in the blood and literature data for the scientific purpose to develop new approaches in the treatment of pathological conditions accompanied by a change in blood concentration.

Claims (1)

A method for determining the content of serotonin in whole blood by means of its biochemical study followed by spectrofluorimetric assessment of the level of serotonin in it, characterized in that the hematocrit of the test blood is additionally determined, and the true level of serotonin C in whole blood is calculated by the formula
With C _{to r about in and} x (I Htn) / (I - Ht _{to r about in and} ),
where C is the _blood level of serotin in whole blood;
I actual blood volume in which serotonin is determined;
Ht hematocrit, normal value;
Nt _{to r about in and} hematocrit, value in the studied blood.