Журнал «Медицина неотложных состояний» №2(97), 2019

Background. Water-electrolyte disturbances that occur in patients with acute stroke (AS) is one of the reasons complications of AS [1]. Concomitant diabetes mellitus (DM) affects the stroke severity and increased mortality rates. The purpose was to investigate the frequency of electrolyte disorders in patients with AS against a background of concomitant diabetes. Materials and methods. A analysis of 416 patients with the treatment of AS was conducted. All patients were divi-ded into three groups: 1) patients with established diabetes before the stroke, 2) patients with newly diagnosed diabetes and 3) patients without diabetes. The second phase was conducted a pilot study with an analysis of the frequency of magnesium and phosphate metabolic disorders in the patients with AS (20 patients with AS on a background of diabetes and 10 stroke patients without diabetes). Results. The diabetic history were present in 110 of 416 patients (26.4 %), another 48 patients (11.5 %) diagnosed with diabetes was first installed. Thus, the incidence of diabetes in patients with AS in our study was approximately 38.0%, much higher than in the corresponding age population. In general, the different types of electrolyte disorders were observed in 258 of 349 (73.9 %) patients with AS, while in patients with underlying disorders of carbohydrate metabolism, these violations occurred significantly more often than patients without such. In particular, carbohydrate metabolism occurred in 82 (81.2 %) and 36 (83.7 %) patients 1 and 2 groups versus 134 (65.4 %) in the control group (p < 0.05). Hypomagnesemia (less than 0.8 mmol/L) was observed in 2 of 10 patients (20 %) in AS without carbohydrate disturbances and in 6 of 20 patients (30 %) in AS with concomitant diabetes. Hypophosphatemia (phosphate levels less than 0.8 mmol/L) was found in patients without diabetes and AS in 2 patients with concomitant DM or newly diagnosed diabetes. Following the correction of oral medication containing phosphates and magnesium blood electrolyte levels was stabilized and that coincided with the improvement of the patients and the degree of disability. Conclusions. Electrolyte disorders are fairly common problem in patients with concomitant diabetes and AS. In patients with impaired carbohydrate metabolism observed significantly higher frequency (more than 81.2 % of patients) occurrence of electrolyte disorders than patients without them. In the case of AS on a background of diabetes electrolyte disturbances occur significantly more frequently than in patients without such comorbid disorders. Further research is needed to elucidate the role of individual electrolyte disorders (eg, magnesium and phosphate) in the course and consequences of AS.