DIAGNOSTIC VALUE OF ENDOGENOUS INTOXICATION LABORATORY PARAMETERS IN COMMUNITY-ACQUIRED PNEUMONIA
DOI:
https://doi.org/10.11603/1811-2471.2017.v1.i3.8154Keywords:
community acquired pneumonia, endogenous intoxication, endotoxicosis.Abstract
Introduction. Syndrome of endogenous intoxication (EI) nowadays remains the leading place in manifestation of community-acquired pneumonia (CAP), and its expression correlates with the severity of the disease. Change of clinical manifestation of pneumonia, high accidence of its atypical forms as well as a significant level of mortality cause the need to find clear criteria for assessment of the pathological process severity. The laboratory markers of EI may be used as such criteria, but their diagnostic importance has been steel studied.
The aim of study was to investigate changes in laboratory parameters of endogenous intoxication in patients with community-acquired pneumonia depending on the severity of the disease.
Materials and methods. The study involved 175 patients with community-acquired pneumonia, which were divided into 3 groups according to Pneumonia PORT scale. In the midst of the disease the following laboratory markers of EI were investigated: the middle-mass molecules (fractions MMM254 and MMM280), leukocyte intoxication index, toxicity of blood serum and interstitial fluid according to spermatic test.
Results and discussion. It was revealed that the development of inflammation in groups of patients with II and III class according to Pneumonia PORT scale was accompanied by toxemia: the value of the studied parameters in groups of surveyed was observed to be increased in proportion to the severity of the disease. In addition, severe course of pneumonia (IV class) was followed by significant accumulation of toxins in the interstitium, marked elevation of MMM280, paradoxic decrease of leukocyte index of intoxication in some patients. These findings indicate the overstrain of detoxification systems which is characteristic of endotoxicosis.
Conclusion. Laboratory markers of endogenous intoxication can be used as criteria of severity of community-acquired pneumonia, but they need to be investigated in complex to characterize both toxemia and endotoxicosis.
References
Turianytsia, S.M., Poliak, M.A., & Kohutych, A.I. (2010). Hryp A (CALIFORNIA)/04/2009 (Н1N1) na Zakarpatti [Influenza A (CALIFORNIA)/04/2009 (Н1N1) in Transcarpathia]. Naukovyi visnyk Uzhhorodskoho natsionalnoho universytetu, seriia “Medytsyna” – Scintifical Journal of Uzhhorod National University, Series Medicine, 38, 95-101 [in Ukrainian].
Zhuravlova, L.V., & Kryvonosova, O.M. (2012). Kliuchovi pytannia farmakoterapii khvorykh na nehospitalnu pnevmoniiu [Key questions of pharmacotherapy for patients with community-acquired pneumonia]. Praktykuiuchyi likar – Doctor Practitioner, (3), 28-34 [in Ukrainian].
Iliuk, I.A. (2014). Klinichna efektyvnist likuvannia khvorykh na nehospitalnu pnevmoniiu iz vykorystanniam tiotriazolinu [Clinical efficacy of treatment of patients with community-acquired pneumonia using thiotriazolin]. Ukrainskyi pulmonolohichnyi zhurnal – Ukrainian Pulmonary Journal, (4), 69-72 [in Ukrainian].
Andreichyn, M.A., Bekh, M.D., & Demianenko, V.V. (1998). Metody doslidzennia endohennoi intoksykatsii orhanizmu: metodychni rekomendatsii [Methods of study of endogenous intoxication of an organism: methodical recommendations]. Ministry of Health Of Ukraine. Ukrainian Centre of Scientific Medical Information and Patent-License Work. Kyiv [in Ukrainian].
Reshetar, D.V. (2015). Nehospitalni pnevmonii: deiaki aspekty patohenetychnykh makhanizmiv rozvytku [community-acquired pneumonia: some aspects of pathogenetic mechanisms of development]. Naukovyi visnyk Uzhhorodskoho universytetu, seriia “Medytsyna” – Scintifical Journal of Uzhhorod National University, Series Medicine, 1 (51), 246-253 [in Ukrainian].
Feshchenko, Yu.I., Dziublyk, O.Ya., & Mukhin, O .O. (2003). Nehospitalna pnevmoniia u doroslykh (etiolohiia, patohenez, klasyfikatsiia, diahnostyka, antybakterialna terapiia (proekt pohodzennia do zizdu ftyziatriv i pulmonolohiv Ukrainy) [Community-acquired pneumonia in adults (etiology, pathogenesis, classification, diagnosis, antibiotic therapy) (draft agreement to the Congress of Phthysiologists and Pulmonologists of Ukraine)]. Ukr. pulmonolohichnyi zhurnal – Ukrainian Pulmonary Journal, (1), 16-29 [in Ukrainian].
