Терапевтический архив (Mar 2009)
Total non-elastic pulmonary resistance and permeability of the alveolar capillary membrane in community-acquired pneumonia
Abstract
Aim. To study alveolar capillary membrane permeability (ACMP) and total non-elastic pulmonary resistance (TNPR) in patients with community-acquired pneumonia (CAP) in an acute period. Material and methods. ACMP of the lungs was studied in 35 CAP patients with ventilation pulmonoscintigraphy. Integral and regional TNPR were registered at inhalation and expiration. Integral TNPR was estimated by simultaneous registration of transpulmonal pressure and spirogram, regional TNPR (in the upper, middle and lower zones of the lungs) - by simultaneous registration of zonal rheograms of ventilation and transpulmonal pressure. Bronchial resistance was measured by bodyplethismograph (Masterlab pro, Erich Jaeger, Germany). Results. In acute CAP integral TNPR rose while regional values varied. Both integral and regional ACMP for affected and intact lungs were significantly elevated showing systemic impairment of the structures of alveolar-capillary membrane of the lungs. More severe alterations of integral ACMP were seen in the affected lung, of regional - in the affected zones. Conclusion. Changes registered in regional TNPR and ACMP may indicate enhanced mechanical activity of the lungs in these zones. This enhanced activity contributes to TNPR overcoming.