Clinico-scintigraphic characteristics and oxidation in community-acquired pneumonia: correlations with severity of pulmonary tissue infiltrative lesion

Abstract

Aim. To investigate clinicoscintigraphic characteristics and oxidation in blood erythrocyte and plasma in debut of community-acquired pneumonia (CAP) with different size of inflammatory infiltrate. Material and methods.Њ A total of 200 patients with non-severe CAP were examined. Additional 35 CAP patients (20 patients with segmentary and 15 patients with polysegmentary infiltrative pulmonary lesion) and 10 healthy volunteers have undergone ventilation-perfusion pulmoscintigraphy and biochemical investigation of oxidation in blood plasma and erythrocytes. Results. In CAP onset more distinct clinical manifestations were characteristic for patients with polysegmentary pulmonary infiltrate. The degree of activation of lipid peroxidation did not depend on the size of the inflammation focus. In CAP, irrespective of the size of pulmonary infiltrate, there is a similar bilateral rise of alveolar-capillary permeability for radioactive aerosol. Conclusion. In CAP clinical signs of systemic inflammation differ depending on the spread of infiltrative process in the lungs. Analysis of oxidation in erythrocytes and plasma shows that in formation of acute inflammation most essential is involvement of at least one segment of the lungs in the pathological process. At the level of molecules and cells, including target organ, oxidative metabolism undergoes dysregulation involving the whole body and similar to that in inflammation of several pulmonary segments. Irrespective of the size of infiltrative lesion, radioaerosol permeability rises similarly in both the lungs evidencing systemic affection of the structures of alveolar-capillary membrane of the lungs.

Keywords

• community-acquired pneumonia
• ventilation-perfusion pulmonoscintigraphy
• alveolar-capillary permeability
• oxidative cell metabolism