Пятница, 29.03.2024, 18:31
Вітаю Вас Гость | Реєстрація | Вхід

і

Архив статей

Головна » Файли » 2014 » 2 (122)

Разумний Р.В. Показники клітинної ланки імунітету у хворих на негоспітальну пневмонію в сполученні зі стеатозом печінки
19.05.2014, 09:01

Резюме
Разумний Р.В. Показники клітинної ланки імунітету у хворих на негоспітальну пневмонію в сполученні зі стеатозом печінки.
Для хворих на негоспітальну пневмонію у сполученні зі стеатозом печінки характерно пригнічення показників клітинної ланки імунітету.
Ключові слова: негоспітальна пневмонія, стеатоз печінки, клітинна ланка імунітету.
Резюме
Разумный Р.В. Показатели клеточного звена иммунитета у больных негоспитальной пневмонией в сочетании со стеатозом печени.
Для больных негоспитальной пневмонией в сочетании со стеатозом печени характерно угнетение показателей клеточного звена иммунитета.
Ключевые слова: негоспитальная пневмонія, стеатоз печени, клеточное звено иммунитета.
Summary
Rasumnyy R.V. Indicators of cellular immunity in patients with community-acquired pneumonia in combination with hepatic steatosis.
For patients with community acquired pneumonia in combination with hepatic steatosis characterized by inhibition of cellular immunity.
Key words: community acquired pnevmonіa, hepatic steatosis, cellular immunity.

УДК 616.24-002+616.36-036

ДЗ «Луганський державний медичний університет»

ГЗ «Луганский государственный медицинский университет»

91045, кв. 50-летия Обороны Луганска, 1 г, Луганск, Украина

State Establishment "Lugansk State Medical University"

91045,50 Rokyv Oborony Luganska Block, 1G, Lugansk,Ukraine

pulmon@mail.ru

The goal of  research was investigation of character and evidence of changes of immunity cellular link for patients with the community-acquired pneumonia combined with hepatic steatosis.

For the studying of features indexes of immunity cellular link for patients with CAP, that proceeded in combination with HS, by the technique of random sampling it was selected 44 patients from which there were 24 men (54,5%) and 20 women (45,5%)  that made the Ist group in that proceeding of CAP of moderately severe was established for 28 patients (63,6%) and  heavy one had 16 patients (36,4%). From the examined patients with CAP with absence of any chronic pathology of liver by the method of random sampling it  was selected 41 patients, among which there were 22 men (53,7%) and 19 women (46,3%)  that made the IInd group in that the proceding of CAP of moderately severe was established for 27 patients (65,9%) and heavy one had 14 patients (34,1%). Researches of all patients were made during the acuty of CAP while hospitalization with corresponding diagnosis to the specialized pulmonary department.

Patients with CAP of both groups at the admission to in-patient department (acuity of pneumonia) had the reduction of relative amount of circulatory T- lymphocytes (CD3+). So in comparison with the referential norm for the patients of the Ist group abundance of CD3+-lymphocytes  was belower than norm on the average in 1,5 times (Р<0,01), in the IInd group it was in 1,3 times (Р<0,05). While intergroup comparison the abundance of CD3+-lymphocytes for the patients of the Ist group was on the average in 1,2 times  belower than analogical index in the IInd group (P<0,05). An absolute number of lymphocytes  with  phenotype  CD3+  in the acuty of CAP for the patients of the Ist group  was belower in regard to the norm on the average in 1,8 times (Р<0,001), in the IInd  group it was belower in 1,4 times (Р<0,01). The comparative analysis of absolute number of CD3+-cells in investigated groups testified that more evidence changes were in the Ist group. So the patients of the Ist group had an absolute number of circulatory T-lymphocytes (CD3+) that was on the average in 1,3 times  belower than in the IInd group (P<0,05).

The abundance of CD4+-lymphocytes (T-helpers/inducing substances) in this period for the examined patients of the Ist  group was decreasing on the average in 1,8 times (P<0,01), in the IInd group it was decreasing in 1,4 times (P<0,05). While intergroup comparison relative content of Т-helpers (CD4+) for the patients of the Ist group was on the average  in 1,3 times belower than analogical index in the IInd group (P<0,05). The  absolute number of lymphocytes with  phenotype  CD4+  in the acute of CAP for the patients of the Ist group was on the average in 2,1 times (Р<0,001) belower in regard to the norm; in the IInd group it was belower in 1,5 times (Р<0,01). Moreover, for the patients of the Ist group an absolute number of circulatory Т-helpers (CD4+) was belower on the average in 1,4 times than for the examined patients of the IInd group (P<0,01). The relative content of CD8+-lymphocytes (suppressor T cells/killers) in the acute of CAP for the most patients of the Ist and IInd groups remained within the limits of the norm. The absolute amount of CD8+-cells was decreased in 1,3 times (Р<0,05) among the examined patients of the Ist group, in that time as for the patients of the IInd group the level of CD8+-lymphocytes was in the lower limit of the norm.  While application of gradation method it was revealed a reliable difference between the values of immunoregulatory index CD4/CD8 for the patients of the Ist and the IInd groups in the acute of CAP (before beginning of treatment). The relative and absolute amount of CD22+-lymphocytes (total population of В-cells) in the acute of CAP for the most patients of both groups were kept within the limits of the norm. While research of functional activity of Т-cells according to the results of LBR with PHA it was set that in the acute of CAP for the patients of the Ist group the value of this index was belower in regard to the referential norm in 1,7 times (Р<0,001), in the IInd group it was belower in 1,3 times (Р<0,01). The comparative analysis of LBR index  for the  examined  patients testified that more evidence changes had  patients of the Ist groups,  whose index of LBR was on the average in 1,3 times belower than for the examined patients of the  IInd group (P<0,05).

In future we plan to study influence of comorbidity on the cytokine profile of blood.

Література
1. Авдеев С.Н. Тяжелая внебольничная пневмония / С.Н. Авдеев, А.Г Чучалин // РМЖ. - 2001. - Т. 9, № 5. - С. 1-11.
2. Внебольничная пневмония у взрослых: практические рекомендации по диагностике, лечению и профилактике: пособие для врачей // Клин. микроб. антимикроб. химиотер. - 2003. - № 3. - С. 198-224.
3. Дворецкий Л.И. Внебольничная пневмония: диагностика и антибактериальная терапия / Л.И. Дворецкий // Consilium medicum. - 2006. - Том 8, № 3. – С. 25-30.
4. Ноников В.Е. Пневмонии. Дифференциальная диагностика и лечение внебольничных пневмоний / В.Е. Ноников [Електронний ресурс] // Consilium medicum. - 2005. - Том 7, № 4. – Режим доступу: http://con-med.ru/magazines/consilium_medicum/214493/214348/
5. Inflammatory biomarkers and prediction for intensive care unit admission in severe community-acquired pneumonia / P. Ramírez, M. Ferrer, V. Martí [et al.] // Crit. Care Med. – 2011. – Vol. 39 (10). – P. 2211-2217.
6. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare- associated pneumonia // J. Respir. Crit. Care Med. - 2005. - Vol. 171. - Р. 388-416.
7. Local and systemic cytokine profiles in non-severe and severe community-acquired pneumonia / M.S. Paats, I.M. Bergen, W.E. Hanselaar [et al.] [Електронний ресурс] // Eur. Respir. J. – 2012. – Режим доступу: http://erj.ersjournals.com/content/early/2012/12/19/09031936. 00060112/suppl/DC1.
8. ERS task force in collaboration with ESCMID. Guidelines for the management of adult lower respiratory tract infections // Eur. Respir. J. - 2005. - Vol. 26, № 6. - Р. 1138-1180.
9. Estella A. Cytokine levels in bronchoalveolar lavage and serum in 3 patients with Influenza A(H1N1) v severe pneumonia / A. Estella // J. Infect. Dev. Ctries. – 2011. – Vol. 5 (7). – P. 540-543.
10. The microcirculation in health and critical disease / C.A. den Uil, E.Klijn, W.K. Lagrand [et al.] // Prog. Cardiovasc. Dis. – 2008. –Vol. 51(2). – P.161-170.

Категорія: 2 (122) | Додав: siderman
Переглядів: 611 | Завантажень: 0 | Рейтинг: 0.0/0
Всього коментарів: 0
Додавати коментарі можуть лише зареєстровані користувачі.
[ Реєстрація | Вхід ]
RSS

Форма входу

Категорії розділу

1 (121) [47] 2 (122) [36]
3 (123) [28] 4 (124) [34]
5 (125) [0] 6 (126) [0]

ПОИСК

НАШ ОПРОС

Оцените наш сайт
Всего ответов: 55

ДРУЗЬЯ САЙТА

Статистика


Онлайн всего: 1
Гостей: 1
Пользователей: 0