Indices of the Oxidant andAntioxidant System and Endogenous Intoxication in the Convalescents After Community-Acquired Pneumonia

The objective was to study the peculiarities of metabolic processes in the system of lipid peroxidation - antioxidant defense and the manifestations of endogenous intoxication in patients with community acquired pneumonia in the acute stage of the disease and after antibiotic therapy in their interrelation with bronchial obstruction. Materials and methods. 81 patients with non-severe community acquired pneumonia at the age of 21 to 65 years were examined on the 2nd day of the hospitalization and after completing antibiotic therapy. The levels of lipid peroxidation products, activity of the antioxidant defense and levels of middle-mass molecules in the blood were determined by conventional methods. Results. Excessive accumulation of mainly final lipid peroxidation products in combination with insufficient activation of antioxidant defense was observed in patients with community acquired pneumonia at the acute stage of the disease. It manifested in the decrease in activity of superoxide dismutase by 1.2 times and the activity of catalase by 1.6 times causing statistically significant increase (by 2.8 times) in the level of oxidative stress coefficient. The level of middle-mass molecules, the markers of endogenous intoxication, also significantly increased. In comparison with the acute stage, increase in the levels of primary and intermediate products of lipid peroxidation was observed after antibacterial therapy while maintaining the high levels of Schiff’s base and middle-mass molecules. Conclusions. The acute period of non-severe community-acquired pneumonia is characterized by imbalance in the oxidant and antioxidant system with the activation of lipid peroxidation processes mainly at the final stages of the reaction on the background of decreased activity of superoxide dismutase and catalase. It is associated with severe endogenous intoxication. The conventional therapy in case of the community-acquired pneumonia does not significantly influence the studied processes. Increase in the levels of the primary and intermediate products of the lipid peroxidation on the background of high level of Schiff’s base, preservation of low activity of superoxide dismutase and catalase were determined. Moreover, metabolic disorders were more significant in patients with symptoms of bronchial obstruction. ?