Indicative role of membranolysis markers in the prognosis of uncomplicated community-acquired pneumonia in children of school age

Aim. To evaluate the indicative role of membranolysis markers in the prognosis of uncomplicated community-acquired pneumonia in school children and to establish its relation with zinc status indices.

Methods. The study included 229 children aged 7 to 17 years with community-acquired pneumonia. The patients were divided into three groups based on morphological form of lung involvement: focal (103 children - group 1), segmental (64 patients - group 2), and lobar pneumonia (62 subjects - group 3). The state of cell membranes was evaluated by the activity of 5’-nucleotidase and rate of sodium-lithium countertransport in erythrocyte membrane. Intensity of peroxidation processes was evaluated by the level of end toxic products and total antioxidative activity, and additionally the blood concentration of zinc was measured by atomic absorption spectrophotometry.

Results. Significant effect of membranolysis processes on the clinical course of pneumonia was revealed. The most prominent pathological changes of the studied indices were registered in patients with focal form of the disease (group 1): increase of the concentration of lipid peroxidation products in average to 5.4±0.06 umol/L and the level of 5’-nucleotidase to 233.90±9.15 nkat, decrease of serum level of zinc to 9.73±0.09 mmol/L and total antioxidative activity to 23.22±0.29%. It was associated with prolonged course and tendency to slow reversal of physical findings in the lungs compared to patients from groups 2 and 3 (p 0.05, respectively).

Conclusion. Damage of cytoplasmic membrane in the focus of inflammation can be an objective marker of the course of community-acquired pneumonia in children and a sensitive prognostic sign and can allow identifying children into groups of high risk of prolonged course.