Заболевания органов дыхания и гипераммониемия

Abstract

Study Objective: To assess the incidence of hyperammoniemia in respiratory diseases. Materials and Methods. 36 patients with respiratory diseases took part in the study: chronic obstructive pulmonary disease (COPD) (21 (58.3%) patients), chronic bronchitis (5 (13.9%) patients), and pneumonia (10 (27.8%) patients). Mean age was 66.8 ± 11.8 years; 9 (25.0%) females and 27 (75.0%) males. Each patient had his/her capillary ammonia measured (microdiffusion). In order to assess the nutrition status, all patients had their primary somatometry measured: height, weight, body mass index, inactive arm circumference, waist circumference, skin-fat rolls thickness under biceps, above triceps, below shoulder blade angle, in inguinal region. Study Results. 9 (25.0%) out of 36 patients had hyperammoniemia (capillary ammonia level: 74.0 ± 7.1 nmol/L); their mean age was 62.3 ± 18.2 years. Patients with COPD/chronic bronchitis had significantly higher ammonia concentration (60.7 ± 16.6 mol/L) vs. patients with pneumonia (48.4 ± 14.3 mol/L; t = 2.2, p < 0.03). COPD patients demonstrated significant differences in ammonia levels depending on duration of disease. In the group of higher ammonia concentration, COPD lasted significantly longer (t = 4.03 p = 0.001). We did not find any sound correlation between nutritional (trophological) status and ammonia concentrations in patients with respiratory diseases (t < 2, p > 0.05). Conclusion. In 25% of cases, respiratory diseases were associated with hyperammoniemia that is non-cirrhotic, because hepatobiliary disorders in this group of patients were an exclusion criterion. Although no statistically significant correlation between non-cirrhotic hyperammoniemia and nutritional (trophological) status was demonstrated, pathogenic relations between them cannot be ruled out. Whether underweight is a determining factor in non-cirrhotic hyperammoniemia is still unclear and requires further research and more observations. Keywords: ammonia, non-cirrhotic hyperammoniemia, nutritional (trophological) status, respiratory diseases.