Abstract
The aim of the work was to determine the diagnostic value of the markers of surfactant protein D (SP-D) and C-reactive protein (C-RP) in patients with community-acquired pneumonia (CAP) with concomitant arterial hypertension (AH) and its effects on the activity of the inflammatory process. The study included 79 people. Among them, 63 patients with CAP and 16 healthy individuals who were a control group. Depending on the presence of hypertension, the patients were divided into two groups. The first group included 26 patients with CAP with AH, the second – 37 patients with CAP without AH. All patients were given general-clinical methods of examination, radiography of the chest organs in two projections. Plasma levels of SP-D and C-RP were determined. Reliable connection (p<0.05) was determined between the presence of AH and the probability of occurrence of CAP (OR - odds ratio 2.27 [95 % CI 1.05–4.94]). The level of SP-D and C-RP in patients with AH on the first day was significantly higher than in healthy subjects (p<0.05). In patients in the first group, SP-D levels were significantly higher (p<0.05) for the first, third and ninth day relative to the second group. The existence of a direct tie of average strength between the presence of AH and SP-D (R=0.41, p<0.05) has been determined. The presence of a direct correlation link of mean strength (R=0.38; p<0.05) between the AH and the level of C-RP indicates that arterial hypertension in patients with CAP increases the activity of the systemic inflammatory response.
Highlights
Community-acquired pneumonia (CAP), as a disease, remains one of the most important unresolved issues in modern pulmonology [1]
The development of anemia is accompanied by violations of microcirculation, which occurs in the mechanism of formation of hypertension, factors of non-specific inflammation characterized by an increase in C-reactive protein (C-RP) [3, 4]
This review summarizes the importance of studying the circulating level of surfactant protein D (SP-D), the ability to interact in a diagnostic program with already well-known markers of systemic inflammation and the effect or dependence on the presence of comorbidity in patients with CAP in a hospital
Summary
Community-acquired pneumonia (CAP), as a disease, remains one of the most important unresolved issues in modern pulmonology [1]. Cardiovascular system dysfunction is almost a constant companion of the CAP and develops from the first hours, with blood circulation disturbances often determine the prognosis and the result of the CAP itself. The spectrum of these violations is varied and depends on the severity of the process [2]. The freaquency of arterial hypertension (AH) can reach 63.9 % with the damage to target organs in patients with CAP. The presence of SP-D in the systemic circulation can contribute to the development of cardiovascular disease and mortality in patients with CAP, as its role in the development of endothelial dysfunction is known [6]. It is important that in the vascular wall SP-D can perform the same anti-inflammatory function as in the lungs or vice versa, leading to a pro-inflammatory reaction [7]
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