Abstract
Research objective: to study the features of the cytokine profile and cytological status in children with community-acquired pneumonia, proceeding against a background of reduced resistance of the organism for improving treatment methods. 53 children aged 3 to 7 years were examined. The main group consisted of 30 children with community-acquired pneumonia, which ran against a background of reduced resistance of the body. The comparison group consisted of 23 children with community-acquired pneumonia who had good resistance. Local immunity was studied on the basis of valuation of cytokine status parameters (tumor necrotic factor-α, interleukin-8, and interferon-γ) and cellular composition with an estimate of destructive changes in neutrophils in induced sputum. It was revealed that in the main group of children there is a depression of the neutrophils’ release into the bronchial secretion and a marked increase in the number of neutrophils with maximum signs of destruction of the nucleus and cytoplasm against the background of cytokine status imbalance, manifested in an increase in the content of the tumor necrotic factor-α and a decrease in interleukin-8 and interferon- γ. Inclusion in the traditional therapy of community-acquired pneumonia in children who have a reduced resistance, anti-inflammatory drug fenspiride, eliminates the imbalance of proinflammatory cytokines and increases the release of functionally complete neutrophils in the bronchial secret.
Highlights
Research objective: to study the features of the cytokine profile and cytological status in children with community-acquired pneumonia, proceeding against a background of reduced resistance of the organism for improving treatment methods. 53 children aged 3 to 7 years were examined
The main group consisted of 30 children with community-acquired pneumonia, which ran against a background of reduced resistance of the body
The comparison group consisted of 23 children with community-acquired pneumonia who had good resistance
Summary
Основную группу составили 30 детей с внебольничной пневмонией, которая протекала на фоне сниженной резистентности организма. Группу сравнения составили 23 ребенка с внебольничной пневмонией, имевшие хорошую резистентность организма – с индексом резистентности 0,2–0,3 и не относящиеся к группе часто болеющих. Этиологическая верификация внебольничной пневмонии у детей проводилась бактериологическим и бактериоскопическим исследованиями индуцированной мокроты в первые сутки госпитализации. Местный иммунитет изучали на основе оценки параметров цитокинового статуса и клеточного состава индуцированной мокроты. Клеточный состав индуцированной мокроты изучали на основе содержания нейтрофилов, лимфоцитов, эозинофилов, альвеолярных макрофагов и эпителиальных клеток. Проводили оценку деструктивных изменений в клеточных популяциях нейтрофилов с выделением четырех классов деструкции – 0, 1, 2, 3, 4 с учетом состояния цитоплазмы клетки и ядра клетки. Проводили расчет индекса деструкции клетки (ИДК), среднего показателя деструкции (СПД), индекса цитолиза клетки (ИЦК). Локальный цитокиновый профиль и цитологический статус у детей с внебольничной пневмонией
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