International Medical Journal, Vol. 23., Iss. 1, 2017, P. 25−28.
DYNAMICS OF CHANGES OF INFLAMMATION INDICATORS IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA AND CONCOMITANT CHRONIC HEART FAILURE
Kharkiv Medical Academy of Postgraduate Education, Ukraine
At present, marker levels are investigated with the purpose of differential diagnosis and treatment of community−acquired pneumonia (CAP) in conjunction with chronic heart failure. To study the dynamics of pro−inflammatory (IL−1?, IL−8, TNF−a), anti−inflammatory (IL−10) cytokines and markers of inflammation CRP in patients with CAP combined with or without heart failure, and their impact on the course of CAP we investigated 105 patients aged 42−73. The levels of pro−inflammatory, anti−inflammatory cytokines in patients were determined on the day of admission to therapy department and two or three days later, by method of immunoenzyme assay. The feature of the course of CAP in patients with chronic heart failure is increased content of CRP in the blood serum in early disease compared with the patients with chronic heart failure without pneumonia, which persists 48−72 hours from the treatment onset. Two−three days after the onset of antibiotic therapy, the content of CRP in patients with САР and heart failure exceeds the concentration of CRP in patients with САР without chronic heart failure. The patients with САР, chronic heart failure and combined pathology were characterized by elevation of IL−10 and reduction of IL−8 and CRP. Our findings show that heart failure negatively affects the clinical course and prognosis in patients with CAP and increases the risk of unfavorable outcome. The interest in the dynamics of the indicators of inflammation: pro−inflammatory, anti−inflammatory cytokines and inflammation marker CRP in patients with mild CAP accompanied by CHF is due to the necessity to find the ways to improve the diagnosis and treatment of it.
Key words: pneumonia, chronic heart failure, cytokines, C−reactive protein.