PURPOSE: To assess influence of efferent detoxication methods (EDM) on these systems in blood pre-post severe community-acquired pneumonia (SCAP)treatment.
METHODS: 107 SCAP in-pts were divided into 4 comparable groups. Pts of the 1-st group underwent standard treatment with antibiotics (STA).Pts of the 2-nd-3-4-th groups were treated with additional courses of extracorporeal ultraviolet light-exposure (UVLE), biospecific hemosoptions (BSS) and BSS+UVLE respectively.
RESULTS: The baseline levels of malondialdehyde and syperoxidedysmutase activity were elevated by about 30% and 1,7 times in all groups (p<0,05 vs. the control). After using of EDM malondialdehyde level αwas decreased by 17%; 33%; 30% (p<0,05) in the 2-4-th groups, but didn’t differ in the 1-st group. Syperoxidedysmutase activity decreased after STA by 1,3 times and by 1,6 times in 2-4-th groups. Catalasa activity before treatment was decrease by 10% in the all groups (p<0,05 vs. the control). After therapy catalasa activity had even decreased by 16% in the 1-st group, didn’t change in the 2-nd group and increased by 6% and 13% (p<0,05) in the 3-4-th groups (achieving the norm). The baseline elastase level and trypsin activity were increased by about 5 times in the 1-4-th groups. After therapy elastase as well as trypsin activity were decreased by 1,5; 2,1; 4,1; 6,6 times (p<0,05) and by 2,1; 3,8; 6,4; 6,0 times (p<0,05) respectively. α1-antitrypsin level before treatment was decreased by about 2,8 times (p<0,05 vs. the control) in 1-st-4-th groups and significantly increased by 1,8; 2,2; 3,0; 2,7 times in these groups after therapy. The baseline level of α2-macroglobulin was significantly decreased by about 2 times in all groups and increased up to the norm to the end of treatment.
CONCLUSION: The use of EDM (better BSS+UVLE) in SCAP therapy is more effective vs. STA for faster improvement of imbalance in oxydant-antioxidant and protease-antiprotease systems.
CLINICAL IMPLICATIONS: The normalization of these systems was accompanied with faster reduction of the patient’s symptoms and roentgenologic terms resolution of SCAP by 3-4 days vs. STA.
DISCLOSURE: Alexander Makarevich, None.