SPECIFIC FEATURES OF NITRIC OXIDE METABOLISM IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ITS COMBINATION WITH COMMUNITY - ACQUIRED PNEUMONIA

The objective of the research was to study nitric oxide metabolism in blood serum and in the condensate of the exhaled air in patients with chronic obstructive pulmonary disease (COPD) and its combination with community - acquired pneumonia (COPD+CAP).55 patients were included into the study. The first group consisted of 28 patients with exacerbated form of COPD. The second group (n=27) consisted of patients with COPD combined with community - acquired pneumonia (COPD+CAP). In patients of both groups the intensity of the symptoms has been assessed, clinical, laboratory and instrumental data have been obtained and analyzed. Dynamic changes in the values of nitrite and nitrate anions (NO2- and NO3-) as well as their total concentration (ƩNO2-/NO3) in the blood serum and exhaled air condensate (EAC) have been determined.In the patients enrolled in the study the increase in NO2-, NO3-, ƩNO2-/NO3- levels in the blood and EAC have been revealed. This indicated the impairment of nitric oxide (NO) metabolism. These changes in the blood were more marked in patients with COPD+CAP. Nitric oxide metabolism values correlated with the state of the lungs function and Creactive protein (C.R.P.) content in the blood serum. Disturbances in the nitric oxide metabolism and signs of the inflammatory process have been found to be preserved during treatment. After the course of treatment more marked symptoms of the disease and higher levels of NO2- in the blood and EAC as well as content of C.R.P. in serum have been found in patients with COPD+CAP compared to the patients with COPD.Thus the course of the disease in patients with COPD+CAP and in patients with exacerbated form of COPD is characterized with the development of nitrosive stress. Its intensity is more marked in patients with COPD+CAP. The study of nitric oxide metabolites in patients gives additional information about the severity of the inflammatory process and the efficacy of the undertaken therapy.

хроническая обструктивная болезнь легких, внебольничная пневмония, оксид азота, community - acquired pneumonia, chronic obstructive pulmonary disease, nitric oxide

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