[Functional condition of the vascular endothelium in patients with extrahospital pneumonia]

The purpose of the study was to investigate the vasomotor and NO-production functions of the endothelium (VFE and NOPFE) in patients with extrahospital pneumonia (EHP) of various severity. 60 patients with EHP of various severity, aged 18 to 35 years, were examined. VFE was studied by ultrasonic method (SonoLine Versa Plus, Siemens, Germany) using reactive hypermia test. NOPFE was investigated by measuring total level of NO metabolites by calorimetric method using Griess reagent. The total oxidative and total anti-oxidative activity (TOA, TAOA) in serum was determined. The study revealed functional disturbances of the vascular endothelium at the culmination of EHP. In cases of severe EHP there was insufficient vasodilatation and even vasoconstriction within the 1st minute after reactive hyperthermia test. During the recovery period the parameters were the same as in the patients of the control group. In cases of mild and moderate EHP moderate vasomotor dysfunction was observed, which was not seen during the recovery period. At the culmination of severe EHP NOPFE dysfunction was observed, which manifested by substantial decrease of basal NO secretion and low NO-reactivity of the endothelium (NORE). In cases of mild and moderate EHP low NORE and normal basal level of NO metabolites were seen. During the recovery period NORE returned to its normal level. The patients displayed TOA/TAOA disbalance in serum. There is a significant correlation between TOA/TAOA balance and the functional condition of the endothelium in patients with EHP. Thus, the study revealed endothelial dysfunction, which was strongly associated with the severity of the disease. TOA/ TAOA disbalance is a potential mechanism of endothelial dysfunction in patients with EHP.