Цито-энергетический статус у детей при внебольничной пневмонии

Objective: to evaluate the cytoenergetic status of children with community-acquired pneumonia (CAP). Materials and methods. In total 63 children with diagnosed CAP were examined and divided into three age groups: group 1 (n=21) comprised children aged from 1 to 6 years, group 2 (n=22) included patients from 7 to 13 years, and group 3 (n=20) – from 14 up to 18 years. The cytochemical method was employed to detect the activity of lactate dehydrogenase (LDH), succinate dehydrogenase (SDH), malate dehydrogenase (MDH), and glutamate dehydrogenase (GDH) in lymphocytes. The LDH/SDH ratio was also calculated. Results. Analysis of the mitochondrial dehydrogenases activity showed that inactivation of MDH was typical for children with CAP of all age groups. Activation of anaerobic energy synthesis was observed in the children of group 1 with CAP, as indicated by a 1.6-fold activity increase in LDH and a 1.7-fold increase in LDH/SDH ratio. In patients of the 2nd group with CAP, the Krebs cycle inhibition was found as represented by a 1.6-fold decreased activity in MDG and twofold decrease in GDH. CAP in children of the group 3 was associated with inactivation of SDH by 1.5 times, half as large of GDH and MDH by 1.7 times against the background of the LDH/SDH ratio increase by 1.5 times, which indicates the anaerobic energy metabolism activation. A correlation was established between the decrease in oxygen saturation in blood of children with CAP and SDH (rs 0.46), LDH (rs 0.56) and GDH activity (rs 0.58), p<0.01. Conclusions. In children with CAP, an increase in LDH/SDH ratio, a decrease in MDH and GDH, which indicate activation of anaerobic energy metabolism and inhibition of the Krebs cycle were determined. The most significant energy deficiency was detected in the children of the first and the third age groups. A correlation between the oxygen saturation of blood in children with CAP and of the Krebs cycle functioning was established.