Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2007, vol. 16, nr 3, May-June, p. 375–382

Publication type: original article

Language: English

Elements of the Antioxidant Barrier and Nutritional Status of Children with Pneumonia

Elementy bariery antyoksydacyjnej oraz stan odżywienia dzieci chorych na zapalenie płuc

Sylwia Małgorzewicz1,, Danuta Rudnik−Czarnecka2,, Ewa Aleksandrowicz−Wrona1,, Wiesława Łysiak−Szydłowska1,

1 Department of Clinical Nutrition, Medical University of Gdańsk, Poland

2 Pediatric Unit City Hospital of Gdynia, Poland

Abstract

Background. Advances in recent years have resulted in more effective treatment of lower respiratory tract infections in children; however, pneumonia is still one of the most common illnesses of childhood. This study focused on the assessment of the antioxidant barrier, inflammation intensity, and nutritional status in children with pneumonia.
Material and Methods. The study was carried out on 152 children with pneumonia treated at the Pediatrics Department of the Gdynia City Hospital and 53 children without any infection symptoms, who formed the control group. The tests were performed at the beginning of hospital treatment and after the clinical signs of disease had subsided, about four weeks after diagnosis. The tests included serum concentrations of prealbumin, albumin, alpha 1−acid glycoprotein, glutathione, C−reactive protein, and vitamin E. Urea and creatinine excretion were determined in urine in order to calculate the catabolic index, the ratio of urea to creatinine. The prognostic inflammatory and nutritional index was also calculated. Nutritional status of the children was assessed using centile charts according to Kopczynska−Sikorska.
Results. In the groups of children with infection, increases in C−reactive protein and alpha 1−acid glycoprotein levels and decreases in albumin and prealbumin levels were observed during the first phase of disease compared with the control group. A gradual normalization of these parameters followed treatment. Changes in mean glutathion and vitamin E concentrations were not statistically significant during the observation. The catabolic and prognostic inflammatory and nutritional indexes in all patients were significantly elevated (p < 0.05) compared with the controls.
Conclusion. In the case of infectious diseases such as pneumonia, essential information about health status should be gathered based on comprehensive patient evaluation, which means determining inflammation markers, nutritional status, and the antioxidant barrier.

Streszczenie

Wprowadzenie. Leczenie zakażeń dolnych dróg oddechowych u dzieci jest coraz bardziej skuteczne, ale mimo postępu w tej dziedzinie zapalenie płuc jest jedną z najczęstszych chorób wieku dziecięcego.
Cel pracy. Ocena bariery antyoksydacyjnej, nasilenia stanu zapalnego oraz stanu odżywienia u dzieci chorych na zapalenie płuc.
Materiał i metody. Zbadano 152 dzieci chorych na zapalenie płuc leczonych na Oddziale Dziecięcym Szpitala Miejskiego w Gdyni oraz 53 dzieci bez cech zakażenia, które należały do grupy kontrolnej. Dzieci podzielono na 3 grupy wiekowe. Badania wykonywano na początku leczenia szpitalnego oraz po ustąpieniu klinicznych objawów choroby, około 4 tygodnie od rozpoznania. Oznaczano stężenie w surowicy prealbuminy, albuminy, alfa 1−kwaśnej glikoproteiny (AGP), glutationu (GSH), białka C−reaktywnego (CRP) oraz witaminy E. Wmoczu oznaczano wydalanie mocznika i kreatyniny w celu obliczenia indeksu katabolicznego. Ponadto obliczano współczynnik prognostyczny zapalenia i odżywienia (PINI). Stan odżywienia oceniano za pomocą siatek centylowych wg Kopczyńskiej−Sikorskiej.
Wyniki. W początkowym okresie choroby w badanych grupach dzieci chorych stwierdzono wzrost stężenia CRP i AGP oraz obniżenie albumin i prealbuminy w stosunku do grupy kontrolnej oraz obserwowano stopniowy powrót tych wskaźników do wartości prawidłowych pod wpływem leczenia. Średnie stężenia GSH oraz witaminy E nie zmieniały się istotnie statystycznie w czasie obserwacji. Indeks kataboliczny oraz PINI były u wszystkich chorych dzieci znamiennie podwyższone (p < 0.05) w stosunku do dzieci zdrowych.
Wnioski. Wprzypadku chorób infekcyjnych, takich jak zapalenie płuc, jest wskazana kompleksowa ocena pacjenta pod względem nasilenia stanu zapalnego, ocena stanu odżywienia oraz bariery antyoksydacyjnej.

Key words

pneumonia, oxidative stress, nutritional status

Słowa kluczowe

zapalenie płuc, stres oksydacyjny, stan odżywienia

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