Losonczy György
Semmelweis Egyetem, Általános Orvostudományi Kar Pulmonológiai Klinika, Budapest.
Orv Hetil. 2012 Jun 10;153(23):884-90. doi: 10.1556/OH.2012.29393.
Community acquired pneumonia is the most frequent infective cause of severe sepsis and death. The risk of mortality in community acquired pneumonia is predictable by the "pneumonia severity index" and various biomarkers (e.g., procalcitonin, troponin-I). Quantitative testing of pneumococcal load (DNA) in blood has also become possible recently. Early death due to acute myocardial infarction is more frequent among patients with previous community acquired pneumonia. The 1-year and the 5-6 year survival is shorter among these patients. Pro-inflammatory cytokines synthesized during community acquired pneumonia accelerate chronic inflammation ongoing in atherosclerotic plaques. The pro-thrombotic condition present in atherosclerosis is also potentiated by community acquired pneumonia. These pathophysiological mechanisms may explain the epidemiologic fact that community acquired pneumonia is an independent risk factor of cardiovascular mortality.
社区获得性肺炎是严重脓毒症和死亡最常见的感染原因。社区获得性肺炎的死亡风险可通过“肺炎严重程度指数”和各种生物标志物（如降钙素原、肌钙蛋白I）来预测。血液中肺炎球菌载量（DNA）的定量检测最近也已成为可能。既往有社区获得性肺炎的患者因急性心肌梗死导致的早期死亡更为常见。这些患者的1年和5至6年生存率较低。社区获得性肺炎期间合成的促炎细胞因子会加速动脉粥样硬化斑块中持续存在的慢性炎症。社区获得性肺炎还会增强动脉粥样硬化中存在的血栓前状态。这些病理生理机制可能解释了社区获得性肺炎是心血管死亡独立危险因素这一流行病学事实。
