Arsent'ev F V, Shustov S S, Barkov V A, Namestnikov V V
Klin Med (Mosk). 1990 Feb;68(2):74-8.
Humoral immunity, body reactivity, reparative function of connective tissue were investigated in 45 patients with poor-symptom acute pneumonia and in 29 lingering pneumonia cases. The patients were examined for the content of IgM, IgG and IgA, haptoglobin, seromucoid, collagen metabolism (by oxyproline) on treatment days 1-5 and 15-25. With prolongation of the inflammation resolution and transformation of the disease into a lingering form, there appeared an imbalance of immunoglobulins manifested by low values of IgG and IgA. The latter immunoglobulins being the most active in body defences, this reflects disturbances in the mechanism of humoral immunity responsible for antiinfectious activity. Haptoglobin concentrations were of certain diagnostic significance, its level being higher in lingering pneumonia. In addition, oxyproline (total and bound) level rose thus evidencing catabolism predominance over collagen synthesis. This may underline delayed repair of the connective tissue in the lungs. Seromucoid, on the contrary, proved an unreliable sign. It is concluded that the level of immunoglobulins (IgG and IgA, in particular) as well as high blood haptoglobin and oxyproline with its components can be considered risk factors for poor-symptom pneumonia progression into a lingering one.
对45例症状较轻的急性肺炎患者和29例迁延性肺炎患者的体液免疫、机体反应性及结缔组织修复功能进行了研究。在治疗的第1 - 5天和第15 - 25天，检测患者的IgM、IgG和IgA、触珠蛋白、血清类黏蛋白、胶原蛋白代谢（通过羟脯氨酸）情况。随着炎症消退的延长以及疾病转变为迁延性形式，出现了免疫球蛋白失衡，表现为IgG和IgA值降低。后两种免疫球蛋白在机体防御中最为活跃，这反映了负责抗感染活性的体液免疫机制受到干扰。触珠蛋白浓度具有一定的诊断意义，其水平在迁延性肺炎中较高。此外，羟脯氨酸（总羟脯氨酸和结合羟脯氨酸）水平升高，从而证明分解代谢超过胶原蛋白合成。这可能突出了肺部结缔组织修复延迟。相反，血清类黏蛋白被证明是一个不可靠的指标。得出的结论是，免疫球蛋白水平（尤其是IgG和IgA）以及高血触珠蛋白和羟脯氨酸及其成分可被视为症状较轻的肺炎进展为迁延性肺炎的危险因素。
