The Changes Of Oxidative/Antioxidant Status In Patients With Community Acquired Pneumonia And The Effect Ofantioxidant Therapy

ObjectiveThe aim of this study was to examine the plasma levels of malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-PX)and total antioxidant capacity(T-AOC)in patients with community-acquired pneumonia(CAP)as well as healthy controls,assess the oxidant/antioxidant status in adults with CAP,and observe the antioxidant effects ofN-acetylcysteine(NAC)in patients with non smokingCAP,to provide laboratory data for the treatment of CAP patients.Methods78 CAP patients were collected(46 male,32 female,mean age 50.40�18.77 years)and 31 Physical examination persons over the same period(20 males,11 females,meanage46.42�13.75years).The diagnosis of CAP was according to community-acquired pneumonia diagnosis and treatment guidelines established by Chinese Medical Association Society of respiratory disease in 2016.ALL patients were selected for laboratory blood routine,liver function,blood coagulation,CRP,PCT and other auxiliary examination.According to the pneumonia severity index(PSI)score,all CAP patients were divided into low-risk group(PSI score ?-? level)in 60 cases,high risk group(PSI score ?-? level)in 17 case.Patientswithnon-smoking history and Less than 60 years of age were randomly divided into experimental group and control group.Finally collected 21 cases of experimental group and 18 cases of control group,both groups were treated with conventional anti-infection,eliminating phlegm treatment,the experimental group was given N-acetylcysteine(NAC)600mg,Po,bid.5ml venous blood was collected in the early morning of the next day(all patient)and seventh days'morming(test group and control group),the plasma MDA,SOD,T-AOC and GSH-PX were detected,observe the changes of plasma oxidative stress,and antioxidant effect of NAC.ResultsIn CAP group,plasma MDA was higher than normal group(2.99� 1.16nmol/ml VS 2.41�1.25nmol/ml),SOD was lower than normal group(67.82�14.75 U/ml VS 84.32�5.44 U/ml)?T-AOC was lower than normal group(7.33�3.57U/ml VS 13.11 �4.11U/ml),GSH-PX was lower than normal group(186.86�44.19 activity unit VS 211.07�41.47 activityunit),the difference was statistically significant(P<0.05).Plasma SOD was negatively correlated with PSI,the correlation coefficient was-0.39(P=0.017),MDA?T-AOC?GSH-PX and PSI were not correlated,PCTand CRP also had no correlation with PSI,PCT and CRP was positively correlated,the correlation coefficient was 0.511(P=0.001).The two groups of T-AOC both increased After treatment,and the Increase degree of plasma T-AOC in the experimental group was significantly higher than control group after the treatment with N-acetyl cysteine(5.83�3.44 vs 9.24�3.38 U/ml,P=0.000)VS(7.47�3.89 vs 9.24�5.06U/ml,P=0.031).The MDA in experimental group decreased compared with pre treatment level(3.1�1.70VS2.14�0.74nmol/l,P=0.006).After treatment,the plasmaSOD in experimental group had a rising trend(54.36�30.31 VS 62.57�40.54,P=0.100),GSH-PX was no significant after the treatment.Conclusion1.Oxidative stress was present in CAP patients,and the Decrease degree of antioxidant capacity is related to the degree of clinical risk of pneumonia.The antioxidant enzyme SOD can reflect the severity of the disease and predict the prognosis of patients.2.After N-acetylcysteine(NAC)treatment,the antioxidant capacity of patients can improve in the short term.NAC contribute to the recovery of CAP patients.