NITRIC OXIDE METABOLISM IN PATIENTS WITH COMMUNITYACQUIRED PNEUMONIA ASSOCIATED WITH CORONARY HEART DISEASE AND THE POSSIBILITY OF ITS MEDICAMENTOUS MANAGEMENT

Abstract

The aim: To assess the metabolic by-products of nitric oxide in peripheral blood before and after the medicamentous management in patients suffering from community-acquired pneumonia associated with coronary heart disease. Materials and methods: We have examined 102 patients with community-acquired pneumonia aged from 50 to 65 years, of which 58 patients were diagnosed with coronary heart disease (CHD). The complex treatment of patients with coronary heart disease was supplemented by the additional use of tivortin aspartate, which was taken orally with food at the dose of 5 ml (1g) 3 times a day for 15 days. The NO content in blood plasma was assessed by the concentration of the amount of final NO metabolites (NO3 + NO2), identified by means of the photocalorimetric method. Results: The content of (NO3 + NO2) in peripheral blood of patients with CAP was slightly higher (6.83 ± 0.29) μmol/l as compared to the group of apparently healthy individuals (5.19 ± 0.14) μmol/l, while in patients with CAP associated with CHD it has markedly increased to (12.74 ± 1.09) μmol/l. Against the background of administered treatment, the index of (NO3 + NO2) in patients with coronary heart disease has decreased to (5.76 ± 0.33) μmol/l, while in the group of patients who were not given tivortin aspartate additionally, this index has even slightly increased (7.01 ± 0.40) μmol/l. Conclusions: Marked increase of (NO3 + NO2) levels in blood pointed to destabilization of the course of coronary heart disease with CAP, which was eliminated by the involvement of tivortin aspartate (15 days) to the main course of treatment.