NL Journal of Medical and Pharmaceutical Sciences
(ISSN: 3108-0502)

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Diagnostic Features of Drug-resistant Pulmonary Tuberculosis in Adults in Lviv Region, Ukraine

Author(s) : Piskur Zoriana Ivanovna*, Sakhelashvili Manana Ivanovna.
DOI : 10.71168/NMP.02.02.126

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Abstract

Aim: The aim of the work is to study the clinical and laboratory features of the diagnosis of drug-resistant pulmonary tuberculosis (DR-PTB) in adults. Materials and Methods: 184 medical files of patients with TB were analyzed. The main group consisted of 134 people who developed DR-PTB, and the control group consisted of 50 patients with susceptibility pulmonary tuberculosis (S-PTB). Results and Discussion: The clinical and radiological course of the specific process depends on the susceptibility/resistance of Mycobacterium tuberculosis. The disseminated form was diagnosed 1.5 times more often, fibrous-cavernous 1.7 times more often and 2.2 times less often infiltrative form of DR-PTB compared to S-PTB. The progression was observed 3.7 times caseous pneumonia and bronchial TB 1.9 times more often. The using of sputum polymerase chain reaction for detection of MBT contributed to timely diagnosis of DR-PTB in 94.0%. In the majority of patients (94.7%) of the main group, an increase in ESR was noted. Moreover, an increase in ESR over 31 mm/h was detected in 23.8%, leukocytosis in 30.6%, eosinopenia in 31.3%, lymphopenia in 58.9%, lymphocytosis in 40.3%. High levels of C-reactive protein were found in 70.9% of patients from the main group and 2.4 times less often in control patients. A 1.2-fold decrease in the phagocytic index, a 2.5-fold in the phagocytic number; a 1.3-fold decrease in the content of unfermented cationic lysosomal proteins of granulocytes, and an immunoregulatory index were found in DR-PTB. The population of T-suppressors increases by 1.2 times, and number of T-helpers decreases by 1.2 times. The tumor necrosis factor-α increased by 2.7 times, IL-6 by 1.9 times in main group. Conclusion: The present study indicates the importance of comprehensive clinical and laboratory diagnostics of DR-PTB to determine the features of the course of a specific process and the appointment of optimal antimycobacterial therapy. Keywords: Diagnosing, Drug-resistant tuberculosis, Immunity, Laboratory parameters.

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