Комп’ютерна денситометрія в оцінці основного курсу антимікобактеріальної терапії у хворих із вперше діагностованим туберкульозом легень

Abstract

Objective — to investigate the effectiveness of the main course of antimycobacterial therapy in patients with newly diagnosed tuberculosis (FDTB) of lungs without bacterial excretion, depending on the method of administration of anti­tuberculosis drugs (based on computer densitometry data). Materials and methods. 89 patients with FDTB of the lungs were examined in the dynamics.Of these, 48 received intravenous forms of anti­TB drugs and 41 patients were prescribed a standard regimen of antimycobacterial therapy orally. For examination of patients, computer tomography of lungs was used at the beginning and at the end of intensive phase of chemotherapy with densitometry of lesions. Results and discussion. It was established that during the intensive phase of treatment of FDTB with the use of intravenous anti­TB drugs most of the cells dissipated (12.5 %) or tended to resorption (77.1 %), with the resorption characteristic of more dense centers ((26 ± 17.3) HU). With the use of standard oral therapy during the intensive phase of treatment, on the contrary, there was a tendency to densify cells in 26.8 % with resorption of soft cells (–26 ± 29.1) HU. After the completion of the main course of treatment, the intravenous use of anti­TB drugs in patients with FDTB reliably led to further resorption of 91.9 % of the centers in which after the intensive phase of chemotherapy expected a corresponding trend. Conclusions. Computer densitometry of focal changes in pulmonary tuberculosis is an informative method for assessing the effectiveness of treatment and allows to objectively evaluate and compare different methods and schemes of antimycobacterial therapy for patients with FDTB.