INDICATORS OF CLINICAL, RADIOLOGICAL, AND LABORATORY STATUS IN MALE PATIENTS WITH NEWLY DIAGNOSED INFILTRATIVE PULMONARY TUBERCULOSIS

Abstract

Introduction. In Ukraine, despite the free medical care in the field of tuberculosis, the effectiveness of tuberculosis treatment does not meet WHO standards. With the lack of resistance of Mycobacterium tuberculosis to the first-line anti-TB agents, the desired improvement in clinical and radiological results in the first 2 months of treatment is not always possible to achieve. The causes of the poor efficiency remain unknown and require detailed study. The objective was to study clinical, radiological, and laboratory data of male inpatients with newly diagnosed infiltrative pulmonary tuberculosis at the beginning of treatment. Materials and Methods. 133 men with newly diagnosed infiltrative pulmonary tuberculosis sensitive to the first-line anti-TB agents were examined. The data of clinical, radiological, and laboratory parameters were studied; immunological parameters of IL‑4, IL-10, IFN-γ, and data of phagocytic activity of neutrophils were additionally examined. All patients were tested for anxiety and depressive disorders using the State-Trait Anxiety Inventory and Beck Depression Inventory. Results. It was found that at the beginning of treatment, patients with pulmonary destruction cavities had a 2.7-fold higher incidence of intensive bacterial excretion and a 1.6-fold reduction in IFN-γ levels as compared with patients without lung tissue destruction. Men with an extended infiltrative process in the lungs presented with fever and symptoms of intoxication more than 2.5 times more often, with cough – more than 4 times more often, with a history of weight loss – more than 2.9 times more often, with Mycobacterium tuberculosis detected by microscopy – more than 6.2 times more often vs. men with a limited process in the lungs. Conclusions. Patients with newly diagnosed infiltrative pulmonary tuberculosis who had destructive changes in lung tissue and a significant extension of the pathological process were characterized by more pronounced clinical manifestations, intoxication, activation of systemic inflammatory response factors, decreased activity of the cellular immune system, and psychological disorders.