| Hygiene of populated places | ISSN: 2707-0441 eISSN: 2707-045X |
Issue 72, 2022 - Pages: 176-184
PROTECTIVE SIGNIFICANCE OF HEMATOLOGICAL AND BIOCHEMICAL INDICATORS FOR ASSESSING THE EFFICIENCY OF TREATMENT REGIMES FOR MULTI-RESISTANT TUBERCULOSIS
K.D. Mazhak1, O.A. Tkach1, H.V. Shchurko1, V.P. Zukova1
1 RESEARCH INSTITUTE OF EPIDEMIOLOGY AND HYGIENE DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY
ÓÄÊ: [616.24-002.5:615.015.8]:[577.1:616.15]:616-08:615.33
SUMMÀRY:
Objective. To study the significance of biochemical and integral hematological indicators for evaluating the effectiveness of chemotherapy regimens (CT) for multidrug-resistant tuberculosis (MDR-TB) in patients with various prognostically unfavorable determinants of treatment.
Materials and methods In 58 patients with new cases and relapses of MR TB, indicators of the systemic inflammatory response (SIR), endogenous intoxication (EI), markers of functional disorders of the liver and kidneys, blood hemogram before and after the use of CT were studied: 28 people received treatment regimens with bedaquiline, 30 - individualized treatment regimens (IRT) without bedaquiline. The obtained digital results are processed by the methods of variational statistics
Results. It was established that the values of the hematological indices of intoxication and the index of inflammation activity are correlated with SIR indicators, markers of protein synthesizing processes in the liver. It was found that the accumulation of endotoxins leads to an imbalance of biochemical homeostasis and a violation of the functions of enzymatic systems of cell membranes, which affects the effectiveness of CT. Determining the indicators of the tested complex makes it possible to improve the individual approach to the management of a case of MR TB of the lungs not only in the intensive phase of treatment at the inpatient stage, but also at the outpatient stage of additional treatment. When using bedaquiline, an increase in the frequency of cessation of bacterial excretion (90.2% vs. 82.1%) and positive radiological dynamics (72.2% vs. 64.2% in the reference group) was noted, which determines its effectiveness.
Conclusions. Calculation of integral hematological indices in patients with MR TB are relevant, they correlate with indicators of EI, SIR, functional state of the liver and kidneys and do not require costs for additional examinations of patients, allow to assess the patient's condition, the severity of the process, the presence of intoxication syndrome, its degree, the strategy of further correction of treatment.
Materials and methods In 58 patients with new cases and relapses of MR TB, indicators of the systemic inflammatory response (SIR), endogenous intoxication (EI), markers of functional disorders of the liver and kidneys, blood hemogram before and after the use of CT were studied: 28 people received treatment regimens with bedaquiline, 30 - individualized treatment regimens (IRT) without bedaquiline. The obtained digital results are processed by the methods of variational statistics
Results. It was established that the values of the hematological indices of intoxication and the index of inflammation activity are correlated with SIR indicators, markers of protein synthesizing processes in the liver. It was found that the accumulation of endotoxins leads to an imbalance of biochemical homeostasis and a violation of the functions of enzymatic systems of cell membranes, which affects the effectiveness of CT. Determining the indicators of the tested complex makes it possible to improve the individual approach to the management of a case of MR TB of the lungs not only in the intensive phase of treatment at the inpatient stage, but also at the outpatient stage of additional treatment. When using bedaquiline, an increase in the frequency of cessation of bacterial excretion (90.2% vs. 82.1%) and positive radiological dynamics (72.2% vs. 64.2% in the reference group) was noted, which determines its effectiveness.
Conclusions. Calculation of integral hematological indices in patients with MR TB are relevant, they correlate with indicators of EI, SIR, functional state of the liver and kidneys and do not require costs for additional examinations of patients, allow to assess the patient's condition, the severity of the process, the presence of intoxication syndrome, its degree, the strategy of further correction of treatment.
KEYWORDS:
Multidrug-resistant tuberculosis, biochemical indicators, hematological indices, bedaquiline.
REFERENCES:
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3. Diacon AH, Pym A, Grobusch MP, de los Rios JM, Multidrug-Resistant Tuberculosis and Culture Conversion with Bedaquiline. N Engl J Med. 2014;371:723-32. doi: https://doi.org/10.1056/NEJMoa1313865
4. Mazhak KD, Tkach OA, Pisarenko EI, Lapovets NE. [Expediency of using pathogenetic therapy in complex treatment of destructive pulmonary tuberculosis]. [Development of science in the 21st century. Part 1]. Kharkiv: Znannia. 2018;23-34. Ukrainian. Available from: http://nicznanie.org.ua/images/docs/October_2018/Kharkiv_october_2018_part_1.pdf
FOR CITATION:
Mazhak KD, Tkach OA, Shchurko HV, Zukova VP. Protective significance of hematological and biochemical indicators for assessing the efficiency of treatment regimes for multi-resistant tuberculosis. Hygiene of populated places. 2022;72:176-184. Ukrainian.