| Hygiene of populated places | ISSN: 2707-0441 eISSN: 2707-045X |
Issue 69, 2019 - Pages: 242-250
IMPACT OF THE ENVIRONMENT ON THE CHANGE OF HEMATOLOGICAL INDICATORS IN PATIENTS WITH PULMONARY TUBERCULOSIS WORKING UNDER HARMFUL CONDITIONS OF PRODUCTION
P.I. Poteiko1, S.I. Tkach1, O.I. Popov1, O.V. Shyrapova1, L.M. Belykh1, L.T. Boiko1, O.S. Konstantinovska2, V.A. Khodakovska2, N.G. Semko2, T.O. Popova2
1 KHARKIV MEDICAL ACADEMY OF POSTGRADUATE EDUCATION
2 SHUPYK NATIONAL MEDICAL ACADEMY OF POSTGRADUATE EDUCATION
2 SHUPYK NATIONAL MEDICAL ACADEMY OF POSTGRADUATE EDUCATION
ÓÄÊ: 502.11: 611.24-002.5-076: 613.6.02
SUMMÀRY:
The impact of the environmental factors on the health of the population is one of the urgent problems. The situation of tuberculosis remains unfavorable in Ukraine. The issue of diagnosis of tu-berculosis, assessment of the severity of the course, prediction of the effectiveness of treatment and identification of the causes that affect these indicators is relevant. The majority of tuberculosis patients are able-bodied people and they have the contacts with harmful factors of production. It affects the manifestation of the disease and the effectiveness of the treatment of tuberculosis.
Objective. We analyzed the diagnostic significance of hematological parameters in the pa-tients with tuberculosis who worked under harmful conditions of production.
Materials and methods. The study was controlled and retrospective in the parallel groups of patients with newly diagnosed pulmonary tuberculosis who worked under harmful conditions of pro-duction. We analyzed 226 case histories of the patients that were treated in the Kharkiv Regional Clinical Tuberculosis Dispensary No. 7 in 2014-2016. To exclude the impact on the hematological parameters of age, gender, duration of the tuberculosis process in the lungs and the resistance profile of tuberculosis mycobacteria, the patients were divided into 2 groups according to case-control prin-ciple. The patients who worked in the contact with harmful factors of production (113 people) were the main group. The patients who worked without exposure to harmful factors (113 people) were a comparison group. Persons from the main group were the most often exposed to harmful chemicals – 50% and physical factors – 30%, more rarely they had contacts with dust of fibrogenic effect (10%) and allergens (10%).
Results and discussion. Based on the data obtained, it may be argued that the hematological index of intoxication in the patients objectively reflects the severity of endogenous intoxication. Irre-spective of the profession of the patients, the level of this indicator depends, first of all, on clinical and radiological form of tuberculosis and the type of inflammatory reaction connected with the duration of the destructive process and the severity of intoxication syndrome.
Conclusions. 1. In people without occupational risks, a tendency to more rapid normalization of deviations in the hemogram is observed. Changes in the hemogram in the patients with tuberculo-sis depend on clinical and radiological form and type of inflammatory reaction. They are associated with the duration of destructive process and severity of intoxication syndrome. 2. A comprehensive assessment of hematological indices is more informative than a study of a simple hemogram, which makes possible to evaluate the development, severity, course of the inflammatory process and endog-enous intoxication, as well as the effectiveness of therapy and to determine the strategy for further treatment correction to achieve the maximum effect. 3. Evaluation of the severity of endogenous in-toxication with the help of the hematological index of intoxication will allow us to understand ade-quately the severity of the state of patients and to make timely a decision about the place of treatment, the amount of necessary assistance and will serve as a prognostic criterion for the outcome of the dis-ease. 4. The data obtained will be useful for the development of the criteria for early diagnosis and the severity of the inflammatory process in the patients with pulmonary tuberculosis working in harm-ful and dangerous production conditions.
Objective. We analyzed the diagnostic significance of hematological parameters in the pa-tients with tuberculosis who worked under harmful conditions of production.
Materials and methods. The study was controlled and retrospective in the parallel groups of patients with newly diagnosed pulmonary tuberculosis who worked under harmful conditions of pro-duction. We analyzed 226 case histories of the patients that were treated in the Kharkiv Regional Clinical Tuberculosis Dispensary No. 7 in 2014-2016. To exclude the impact on the hematological parameters of age, gender, duration of the tuberculosis process in the lungs and the resistance profile of tuberculosis mycobacteria, the patients were divided into 2 groups according to case-control prin-ciple. The patients who worked in the contact with harmful factors of production (113 people) were the main group. The patients who worked without exposure to harmful factors (113 people) were a comparison group. Persons from the main group were the most often exposed to harmful chemicals – 50% and physical factors – 30%, more rarely they had contacts with dust of fibrogenic effect (10%) and allergens (10%).
Results and discussion. Based on the data obtained, it may be argued that the hematological index of intoxication in the patients objectively reflects the severity of endogenous intoxication. Irre-spective of the profession of the patients, the level of this indicator depends, first of all, on clinical and radiological form of tuberculosis and the type of inflammatory reaction connected with the duration of the destructive process and the severity of intoxication syndrome.
Conclusions. 1. In people without occupational risks, a tendency to more rapid normalization of deviations in the hemogram is observed. Changes in the hemogram in the patients with tuberculo-sis depend on clinical and radiological form and type of inflammatory reaction. They are associated with the duration of destructive process and severity of intoxication syndrome. 2. A comprehensive assessment of hematological indices is more informative than a study of a simple hemogram, which makes possible to evaluate the development, severity, course of the inflammatory process and endog-enous intoxication, as well as the effectiveness of therapy and to determine the strategy for further treatment correction to achieve the maximum effect. 3. Evaluation of the severity of endogenous in-toxication with the help of the hematological index of intoxication will allow us to understand ade-quately the severity of the state of patients and to make timely a decision about the place of treatment, the amount of necessary assistance and will serve as a prognostic criterion for the outcome of the dis-ease. 4. The data obtained will be useful for the development of the criteria for early diagnosis and the severity of the inflammatory process in the patients with pulmonary tuberculosis working in harm-ful and dangerous production conditions.
KEYWORDS:
environmental factors, hematological parameters, patients with pulmonary tuberculosis, harmful working conditions.
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FOR CITATION:
Poteiko P.I., Tkach S.I., Popov O.I., Shyrapova O.V., Belykh L.M., Boiko L.T., Konstantinovska O.S., Khodakovska V.A., Semko N.G., Popova T.O. Vozdeistvie okruzhaiushchei sredy na izmenenie hematolohicheskikh pokazatelei u bolnykh tuberkulezom lehkikh, rabotavshikh vo vrednykh usloviiakh proizvodstva [Impact of the environment on the change of hematological indicators in patients with pulmonary tuberculosis working under harmful conditions of production]. In : Hihiiena naselenykh mists : zb. nauk. pr. [Hygiene of Populated Places]. Kyiv ; 2019 ; 69 : 242-250 (in Russian).