FUNCTIONAL STATE OF THE LIVER IN PULMONARY TUBERCULOSIS IN THE DYNAMICS OF PATHOGENETIC TREATMENT WITH A COMPLEX OF AMINO ACIDS.

OBJECTIVE: The aim: To investigate the in!uence of prescribing a complex of amino acids in pathogenetic therapy in patients with pulmonary tuberculosis on liver function. PATIENTS AND METHODS: Materials and methods: The study included 50 patients with drug susceptible TB and 50 patients with drug-resistant TB (multidrug-resistant and extensively drug-resistant). RESULTS: Results: The study included 50 patients with drug susceptible tuberculosis (TB) and 50 patients with drug-resistant TB. When comparing biochemical pa-rameters characterizing liver function in patients with drug-susceptible TB after 1 month of anti-tuberculosis therapy, it was found that patients receiving additional therapy with a complex of amino acids had a lower level of bilirubin, p <0.05. After 60 doses, patients receiving additional therapy with amino acids had significantly lower bilirubin levels alanine aminotransferase (ALT) and aspartate aminotransferase (AST), p <0.05. When comparing the biochemical parameters characterizing liver function in patients with drug-resistant tuberculosis after a month of anti-tuberculosis therapy, significantly higher protein level was found in the groups of patients receiving additional therapy with amino acids, as well as significantly lower ALT level, AST and creatinine p <0.05. CONCLUSION: Conclusions: The additional appointment of the complex of amino acids in the pathogenetic therapy of patients with pulmonary tuberculosis makes it possible to reduce the severity of hepatotoxic reactions manifested by the main parameters (AST, ALT, total bilirubin) and to increase the protein-synthetic function of the liver, which allows us to recommend their appointment to improve the tolerance of anti-tuberculosis therapy.

A MATHEMATICAL MODEL FOR PREDICTING THE OUTCOME OF TREATMENT OF MULTIDRUD-RESISTANT TUBERCULOSIS.

OBJECTIVE: The aim: Predicting the effectiveness of treatment for MRI of the lungs by developing a mathematical model to predict treatment outcomes. PATIENTS AND METHODS: Materials and methods: 84 patients with MRI of the lungs: group 1 (n = 56) - with signs of effective TB treatment at the end of the intensive phase; group 2 (n = 28) - patients with signs of ineffective treatment. We used the multivariate discriminant analysis method using the statistical environment STATISTICA 13. RESULTS: Results: During the discriminant analysis, the parameters of the clinical blood analysis (monocytes, stab leukocytes, erythrocytes) were selected, which were associated with high (r> 0.5) statistically significant correlations with the levels of MMP-9, TIMP-1, oxyproline and its fractions and aldosterone in the formation of the prognosis. The mathematical model allows, in the form of comparing the results of solving two linear equations and comparing their results, to predict the outcome of treatment: "1" effective treatment, "2" - ineffective treatment. Early prediction of treatment effectiveness is promising, as it allows the use of the developed mathematical model as an additional criterion for the selection of patients for whom surgical treatment is recommended, in order to increase the effectiveness of treatment. CONCLUSION: Conclusions: An additional criterion for predicting ineffective MRI treatment, along with the criteria provided for by WHO recommendations, is a mathematical model that takes into account probably strong correlation (r = 0.5, p <0.05) between the factors of connective tissue destruction, collagen destruction, aldosterone , and indicators of a clinical blood test (between levels of OBZ and monocytes (r = 0.82, p = 0.00001), OB and monocytes (r = 0.92, p = 0.000001) OB and stab leukocytes (r = - 0.87, p = 0.0003) OBZ and stab leukocytes (r = - 0.53, p = 0.017), aldosterone and ESR.