Factors of chemoresistant pulmonary tuberculosis progression in patients receiving palliative treatment

• Main Authors: O. M. Raznatovska, G. V. Khudiakov
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2018-06-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: drug-resistant tuberculosis; palliative care; quality of life; tumor necrosis factor; body mass index
• Online Access: http://zmj.zsmu.edu.ua/article/view/130829/130849
• ISSN: 2306-4145; 2310-1210

Objective – to define factors of chemoresistant pulmonary tuberculosis (CRPTB) progression in patients receiving palliative treatment by means of their QL, TNF-α levels and body mass index complex assessment. Materials and methods. 81 CRPTB patients were examined and divided into two groups: the main group consisted of 52 patients receiving palliative treatment and the control group consisted of 29 patients receiving antimycobacterial therapy by category 4 according to drug resistance. The MOS SF-36 questionnaire was used to evaluate the quality of life. Studies of serum TNF-α level were determined by enzyme-linked immunosorbent assay using immunoenzymometric reader Sirio S and a set “Bender MedSystems GmbH” (Austria), (pg/ml). Body mass index was calculated with the help of calculator New BMI (New Body Mass Index), (kg/m2). Results of this study were processed using the modern methods of analysis with the help of a personal computer and the statistical package of the licensed software program Statistica® for Windows 6.0 (StatSoft Inc., № AXXR712 D833214FAN5). Results. CRPTB patients receiving palliative treatment have simultaneously a high activity of inflammatory specific process, predominant body mass deficit and low quality of life (both its physical and mental component). And along with this in patients receiving CRPTB treatment, activity of specific inflammatory process is 2.2 times lower, normal level of body weight predominate and quality of life is satisfactory (with satisfactory levels of both its components). Assessment of correlation relationships gave an opportunity to find out that in CRPTB patients, receiving palliative treatment, absence of the specific process antimycobacterial therapy leads to an increase in blood serum TNFα which in its turn promotes development of body mass deficit and as a consequence quality of life is decreased through decrease of all its components. In patients receiving etiotropic treatment activity of specific inflammatory process promotes decrease of body mass and quality of life but these changes are not so expressed as in case with patients receiving palliative treatment. Conclusions. Factors of CRPTB progression in patients receiving palliative treatment include increase of TNFα level in the blood serum (≥180 pg/ml), deficit in body mass (≤18,1 kg/m2), decrease in quality of life index (≤50 relative units).