Abstract
Objective: To determine the role of aggravating factors in the development of destructive pulmonary tuberculosis and to develop a model for predicting the probability of closure of decay cavities in patients with destructive forms of pulmonary tuberculosis.
A prospective study was conducted cohort study. Patients admitted to the hospital of the Grodno Regional Clinical Center “Phthisiology”, as well as to the Republican Tuberculosis Hospital “Novoelnya” were examined. Depending on the prevailing aggravating factor, patients are divided into 10 groups. In addition, 2 more groups of patients with XDR MBT were formed. The results obtained indicate a significant negative impact of aggravating factors on the formation of destructive processes in the lungs. Patients with TB accompanied by diabetes mellitus, ADS, CNRD, patients arriving from places of detention and with the presence of several factors simultaneously should be considered more significant for this factor.
The results obtained indicate that the frequency of formation of destructive forms of tuberculosis in MDR-TB depends on a number of aggravating factors. The most significant in this regard: diabetes mellitus, several factors at the same time, ADS, patients arriving from places of detention, CNRD. Factors such as contact and gastrointestinal morbidity do not have a significant impact on the formation of destruction in the lungs in MDR-TB.
In the presence of XDR-TB, the highest frequency of destructive forms is observed (over 70%), reaching 76.0% in patients with XDR-TB in combination with ADS.
In order to develop a mathematical model for predicting the probability of closure of decay cavities in patients with destructive forms of pulmonary tuberculosis, studies were carried out on 105 patients with pulmonary tuberculosis, who had different patterns of destruction of lung tissue.
As a result of the study, it was established that prognostically important signs of the likelihood of closure of decay cavities are: clinical form, number of cavities, dependence on alcohol, and timing of abacillation.
When Z ≥ -1.304, closure of the decay cavity is predicted within 6 months of chemotherapy. If Z< -1.304 - the decay cavity does not close within a given period, the risk of developing gross morphological, sometimes irreversible changes increases.
Keywords: destructive tuberculosis, risk factors for tuberculosis, multiple and extensive drug resistance of Mycobacterium tuberculosis, long-term results, prognosis
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