The objective: the study of dynamics of clinical and laboratory data after an intensive phase of treatment in patients with firstly diagnosed pulmonary tuberculosis (FDTB) who consume alcohol, and the development of a method for predicting the effectiveness of treatment.
Materials and methods. A total of 109 men with FDTB aged 20 to 50 years were examined. Depending on the level of alcohol consumption, 3 groups of patients were formed. Patients of each group are divided into two subgroups depending on the treatment regimen.
Results. An analysis of the dynamics of immuno-inflammatory indicators showed the greatest response to antioxidant therapy data of phagocytic and enzymatic activity of neutrophils and endogenous intoxication (p<0.05). Assessment of the oxidative status indicators dynamics demonstrated the most significant effect of antioxidant in groups 1st and 2nd. The dynamics of a decrease in all indicators of oxidative stress in these groups was higher in patients receiving additional antioxidant therapy (p<0.01). In group 3, the positive effect was less pronounced: an increase in blood levels of GPx and a decrease in diene conjugates and NO2 (p≤0.05) were determined. Models have been developed to predict the level of positive dynamics in the treatment of patients depending on the therapy received.Conclusions. The administration of antioxidants had the most significant positive effect on the dynamics of the levels of phagocytosis completeness, enzyme activity of neutrophils, medium molecular weight peptides and CRP and indicators of oxidative stress with the best effect in patients who drink alcohol at low and health-threatening levels. The initial alcohol consumpyion, phagocytic index and blood lymphocytes affect the positive effect of treatment according to the standard scheme of anti-tuberculosis therapy; when antioxidants are added to the standard scheme, the initial indicators of the alcohol consumption level and phagocytic number affect.
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Мельник В.М., Турченко Л.В. (2016). Туберкульоз і алкогольна залежність – актуальна проблема сьогодення. Український пульмонологічний журнал, 4, 9–18.
Наказ МОЗ України від 25.02.2020 № 530 «Про затвердження стандартів охорони здоров’я при туберкульозі»
Babor T. (2001). Audit, the alcohol use disorders identification test: guidelines for use in primary care. Geneva: World Health Organization.
Barr T., Helms C., Grant K., Messaoudi I. (2016). Opposing effects of alcohol on the immune system. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 65, 242–251. doi: http://doi.org/10.1016/j.pnpbp.2015.09.001
Francisco J., Oliveira O., Felgueiras Ó., Gaio A.R., Duarte R. (2016). How much is too much alcohol in tuberculosis? European Respiratory Journal, 49 (1), 1601468. doi: http://doi.org/10.1183/13993003.01468-2016
Global tuberculosis report 2019 (2019). Geneva: World Health Organization; Licence: CC BY-NC-SA 3.0 IGO.
Laprawat S., Peltzer K., Pansila W., Tansakul C. (2017). Alcohol use disorder and tuberculosis treatment: A longitudinal mixed method study in Thailand. South African Journal of Psychiatry, 23. doi: http://doi.org/10.4102/sajpsychiatry.v23i0.1074
Pasala S., Barr T., Messaoudi I. (2015). Impact of Alcohol Abuse on the Adaptive Immune System. Alcohol research: current reviews, 37 (2), 185–197.
Silva D.R., Muñoz-Torrico M., Duarte R., Galvão T., Bonini E.H., Arbex F.F. et. al. (2018). Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs. Journal Brasileiro de Pneumologia, 44 (2), 145–152. doi: http://doi.org/ 10.1590/s1806-37562017000000443
Simou E., Britton J., Leonardi-Bee J. (2018). Alcohol consumption and risk of tuberculosis: a systematic review and metaanalysis. The International Journal of Tuberculosis and Lung Disease, 22 (11), 1277–1285. doi: http://doi.org/10.5588/ijtld.18.0092
Ware J.E., Sherbourne C.D. (1992). The MOS 36-ltem Short-Form Health Survey (SF-36). Medical Care, 30 (6), 473– 483. doi: http://doi.org/10.1097/00005650-199206000-00002