Vіsnik Naukovih Doslіdžen' (Jan 2018)
THE USE OF BIOCHEMICAL MARKERS AND COMPUTER TOMOGRAPHY IN DIAGNOSIS OF LIVER DAMAGE IN PULMONARY TUBERCULOSIS
Abstract
Dysfunction of the liver in patients with respiratory tuberculosis is due to various factors, in particular the toxic effects of anti-tuberculosis drugs. Diagnosis of such disorders can be detected using biochemical and instrumental studies. The aim of the study – to determine the biochemical markers of the liver, as well as changes in liver tissue in patients with newly diagnosed lung tuberculosis with the help of computed tomography, before treatment and at discharge from the hospital. Results and Discussion. To implement this goal we examined 29 patients with newly diagnosed pulmonary tuberculosis before treatment and at discharge from hospital after treatment with anti-TB drugs of the first row. Patients were divided into two groups: the first – patients (15 people), who had a moderate onset of intoxication syndrome, the second – patients (14 people) who had severe intoxication syndrome by admission to the hospital. All patients at the time of admission and on discharge had a computer tomography of the lungs and liver. Liver density was determined in IV, VII and VIII segments of the liver with the definition of Hounsfield units using the Radi Ant DICOM Viewer program. Correlation analysis of changes in biochemical markers and liver tissue density in groups was carried out. According to the results obtained before treatment in the second group there was a high-power feedback between the levels of ACT and HU (r=-0.72, -0.83, -0.64), ALT and HU (r=-0.62, -0.73, -0.61). In patients with newly diagnosed pulmonary tuberculosis after treatment, a significant increase in such parameters as alanine aminotransferase, alkaline phosphatase and gammaglutamyl transpeptidase was observed. Prolonged anti-tuberculosis therapy results in a decrease in liver density, which is reflected by a decrease in Hounsfild units and may be associated with the development of fatty liver hepatosis. Conclusions. Determination of the density of liver tissue in patients with newly diagnosed pulmonary tuberculosis before treatment and release from a hospital can be used as an auxiliary method for diagnosing functional liver disorders using computer tomography.
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