Predictors of the inefficiency of combination treatment in patients with infiltrative pulmonary tuberculosis

Abstract

Aim. To reveal the predictors of inefficiency of combination treatment in patients with infiltrative pulmonary tuberculosis (IPT). Subjects and methods. One hundred and three patients with new-onset IPT underwent a complex clinical, radiological, laboratory and psychological examination before treatment. The findings were compared with the results of combination treatment for IPT within a year after the initiation of therapy. Results. The standard treatment regimens was ascertained to cause no clinical recovery in 6.8% of the patients who were characterized by the baseline excretion of M. tuberculosis and sputum in 100% of cases, by the highest X-ray and clinical manifestations of IPT with simultaneously evolving leukocytosis, increased erythrocyte sedimentation rate (ESR), elevated serum ceruloplasmin and enzyme markers of cholestasis, depressive fatigability, weight loss, and a worsening quality of life because of pain. Discriminant analysis yielded an algorithm for predicting the inefficiency of standard treatment for IPT, which was based on the integrative evaluation of thoracic pain, ESR, circulating ceruloplasmin levels, γ-glutamyl transpeptidase and alkaline phosphatase activities in the serum. Conclusion. It has been demonstrated that the inefficiency of IPT therapy may be predicted from the data of a complex clinical, hematological, and biochemical examination of patients before therapy.

Keywords

• infiltrative pulmonary tuberculosis
• inefficiency of treatment