Abstract
In conditions of tuberculous inflammation, decompensation occurs in the system of peroxidation – antioxidant protection, in which the mechanisms of oxygen transport by blood play an important role.
Many pathogenetic links in the development of tuberculosis (TB) lungs insufficiently studied, in particular, of blood oxygen carrying (OC) of blood.
Purpose of the work To determine the nature of changes in the oxygen-binding properties of blood and the main parameters of the pro-oxidant-antioxidant balance in pulmonary tuberculosis and in the conditions of complex treatment of destructive forms of pulmonary tuberculosis.
Material and methods. 120 patients with different types of pulmonary tuberculosis were examined. In the first 10 days after the patient’s admission to the hospital, 10 ml of blood was taken from the ulnar vein against the background of restored outflow. OC was evaluated within one hour after venous blood sampling. The remaining part of the blood was separated by centrifugation into plasma and red blood cell mass, which were stored at a temperature of-80 ° C, followed by measurement of the pro-oxidant-antioxidant state for one month.
Then, 26 patients with various forms of destructive pulmonary tuberculosis were examined, in the treatment of which, along with standard chemotherapy, an artificial pneumothorax was used.
Results. It was found that the deterioration of blood oxygen transport function indicators occurs depending on the prevalence of the tuberculosis process and the severity of the patient’s condition. High values of nitrate/nitrite concentrations are observed: in disseminated forms, they increase by 45.7% (p<0,05), while in small forms – by 18.6% (p< 0,05). The development of tuberculosis causes the development of oxidative stress. The highest activity of free radical processes is observed in disseminated, and less pronounced in small forms of pulmonary tuberculosis.
The analysis of the oxygen transport function of blood and the pro-oxidant-antioxidant state in different types of tuberculosis process was carried out. Changes in the oxygen transport function of the blood, the activity of free radical oxidation in pulmonary tuberculosis depends on the prevalence of the tuberculosis process, the presence of destruction in the lung tissue, bacterial excretion, and especially multidrug resistance.
The main parameters of blood oxygen transport function and pro-oxidant-antioxidant balance were studied in patients with destructive pulmonary tuberculosis under the conditions of complex treatment (a combination of chemotherapy and artificial pneumothorax).
Conclusions. These results indicate an important role of oxygen-dependent processes in the pathogenesis of pulmonary tuberculosis, which should be taken into account when it comes to complex therapy of this disease. It was found that the positive effect of collapse therapy is realized through the influence of the oxygen transport function of blood and the NO gas transmitter, which is manifested in a decrease in the pro-oxidant-antioxidant imbalance.
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