ABSTRACT
The efficiency of complex methods of examination, including that of the new special ones, for the diagnosis of disseminated processes in the lungs has been studied in 300 patients between the ages of 20 and 76 years. The following methods were used: microbiological (including a new nutritive medium for mycobacteria activation), immuno-enzymatic (detection of specific antigens), immuno-morphologic with determination of antigen determinants of tuberculosis mycobacteria and their L-forms with the help of specific antisera, cytologic, biochemical (the content of phospholipids and their fractions in the bronchoalveolar washing and blood plasma cortisol/insulin ratio), ++tracheo-bronchoscopic and surgical methods. A possibility of the verification of the clinical diagnosis of various diseases was established with the help of each method being used. Surgical intervention (thoracoscopy with lung biopsy and open lung biopsy) which confirm the diagnosis in 96.4% of cases proved to be the most informative diagnostic method.
Subject(s)
Lung Diseases/diagnosis , Pneumonia/diagnosis , Sarcoidosis/diagnosis , Tuberculosis, Pulmonary/diagnosis , Adult , Aged , Bronchoalveolar Lavage Fluid/pathology , Female , Humans , Lung/pathology , Male , Middle Aged , Sputum/microbiologyABSTRACT
The results of bronchological examinations were analysed in 650 patients (between the ages of 1 and 89 years) with tuberculosis of respiratory organs. Three age groups were specified: group I included children and adolescents to 17 years (152 subjects); group II-adults aged 18 to 59 years (408 subjects), and group III--those aged 60 to 89 years (90 subjects). In group I active bronchial tuberculosis was diagnosed in 14.3% of the cases, residual changes after past tuberculosis in 11.1%, nonspecific endobronchitis in 33.3%; the respective figures for group II were 7.1%, 11% and 43.3% and those for group III 20%, 31.1% and 24.4% of the cases. Isolated froms of bronchial tuberculosis account for 0.9% among all clinical froms of tuberculosis of respiratory organs. Nonspecific endobronchitis in cases with tuberculosis of respiratory organs occur in the form of bilateral catarrhal processes. With age catarrhal changes decline from 92.2% to 54.7% and atrophic and hypertrophic bronchial changes increase and amount to 9.2% and 22.3%, respectively. The character of bronchial pathology is determined by the initial forms of tuberculosis.
Subject(s)
Bronchitis/diagnosis , Tuberculosis, Pulmonary/diagnosis , Adolescent , Adult , Age Factors , Aged , Bronchitis/epidemiology , Bronchography , Bronchoscopy , Child , Humans , Male , Middle Aged , Republic of Belarus , Tuberculosis, Pulmonary/epidemiologyABSTRACT
The level and antigenic composition of immune complexes (ICs) in 49 patients with nonspecific inflammatory diseases of the respiratory organs (NIDRO) and tuberculosis were studied in relation to separate indices of systemic and local immunity. Involvement of the ICs in the pathogenesis of tuberculosis and NIDRO was shown and the role of the level and composition of the ICs in the prognosis and differential diagnosis of the indicated pathological processes was revealed. It was noted that in patients with active tuberculosis and in patients with chronic bronchitis and residual lesions after cured tuberculosis of the respiratory organs the ICs mainly formed by antigenic substances of tubercle bacilli. In the patients with chronic bronchitis and suppurative affections of the lungs the ICs formed due to antigenic substances of bacterial infections. The use of a technique for simultaneous cleavage of the ICs in blood and bronchoalveolar secretion provided determination of etiology of the inflammatory processes in the lungs and bronchi. The technique proved to be highly efficient for early differential diagnosis of tuberculosis and NIDRO.
