[Effect of Remaxol on the efficiency of standard treatment for infiltrative pulmonary tuberculosis].

AIM: To investigate the effect of Remaxol on the efficiency of standard treatment in patients with infiltrative pulmonary tuberculosis (IPT). MATERIALS AND METHODS: The results of treatment were analyzed in 90 patients with new-onset IPT in the phase of decay who received basic tuberculosis treatment regimens I, IIb, and IV. In addition, a study group of 45 patients used dropwise intravenous Remaxol 400 ml daily and a control group 45 patients had dropwise intravenous 5% glucose solution 400 ml daily. All the patients underwent clinical, laboratory and instrumental (X-ray) examinations over time. RESULTS: The incorporation of remaxol into the combination treatment of IPT enhanced the efficiency of therapy, which manifested as reductions in the hepatotoxicity of etiotropic drugs and in the degree of dysproteinemia and as accelerated destructive regression in tuberculous infiltrates with a subsequent decrease in the need for phthisiosurgical care. Remaxol included into the standard complex treatment regimens for IPT contributed to the rapider normalization of laboratory parameters of the liver and to the accelerated regression of destructive changes in the tuberculous infiltrates. CONCLUSION: Incorporation of remaxol into the combination treatment of patients with IPT enhances the efficiency of its therapy, promotes the rapider normalization of laboratory indices of the liver and the accelerated regression of destructive changes in tuberculous infiltrates, which reduces the need for phthisiosurgical care.

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

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, gamma-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.