ДИНАМИКА ТУБЕРКУЛЕЗНОГО ПРОЦЕССА У ПАЦИЕНТОВ С РАЗЛИЧНЫМ ПСИХОЛОГИЧЕСКИМ СТАТУСОМ

The objective of the study: to investigate the changes in the course of tuberculosis in the patients with different psychological status.Subjects and methods. The changes in the course of tuberculosis were studied in 249 new pulmonary tuberculosis patients who had in-patient treatment in CTRI. The groups within the study were formed basing on the results of psychological status assessment: Group 1 included patients with favorable psychological status (171; 68.7% of patients) and Group 2 included patients with different psychological disorders (78; 31.3% of patients) (p < 0.001). Among patients from Group 2 women (66; 84.6%) significantly prevailed over men (12; 15.4%) (< 0.001).Results. It has been found out that groups with different psychological status did not confidently differ in their clinical and X-ray signs before the treatment start. Whereby, in patients from Group 2 versus patients from Group 1, the abnormalities in the results of laboratory tests were registered confidently more often (87.2 versus 75.4% cases) (p < 0.05), as well as multiple drug resistance (58 versus 41.4% of cases) (p < 0.05). The frequency of adverse events caused by anti-tuberculosis drugs was higher in Group 2 versus Group 1 (25; 32.1% and 28; 16.4% of cases) (p < 0.05). After management of adverse events, the number of patients with poor tolerance was still confidently higher in Group 2 (14; 17.9% of cases), compared to Group 1 (11; 6.4%) (p < 0.05). It was found out that the efficiency of in-patient treatment did not confidently differ in the patients with different psychological status.Цель исследования: изучение динамики туберкулезного процесса у пациентов с различным психологическим статусом.Материалы и методы. Изучена динамика туберкулезного процесса у 249 впервые выявленных пациентов, находившихся на стационарном лечении в ФГБНУ «ЦНИИТ». Группы исследования сформированы по результатам диагностики психологического статуса: 1-я группа с благоприятным психологическим статусом (171; 68,7% пациентов) и 2-я группа с различными нарушениями психологического статуса (78; 31,3% пациентов) (p < 0,001). Среди пациентов 2-й группы доля женщин (66; 84,6%) значительно преобладала по сравнению с мужчинами (12; 15,4%) (p < 0,001).Результаты. Установлено, что группы с различным психологическим статусом до начала терапии достоверно не различались по клинико-рентгенологическим проявлениям заболевания. При этом у пациентов 2-й группы по сравнению с пациентами 1-й группы достоверно чаще регистрировались отклонения лабораторных показателей от нормы (87,2 и 75,4% случаев) (p < 0,05), а также выявлялась множественная лекарственная устойчивость МБТ (58 и 41,4% случаев) (p < 0,05). Частота выявления нежелательных реакций на прием противотуберкулезных препаратов оказалась более высокой во 2-й группе по сравнению с 1-й группой (25; 32,1% и 28; 16,4% случаев) (p < 0,05). После терапевтической коррекции нежелательных реакций доля пациентов с неудовлетворительной переносимостью оставалась во 2-й группе достоверно более высокой (14; 17,9% случаев), чем в 1-й группе (11; 6,4%) (p < 0,05). Установлено, что результативность стационарного лечения достоверно не различалась среди пациентов с различным психологическим статусом

CHANGES IN THE COURSE OF TUBERCULOSIS IN THE PATIENTS WITH DIFFERENT PSYCHOLOGICAL STATUS

The objective of the study: to investigate the changes in the course of tuberculosis in the patients with different psychological status.Subjects and methods. The changes in the course of tuberculosis were studied in 249 new pulmonary tuberculosis patients who had in-patient treatment in CTRI. The groups within the study were formed basing on the results of psychological status assessment: Group 1 included patients with favorable psychological status (171; 68.7% of patients) and Group 2 included patients with different psychological disorders (78; 31.3% of patients) (p < 0.001). Among patients from Group 2 women (66; 84.6%) significantly prevailed over men (12; 15.4%) (< 0.001).Results. It has been found out that groups with different psychological status did not confidently differ in their clinical and X-ray signs before the treatment start. Whereby, in patients from Group 2 versus patients from Group 1, the abnormalities in the results of laboratory tests were registered confidently more often (87.2 versus 75.4% cases) (p < 0.05), as well as multiple drug resistance (58 versus 41.4% of cases) (p < 0.05). The frequency of adverse events caused by anti-tuberculosis drugs was higher in Group 2 versus Group 1 (25; 32.1% and 28; 16.4% of cases) (p < 0.05). After management of adverse events, the number of patients with poor tolerance was still confidently higher in Group 2 (14; 17.9% of cases), compared to Group 1 (11; 6.4%) (p < 0.05). It was found out that the efficiency of in-patient treatment did not confidently differ in the patients with different psychological status