Study of fibrosis factors in patients with firstly diagnosed multidrug-resistant pulmonary tuberculosis
Keywords:multidrug-resistant pulmonary tuberculosis, fibrosis, oxyproline, aldosterone, metalloproteinase-9, tissue inhibitors of metalloproteinase-1
Aim. To study the levels of tissue factors of fibrosis and markers of destruction of the pulmonary tissue in patients with firstly diagnosed multidrug-resistant pulmonary tuberculosis.
Materials and methods. There were examined 48 patients with firstly diagnosed multidrug-resistant pulmonary tuberculosis, divided in groups depending on treatment results, with studied levels of general oxyproline, free and protein-bound oxyproline and also aldosterone, matrix metalloproteinase-9 and tissue inhibitor of metalloprotainase-1 at the beginning of the treatment. Pearson’s χ2 and Fisher methods, Kruskel-Wallis criteria, Spearman methods were used.
Results. The group of patients, who finished their treatment successfully, demonstrated the mean values of oxyproline and MP-9, the highest levels of aldosterone and TIMP-1 compared with other groups of patients. Patients, who died before the finish of the main course of chemotherapy, had demonstrated the highest levels of bound oxyproline and MP-9, and also a bit lower levels of free oxyproline and TIMP-1 compared with the group of effectively treated ones. The least levels of all studied parameters were observed in the group of unsuccessfully treated patients.
Conclusion. The processes of decay of the pulmonary tissue prevailed over the reparation ones in the groups of the non-effective treatment that is indicated by an imbalance of free and protein-bound oxyproline and MP-9/TIMP-1 ratio. The exhaustion of compensatory mechanisms may be indicated by the lower level of aldosterone in the groups of the non-effective treatment and its reverse correlation with the prevalence of tuberculosis process and intoxication signs
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