Volnytska K. Differential diagnosis of bronchial obstruction syndrome in patients with pulmonary tuberculosis or pneumonia

Object of study: bronchial obstructive syndrome in patients with pulmonary tuberculosis, or pneumonia; goal - to improve the effectiveness of differential diagnosis of bronchial obstructive syndrome (BOS) in patients with pulmonary tuberculosis or pneumonia based on the study of clinical and pathogenetic features of their occurrence in these patients; methods of study - clinical and instrumental (spirometry, radiological, bronchoscopic with bronchoalveolar lavage), laboratory, mathematical, statistical; originality - diagnostic information content of clinical and laboratory data (respiratory syndrome, mixed shortness of breath, cough, purulent sputum, CIC, Ig E, Ig G, IL-1beta, IL-2, IL-4, IL-6, blast-transformation reaction with PHA, haptoglobin, transferrin, ceruloplasmin) and instrumental data (endoscopy, bronchoalveolar lavage, cytology) for the differential diagnosis of BOS caused by chronic obstructive pulmonary disease (COPD) or bronchial asthma (BA) in patients with pulmonary tuberculosis, or pneumonia with low information content of standardized criteria have been proved for the first time. Scientific data on manifestations of BOS caused by COPD in patients with pulmonary tuberculosis, which is accompanied by deeper immunological, biochemical and cytological changes in comparison with the data at BOS, caused by BA have been ascertained. Difference in parameters at BOS, caused by COPD or BA in patients with pneumonia is similar, but less pronounced. Method of mathematical verification of diagnosis of COPD or BA at BOS in patients with pulmonary tuberculosis or pneumonia has been developed for the first time, which showed the diagnostic information content of routine clinical and anamnestic data, to which a set of laboratory parameters and instrumental investigations should be added when there are difficulties in differentiation in case of the presence of bronchial obstructive syndrome in patients. Sphere of application - medicine.