Korchynska M. Peculiarities of management of patients suffering from newly diagnosedpulmonary tuberculosis with associated viral hepatitis В and/or С

The object of the study: firstly diagnosed tuberculosis with concomitant viral hepatitis B and / or C; purpose - to improve the scheme of examination and treatment of pathogenic firstly diagnosed tuberculosis with concomitant viral hepatitis B and / or C by developing adjuvant therapy depending on the functional state of the liver to prevent severe hepatotoxic reactions and to ensure continuity of treatment; methods: clinical and medical history, laboratory (microbiological, biochemical, immune-enzyme (ELISA), polymerase chain reaction (PCR) with the definition of RNA and DNA viruses of hepatitis B and C), X-ray, instrumental - ultrasound (US) hepatobiliary system, statistics; novelty For the first time in patients firstly diagnosed tuberculosis with concomitant viral hepatitis B and / or C revealed that regardless of etiology of viral hepatitis features of changes in the functional state of the liver are increased levels of transaminases, bilirubin, gamma-glutamyltransferase, alkaline phosphatase, decrease in score, albumin and prothrombin index, and changes in the parenchyma and blood flow in it are characterized by hepato- and splenomegaly, increased acoustic density parenchyma, its heterogeneity with a decrease in the average velocity of portal blood flow. First established risk factors hepatotoxic reactions in patients firstly diagnosed tuberculosis combined with viral hepatitis B and / or C based on biochemical and ultrasound data. Developed and proved the feasibility of a comprehensive treatment of firstly diagnosed tuberculosis with concomitant viral hepatitis B and / or C by an additional application Hepatoprotectors-glutamyl-glycine disodium tsysteyinil in the intensive phase of antimycobacterial therapy can increase the effectiveness of treatment by 27,6%. Field of application - medicine.