Hovardovska O. Assessment of the dynamics of levels of neopterin and inflammation biomarkers in monitoring and predicting the effectiveness of treatment of patients with mono- and polyresistant pulmonary tuberculosis

Object of the study: mono- and polyresistant tuberculosis (M-P TB) of lungs; aim: to optimize monitoring and predicting the effectiveness of treatment of patients with M-P TB of lungs, based on the study of the dynamics of serum neopterin (NP) levels and inflammation biomarkers. methods of research: general clinical, laboratory, enzyme-linked immunosorbent, cytological, bacteriological, instrumental, epidemiological, analytical and statistical; novelty: the average rate of M-P TB to isoniazid in Kharkiv region for the period of 2012-2017 was identified, it was 16.7 and 17.2% among new and recurred cases, respectively; tendency for an increase of it’s rate due to primary resistance (+ 144.4%) was identified. It was determined that the main factors for the ineffective treatment of patients with M-P TB are adverse reactions to antimycobacterial drugs (AMBD), the polyresistance of pathogen, treatment with using of only AMBD of I-line, and the long term for the appointment of an individual treatment regimen; dependence of NP rate from the massiveness of bacterial excretion, the volume of a specific process in lungs and hemoglobin levels in blood were found; it was proved that with effective treatment a significant decrease of NP was determined, and at the end of treatment, the indices reached control values; the dynamics of NP levels is highlighted as a criterion for monitoring the effectiveness of chemotherapy of pulmonary TB; significant deficiency of viable leukocytes in TB patients, which did not depend on the effectiveness of treatment, was established firstly; mathematical model for predicting treatment efficacy on base of rate in the serum of NP, seromucoids and lymphocytes count in blood was developed. Field of application: medicine.