Butova Tetiana, Borysova Olena, Sapelnik Nadia, Butov Dmytro
Department of Outpatient, Merefa Central District Hospital, Merefa, Ukraine.
Department of Phthisiology and Pulmonology, Kharkiv National Medical University, Kharkiv, Ukraine.
Int J Mycobacteriol. 2023 Jul-Sep;12(3):282-288. doi: 10.4103/ijmy.ijmy_128_23.
Making a preliminary diagnosis using X-ray methods for the study of resistant and resistant tuberculosis (TB) will help to make a preliminary diagnosis and determine further tactics for the treatment of TB, even with limited resources for microbiological diagnosis of drug resistance of TB. The present study was aimed at identifying chest X-ray differences between susceptible and resistant TB.
A prospective cohort study of data from all consecutive patients with culture-confirmed pulmonary TB admitted during the year to the Kharkiv TB Dispensary No. 1 in Kharkiv, Ukraine.
One hundred and sixty-eight patients with lung TB were examined. Patients were divided into two groups: 1 patients with pulmonary TB with resistance of Mycobacterium tuberculosis (MTB) to at least isoniazid and rifampicin (resistant TB) and 2 pulmonary TB with preserved susceptibility of MTB to anti-TB drugs (susceptible-TB). Patients of 1 group often had lesions in two lobes of the lungs 31.1% and one lung 43.3% versus 15.4% and 2.6% of patients with susceptible TB (P < 0.001). In addition, more than 3 cavities in the lungs 45.5% were significantly more often observed in patients with resistant TB versus 7.9%-the 2 group (P < 0.001). Smaller cavities were observed in patients with susceptible TB up to 1.99 cm 74% versus 35.2% in 1 group (P < 0.001). We did not observe any significant radiological features depending on the right or left lung, as well as the lobar localization of the TB process.
For resistant forms of TB, radiologically, a more widespread TB process in the lungs with the presence of a larger number of cavities and their larger size against a background of a more pronounced clinical picture and mycobacterium excretion than with susceptible TB is characteristic.
即使在结核病耐药性微生物诊断资源有限的情况下，使用X线方法对耐多药和利福平耐药结核病（TB）进行初步诊断，将有助于做出初步诊断并确定结核病的进一步治疗策略。本研究旨在确定敏感结核病和耐药结核病之间胸部X线的差异。
对乌克兰哈尔科夫第1结核病防治所当年收治的所有连续的培养确诊肺结核患者的数据进行前瞻性队列研究。
对168例肺结核患者进行了检查。患者分为两组：1组为结核分枝杆菌（MTB）对至少异烟肼和利福平耐药的肺结核患者（耐药结核病），2组为MTB对抗结核药物仍敏感的肺结核患者（敏感结核病）。1组患者肺部两叶受累的情况较为常见（31.1%），单肺受累的情况也较多（43.3%），而敏感结核病患者中这两个比例分别为15.4%和2.6%（P<0.001）。此外，耐药结核病患者肺部出现3个以上空洞的比例（45.5%）明显高于2组患者（7.9%）（P<0.001）。敏感结核病患者的空洞较小，直径达1.99 cm的占74%，而1组为35.2%（P<0.001）。我们未观察到与右肺或左肺以及结核病变的叶定位相关的任何显著放射学特征。
对于耐药型结核病，在放射学上，与敏感结核病相比，其特征在于肺部结核病变范围更广，空洞数量更多且尺寸更大，同时伴有更明显的临床表现和结核分枝杆菌排出。
