LIVER FUNCTION DISORDERS IN PATIENTS WITH FIRST DIAGNOSED PULMONARY TUBERCULOSIS

The patients with pulmonary tuberculosis suffer from hepatic dysfunction due to both hepatotoxic affection with anti-TB drugs and other factors (hypoxia, antioxidant deficiency, intoxication). Therefore, the aim of the research was to study the markers of cytolytic and cholestatic syndromes in cases of hepatic dysfunction in the first diagnosed patients with pulmonary tuberculosis before treatment and in two months of treatment with first-line antituberculous drugs. Three groups of persons were examined: the first group of almost healthy donors (control) - 31 persons. Also, 62 patients were examined for the first time diagnosed pulmonary tuberculosis before treatment and in two months of therapy with first-line antituberculous drugs, which were divided into two groups: the second - the patients (31 persons), who had a moderate intoxication syndrome; the third - the patients (31 persons), who had a severe toxicity syndrome when admitted to hospital. A significant hepatic dysfunction in the first diagnosed patients with pulmonary tuberculosis and severe intoxication syndrome has been established. In the patients with moderate intoxication syndrome, the markers of cytolysis and cholestasis were within normal range before treatment, but after the intensive phase of treatment, the levels of LDH, LF, and GGT were significantly increased. In patients with severe intoxication syndrome, even before treatment, the increase in markers of cytolysis and cholestasis was evidenced. After the intensive phase of treatment, the increase in these rates sustained. It is recommended for patients with pulmonary tuberculosis and severe intoxication syndrome to perform diagnostics of such hepatic dysfunction markers as LDH, ALP and GGT, and if any disorders revealed, to prescribe additional hepatoprotective therapy.