胸部器官ct对冠状病毒感染背景下肺结核病程特征的探讨

М.І. Lynnyk, V.І. Іgnatieva, G.L. Gumeniuk, V.А. Svyatnenko, V.Ye. Ivashchenko, О.P. Chobotar, М.G. Palivoda
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 OBJECTIVE. To investigate the dynamics of the course of pathological changes in the lungs in patients with pulmonary TB against the background of coronavirus infection by analyzing the data of computed tomography (CT) of the chest organs.
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摘要

背景。2020年初针对冠状病毒病(COVID-19)大流行采取的隔离措施,以及随后在乌克兰发生的大规模敌对行动,导致结核病患者检出率下降,该病死亡率上升。需要特别注意的是,在冠状病毒感染的背景下,肺结核病程的特殊性,这可能是由于SARS-CoV-2的影响特点和肺结核患者对抗结核药物(DSTB)保持敏感性和耐药的免疫状态的特点。目标。通过分析肺部器官CT资料,探讨冠状病毒感染背景下肺结核患者肺部病理变化的动态变化。 材料和方法。根据乌克兰卫生部第530号命令,建立了肺结核的诊断和治疗。根据目前治疗冠状病毒感染的方案,在接受肺结核治疗的患者中诊断为COVID-19。所有患者均在Aquilion TSX-101A扫描仪(Toshiba, Japan)上进行胸部器官动态CT扫描。结果和讨论。对肺结核合并新冠肺炎患者的临床、实验室和x线资料进行动态分析。已经确定,通过及时诊断和适当治疗肺部的DSTB,病毒性肺炎(COVID-19)不会使结核病过程复杂化。2019冠状病毒病期间的特点是结核病进程的积极动态继续存在。在多重耐药结核病患者中,病毒性肺炎(COVID-19)不会引起严重并发症,但COVID-19病程期间的特点是缺乏结核病过程的积极动态。在病毒性肺炎(COVID-19)的背景下,未经治疗的肺结核可能会变得严重并最终导致死亡。结论。新冠肺炎背景下肺结核患者胸部脏器CT对监测病理过程、发现并发症、评价治疗效果具有很高的信息价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of the course of pulmonary tuberculosis against the background of coronavirus infection according to computed tomography of the chest organs
BACKGROUND. Quarantine measures regarding the coronavirus disease (COVID-19) pandemic, initiated in early 2020, and subsequently large-scale hostilities in Ukraine, led to a decrease in the detection of tuberculosis (TB) patients and an increase in mortality from this disease. Particular attention needs to be paid to the peculiarities of the course of pulmonary TB against the background of a coronavirus infection, which may be due to both the features of the impact of SARS-CoV-2 and the features of the immunological status of patients with pulmonary TB with preserved sensitivity to antimycobacterial drugs (DSTB) and with drug resistance. OBJECTIVE. To investigate the dynamics of the course of pathological changes in the lungs in patients with pulmonary TB against the background of coronavirus infection by analyzing the data of computed tomography (CT) of the chest organs. MATERIALS AND METHODS. Establishing the diagnosis and treatment of pulmonary TB were carried out in accordance with the Order of the Ministry of Health of Ukraine No. 530. The diagnosis of COVID-19 was established in patients who were treated for pulmonary TB in accordance with the current protocols for the treatment of the coronavirus infection. All patients underwent dynamic CT of the chest organs was performed on the Aquilion TSX-101A scanner (Toshiba, Japan). RESULTS AND DISCUSSION. Clinical, laboratory and X-ray data of patients with pulmonary TB and COVID-19 were analyzed in dynamics. It has been established that with timely diagnosis and adequate treatment of DSTB of the lungs, viral pneumonia (COVID-19) does not complicate the course of the TB process. The period of the course of COVID-19 is characterized by the continuation of the positive dynamics of the TB process. In patients with TB with multiple drug resistance, viral pneumonia (COVID-19) does not cause serious complications, but the period of the course of COVID-19 is characterized by the absence of positive dynamics of the TB process. With untreated pulmonary TB on the background of viral pneumonia (COVID-19), the disease can become severe and end in death. CONCLUSIONS. CT of the chest organs in patients with pulmonary TB against the background of COVID-19 is highly informative in monitoring the pathological process, detecting complications and evaluating the effectiveness of treatment.
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