tbjournalТуберкулез и социально значимые заболеванияTuberculosis and socially significant diseases2413-03462413-0354ООО «Ин-Тренд10.54921/2413-0346-2022-10-2-28-33tbjournal-28Research ArticleДИАГНОСТИКА И КЛИНИКА ТУБЕРКУЛЕЗАDIAGNOSIS AND CLINIC OF TUBERCULOSISОсобенности выявления и диагностики туберкулезного плеврита у больных с циррозом печениFeatures of detection and diagnosis of tuberculous pleurisy in patients with cirrhosis of the liverСтоговаН. А.StogovaN. A.

Стогова Наталья Аполлоновна – профессор кафедры фтизиатрии, доктор медицинских наук, профессор 

394036, г. Воронеж, ул. Студенческая, д. 10

Тел.: (473) 237-28-53; +7 (910) 284-80-55; факс: (473) 253-00-05

stogova.51@mail.ruФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава России, кафедра фтизиатрииRussian Federation2022300620221022833Copyright © Стогова Н.А., 20222022Стогова Н.А.Stogova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tb-journal.ru/jour/article/view/28Обоснование

Обоснование. Известно, что пациенты с циррозом печени более восприимчивы к туберкулезу вследствие нарушений иммунитета. В связи с этим диагностика туберкулезного экссудативного плеврита у больных с циррозом печени является актуальной медицинской проблемой.

Цель

Цель. Oценить особенности выявления, дифференциальной диагностики и течения туберкулезного экссудативного плеврита у больных с циррозом печени.

Материалы и методы

Материалы и методы. По архивным историям болезни проведен анализ данных клинического, рентгенологического, лабораторного и микробиологического обследования 84 больных в возрасте от 17 до 82 лет с плевральным выпотом и циррозом печени.

Результаты

Результаты. Гидроторакс у больных с циррозом печени имел туберкулезную этиологию в 21,4% случаев, причем в 61,1% случаев туберкулезный плеврит сочетался с туберкулезом легких, в 50,0% сопровождался выделением микобактерий туберкулеза с мокротой, летальный исход отмечен у 11,1% больных. С целью раннего выявления туберкулезного плеврита у больных с циррозом печени и гидротораксом необходимы регулярные флюорографические обследования пациентов, при подозрении на туберкулез – использование микробиологических и морфологических методов верификации диагноза.

Rationale

Rationale. It is known that patients with cirrhosis of the liver are more susceptible to tuberculosis due to impaired immunity. In this regard, the diagnosis of tuberculous exudative pleurisy in patients with cirrhosis of the liver is an urgent medical problem.

Purpose

Purpose. To evaluate the features of detection, differential diagnosis and course of tuberculous exudative pleurisy in patients with liver cirrhosis.

Materials and methods

Materials and methods. Based on archived case histories, an analysis was made of clinical, radiological, laboratory and microbiological examination data of 84 patients aged 17 to 82 years with pleural effusion and cirrhosis of the liver.

Results

Results. Hydrothorax in patients with liver cirrhosis had a tuberculous etiology in 21.4% of cases, and in 61.1% of cases tuberculous pleurisy was combined with pulmonary tuberculosis, in 50.0% it was accompanied by the release of mycobacterium tuberculosis with sputum, lethal outcome was observed in 11.1% of patients. For the purpose of early detection of tuberculous pleurisy in patients with liver cirrhosis and hydrothorax, regular fluorographic examinations of patients are necessary, and if tuberculosis is suspected, the use of microbiological and morphological methods for verifying the diagnosis is necessary.

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The authors declare that there are no conflicts of interest present.