The effect of complex therapy on the state of the systemic inflammatory response and adaptive mechanisms of the body in patients with pulmonary tuberculosis with chronic obstructive pulmonary disease

Abstract

Aim. To evaluate the effect of antituberculosis therapy with simvastatin and methyluracil on systemic inflammation syndrome and homeostatic balance of the organism in patients with pulmonary tuberculosis and COPD.Methods. 90 patients with newly diagnosed pulmonary tuberculosis (TB) and COPD were included; group 1 52 patients received only antituberculosis therapy (group 1), 38 patients received antituberculosis therapy in combination of simvastatin and methyluracil (group 2). The dynamics of functional cardiorespiratory parameters, indicators of systemic inflammation and lipid spectrum, type of adaptive reactions, efficiency of tuberculosis and COPD treatment were evaluated.Results. Patients with comorbidity of tuberculosis and COPD have high frequency of widespread lung lesions and destructions, bacterial excretion, functional cardiorespiratory disorders on the background of systemic inflammation, endothelial dysfunction, dyslipidemia, pathological types of adaptive reactions. Duriing treatment in the 2nd group the decrease of systemic inflammation and endothelial dysfunction indices, lipid spectrum normalization (76,4% vs. 53,4% in the 1st group, p=0,001), appearance of harmonious types of adaptive reactions, more rare formation of large residual changes (26,3% vs. 65,4%, p=0,003), reduction of COPD clinical manifestations with decreased risk of exacerbations (63,2% vs. 13,5%, p=0,04) were noted more often.Conclusion. Inclusion of simvastatin and methyluracil in the complex treatment of patients with tuberculosis combined with COPD contributes to the reduction of systemic inflammatory response, recovery of adaptive reactions, improvement of disease course and increase of therapy efficiency.