| 摘要 |
FIELD: medicine.SUBSTANCE: patient is examined to detect predictors of the mycobacterium tuberculosis resistance to fluoroquinolones, and if any are detected, the predictors are assigned with respective numerical values. The presence of infiltrative-degenerative changes in the lung in a combination with dissemination stands for +15 points. If observing the inoculation of solid media with more than 100 M. tuberculosis colonies growing or a positive direct microscopic test of the Ziehl-Neelsen stained diagnostic material stained, +17 points are assigned. The presence of the initial mycobacterium tuberculosis (MTB) resistance to aminoglycosides and/or capreomycin is evaluated as +7 points. If the patient is diagnosed with a comorbid renal disorder, +3 points are added, whereas alcohol and/or drug dependence is associated with +6 points. If the course of the multiple resistant TB polychemotherapy has been terminated for 2 weeks or more, +38 points are assigned. Provided fluoroquinolone has been prescribed in a daily dose, which is below a recommended intake, +5 points are assigned. Prescribing individual regimens of the multiple resistant TB polychemotherapy including less than 5 anti-tuberculosis drugs with preserved MBT sensitivity requires +8 points to be added. Using resection-based surgical approaches stands for -3 points. The total risk score is further calculated. That is followed by identifying a probability or a degree of the risk of the mycobacterium tuberculosis resistance to fluoroquinolones. The degree of the risk is predicted by either an interval scale, or calculating the precise probability by formula: p=1/1+e-0.055x-2.964, wherein e is a base of the natural logarithm, a constant value equal to 2.718?, x is an absolute value of the total risk score. In the event that the interval scale is supposed to be applied with the total risk score of < 30, the degree of the risk is considered to be low with the probability (p) of 0.0-0.2. The total risk score ranging within 30-50 points, the degree of the risk is stated as moderate with p>0.2-0.5. If the total risk score is 50-70 points, the degree of the risk is high with p>0.5-0.7. The total risk score being >70 points shows the very high degree of the risk with p>0.7-0.9.EFFECT: method is easy to use; it requires no calculating devices to be involved, enables predicting the risk of the mycobacterium tuberculosis resistance to all fluoroquinolone preparations and is applicable where choosing a chemotherapy regimen, specifying its length and can assist making timely decisions related to surgical management.1 dwg, 4 tbl, 2 ex |
