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THE IMPORTANCE OF SPUTUM COMPOSITION IN NON-
SPECIFIC INTERSTITIAL PNEUMONIA
Seekoti Manasa
Student of group 5M55, faculty of General medicine
Scientific Supervisor: N.N. Makhmatmuradova Associate Professor of the
Department of Internal Medicine № 4
Samarkand State Medical University, Uzbekistan
Relevance
. In recent years, according to WHO data, many countries have seen an
increase in respiratory diseases, which leads to an increase in not only disability but also
mortality. An increase in chronic respiratory diseases, including non-specific interstitial
pneumonia, is observed in all countries of the world.
The aim of the study
is to identify the cellular characteristics of sputum in nonspecific
interstitial pneumonia.
Material and methods of the study
. The material was a retrospective analysis of the
medical records of 140 patients with non-specific interstitial pneumonia admitted to the
pulmonology department of the Samarkand City Medical Hospital. All patients underwent a
general clinical examination according to ICD-10. The diagnosis was confirmed based on a
combination of clinical and laboratory-instrumental indicators.
Results of the study and discussion
. Patients were conditionally divided into
conditional groups according to the severity of the course of NIP - mild (NIPMC) 16 (11.4%),
moderate (NIPMRC) 59 (42.1%) and severe (NIPSC) 65 (46.4%).
In the groups of patients with mild and moderate NIP, a higher level of sputum
eosinophilia was found compared to the others. According to the cytological characteristics of
sputum, the inflammatory process was moderate.
When comparing the percentage of epithelium in sputum in patients of all groups with
NIP, no significant differences were found. Approximately the same is observed in relation to
the proportion of macrophages in sputum. In all groups of patients with NIP, a unilateral
distribution of epithelium and macrophages in sputum is noted.
When comparing the percentage of neutrophils in sputum, it was found that in patients
with NIPMC and NIPMRC, the content of these cells was significantly higher than in patients
with NIPSC. Other data were obtained on the number of eosinophils in sputum in patients with
NIPMC, in whom the proportion of eosinophils is higher than in patients with NIPMRC and
NIPSC. The heterogeneous distribution of neutrophils and eosinophils in sputum in all groups
of patients with NIP is noteworthy.
The percentage of lymphocytes in patients with NIPMC is significantly higher than in
patients with NIPSC. The composition of lymphocytes in the sputum of patients with NIPMRC
and NIPSC is not statistically different. Similar data were obtained for monocytes. The
percentage of monocytes in patients with NIPMC was significantly higher than in patients with
NIPSC, and the difference was observed when comparing the groups with NIPMRC. The
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percentage of lymphocytes and monocytes in sputum was higher in patients with NIPMRC
than in patients with NIPSC.
Thus, the composition of the epithelium, macrophages, neutrophils, lymphocytes and
monocytes in the groups of patients with NIPMRC and NIPSC did not differ significantly.
Patients with NIPMC and NIPMRC were characterized by the highest percentage of
eosinophils in sputum compared to others. Patients with NIPSC had the lowest levels of
epithelium, macrophages, eosinophils, neutrophils, lymphocytes and monocytes compared to
the sputum cytogram of other examined groups. A direct correlation was found between the
percentage of eosinophils in sputum and their number in peripheral blood. Eosinophils are
probably regulated at the systemic level. The results of comparing the percentage of
neutrophils in sputum and peripheral blood in the examined groups of patients do not differ
statistically. In the early stages of inflammation, the macrophage mechanism predominates, so
there is no significant increase in ESR. The predominance of the neutrophilic mechanism of
inflammation is accompanied by an increase in ESR.
Conclusion
. Thus, the results of the study revealed different neutrophilic, eosinophilic
character and severity of inflammation in sputum in different groups of patients. The levels of
inflammation in different groups were determined - mild, moderate and severe. Different
results were noted at different stages of inflammation: at the early stages of inflammation,
there is no significant increase in the erythrocyte sedimentation rate, the macrophage defense
mechanism prevails. Later, as the dynamics of inflammation develops, the neutrophilic
defense mechanism begins to dominate, which is accompanied by an increase in the
erythrocyte sedimentation rate.
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