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Выпуск журнала №-24
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PRIMARY TUBERCULOSIS IN CHILDREN AND ADOLESCENTS
Daminov F.A.– DSc, Ass.Professor, head of the department of clinical
laboratory diagnosis with the course of clinical laboratory diagnostics of PGD;
Djabbarova N.R.- assistant of the department of clinical laboratory diagnosis
with the course of clinical laboratory diagnostics of PGD;
Ro’ziyeva M.A.- cadet of the department of clinical laboratory diagnosis with
the course of clinical laboratory diagnostics of PGD;
Samarkand state medical university
Samarkand, Uzbekistan
At present, there are a large number of various methods of laboratory
diagnostics of tuberculosis, to a greater or lesser extent reflecting the peculiarities of
the course of the pathological process. General clinical, biochemical, immunological,
bacteriological studies provide clinicians with the most accurate and reliable
information about the state of the internal environment of the patient's organism and
the course of vital processes, help to adequately judge the presence or absence of a
pathological condition, its dynamic changes, and the effectiveness of treatment
[1,2,3,4,5].
Keywords: laboratory diagnostics of tuberculosis, internal environment,
dynamic changes, toxic granularity of neutrophils;
The first serious and detailed analysis of the cytologic composition of blood in
tuberculosis in our country was conducted in 1959 [1,2,3]. It was noted that in
tuberculosis patients red blood reacts very poorly to the infectious process in the div.
In particularly severe cases, there is a decrease in hemoglobin level with normal
erythrocyte count [6,11,20,21,22,23,24].
Children and adolescents are an age group that requires special attention during
the period of increasing tuberculosis morbidity. Significant deterioration of the
epidemiologic situation, clinical polymorphism of tuberculosis in children, manifested
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both by asymptomatic and pronounced picture with extensive destructive changes, low
frequency of bacterial excretion require improvement of methods for diagnosing
tuberculosis in children [8, 9,10,11,12,13].
In the analysis of white blood, very significant patterns have been revealed.
Thus, in a pronounced inflammatory process accompanied by tissue destruction and
caseous necrosis, there is a moderate increase in the total number of leukocytes with a
shift toward paloconuclear forms of neutrophils. In limited tuberculous processes, the
total number of leukocytes, as a rule, remains normal, and there is no paloconuclear
shift. The appearance of toxic granularity of neutrophils is a signal of the age of the
disease, which has already influenced the formation of these blood elements. The
adverse variant of the course of tuberculosis is indicated by the appearance of
lymphocytopenia. Lymphocytosis with eosinophilia, on the contrary, indicate the
beginning of the recovery period.
Monocytosis reflects the moment of intense formation of epithelioid cells
involved in the formation of tuberculous tubercles [1,2,3]. The dynamics of the
hemogram during treatment was also covered by other authors [7, 8,9]. According to
these researchers, only 56% - 71.4% of patients showed changes in the leukocytic
blood formula (leukocytosis with a shift of the formula to the left) and an increase in
ESR. In the literature of recent years it was not possible to find a serious analysis of
changes in the peripheral blood picture in children with various forms of primary
tuberculosis and the dynamics of hematologic abnormalities against the background of
specific treatment in connection with age-related peculiarities.
It is generally recognized that the study of blood biochemical parameters is
more indicative both in terms of determining the severity of tuberculosis inflammation
and early detection of toxic-allergic reactions of the organism to the ongoing
chemotherapy [6]. Such indicators as a2- and u-globulins, ceruloplasmin, haptoglobin,
thymol test in combination allow to determine the degree of activity of the tuberculosis
process in children. In children during the period of virage general biochemical indices
did not change significantly. The content of sialic acids and C-reactive protein
remained normal. With a normal amount of total protein, albumin, Ar and Ag-globulin
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fractions and (3-globulin, only the content of U-globulin changed, indicating the
presence of an immune response to the introduction of an infectious agent [11,12].
When analyzing biochemical changes in the serum of children with small forms
of intrathoracic lymph node tuberculosis, abnormalities in the proteinogram were
observed in 26.8% of cases [1,8]. In children with active primary tuberculosis, there
was a significant increase in globulins (due to an increase in (3- and y-fractions), a
decrease in os-globulins and albumin, and an increase in haptoglobin [4]. For the
exacerbation of the tuberculosis process is characterized only by changes in the
proteinogram: a decrease in the albumin fraction and an increase in the level of
globulins. In children at an early age there is a physiological weakening of the
biosynthesis of u-globulins, and the synthesis of a- and P-globulins is higher than in
an older child. Therefore, the infant usually responds to any infectious process by
increasing the a- and p-fractions. With significant intoxication in such children, the
concentration of albumin and globulin increases. In this regard, the ratio of albumin to
globulins does not change [4, 11].
Special attention in phthisiatric practice is paid to proteins of the acute phase
of inflammation - ceruloplasmin and haptoglobin. These proteins participate in the
transport and utilization of copper, neuroendocrine regulation, hematopoiesis,
formation of nonspecific resistance of the organism. Many researchers [1,2,3] have
found that the levels of ceruloplasmin and haptoglobin increase significantly in
tuberculosis. The clinical course of tuberculosis during the period of antibiotic therapy
has its own peculiarities. This requires an objective assessment of the degree of activity
of the specific process, the state of metabolic changes in the div during the period of
chemotherapy.
To date, the damaging effect of both the tuberculosis process itself and
tuberculostatic agents on the liver, central and peripheral nervous system, energy,
protein and carbohydrate metabolism has been studied in detail. Both in children and
adults with tuberculosis, functional and morphological changes in the liver, caused by
tuberculosis intoxication proper, can be detected before the start of antibiotic therapy
[4,5,6,7].
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Against the background of chemotherapy, a significant increase in the activity
of hepatic enzymes alanine aminotransferase and aspartate aminotransferase was
found [2], which many authors attribute to the toxic effect of antituberculosis drugs on
the liver [1, 2,3,4,5,6]. Hyperfermentemia is often transient, is not combined with
adverse reactions and does not require special measures for its treatment. Withdrawal
of antituberculosis drugs leads to normalization of indicator enzyme activity within 5-
7 days.
References
1.
Abduhakimov B. A. et al. Bolalar va o'smirlarda birlamchi tuberkulyozning
o’ziga xos kechish xususiyatlari va klinik-laboratoriya usullari //Ta'lim innovatsiyasi
va integratsiyasi. – 2024. – Т. 32. – №. 3. – С. 139-143.
2.
Бердиярова Ш. Ш. и др. Клинико-лабораторная диагностика фолиевой
кислотодефицитной анемии //TADQIQOTLAR. UZ. – 2024. – Т. 49. – №. 3. – С.
46-53.
3.
Umarova T. A., Kudratova Z. E., Axmadova P. Role of conditionally pathogenic
microflora in human life activities //Web of Medicine: Journal of Medicine, Practice
and Nursing. – 2024. – Т. 2. – №. 11. – С. 29-32.
4.
Muhamadiyeva L. A., Kudratova Z. E., Sirojeddinova S. Pastki nafas yo’llari
patologiyasining rivojlanishida atipik mikrofloraning roli va zamonaviy diagnostikasi
//Tadqiqotlar. Uz. – 2024. – Т. 37. – №. 3. – С. 135-139.
5.
Umarova T. A., Kudratova Z. E., Norboyeva F. Modern aspects of etiology and
epidemiology of giardias //Web of Medicine: Journal of Medicine, Practice and
Nursing. – 2024. – Т. 2. – №. 11. – С. 25-28.
6.
Isomadinova L. K., Daminov F. A. Glomerulonefrit kasalligida sitokinlar
ahamiyati //Journal of new century innovations. – 2024. – Т. 49. – №. 2. – С. 117-120.
7.
Umarova T. A., Kudratova Z. E., Maxmudova H. Mechanisms of infection by
echinocococosis //Web of Medicine: Journal of Medicine, Practice and Nursing. –
2024. – Т. 2. – №. 11. – С. 18-21.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-24
Часть–3_ Апрель –2025
421
8.
Даминов Ф. А., Исомадинова Л. К., Рашидов А. Этиопатогенгетические и
клинико-лабораторные особенности сальмонелиоза //TADQIQOTLAR. UZ. –
2024. – Т. 49. – №. 3. – С. 61-67.
9.
Umarova T. A., Kudratova Z. E., Baxromova M. Autoimmune diseases: new
solutions in modern laboratory diagnostics //International Conference on Modern
Science and Scientific Studies. – 2024. – С. 78-81.
10.
Бердиярова Ш. Ш. и др. Узловой зоб и его клинико-лабораторная
диагностика //TADQIQOTLAR. UZ. – 2024. – Т. 49. – №. 3. – С. 38-45.
11.
Umarova T. A., Kudratova Z. E., Muhsinovna R. M. The main purpose of
laboratory diagnosis in rheumatic diseases //International Conference on Modern
Science and Scientific Studies. – 2024. – С. 82-85.
12.
Umarova T. A., Kudratova Z. E., Ruxshona X. Contemporary concepts of
chronic pancryatitis //International Conference on Modern Science and Scientific
Studies. – 2024. – С. 11-15.
13.
Хамидов З. З., Амонова Г. У., Исаев Х. Ж. Некоторые аспекты
патоморфологии неспецифических язвенных колитов //Молодежь и
медицинская наука в XXI веке. – 2019. – С. 76-76.
14.
Umarova T. A., Kudratova Z. E., Muminova G. Instrumental diagnostic studies
in chronic pancreatitis //International Conference on Modern Science and Scientific
Studies. – 2024. – С. 16-20.
15.
Атамурадовна М.Л., Рустамовна Р.Г., Эркиновна К.З. Роль современных
биомаркеров в изучении различных поражений головного мозга //Достижения
науки и образования. – 2020. – №. 10 (64). – С. 88-90.
16.
Рустамова Г. Р., Мухамадиева Л. А. Современные аспекты клинико-
лабораторных методов исследования острой ревматической лихорадки
//International scientific review. – 2020. – №. LXVI. – С. 106-110.
17.
Кудратова З.Е. и др. Роль цитокиновой регуляции при обструктивном
синдроме атипичного генеза у детей // Анналы Румынского общества клеточной
биологии. – 2021. – Т. 25. – №. 1. – С. 6279-6291.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-24
Часть–3_ Апрель –2025
422
18.
Erkinovna K. Z. et al. Bronchial obstruction syndrome in young children with
respiratory infections of different etiology: features of clinical manifestations and
immune response //Проблемы науки. – 2021. – №. 1 (60). – С. 60-62.
19.
Кудратова З.Е. и др. Хламидийные инфекции (внутриклеточная инфекция)
в развитии бронхита // TJE-Tematics journal of Education ISSN. – 2021. – С. 2249-
9822.
20.
Kudratova Z. E. et al. Principles of therapy of chlamydial and mycoplasma
infections at the present stage //Вопросы науки и образования. – 2021. – №. 28 (153).
– С. 23-26.
21.
Rustamova G. R., Kudratova Z. E. CHRONIC ENDOMETRITIS OLD ISSUES
NEW POSSIBILITIES //Western European Journal of Medicine and Medical Science.
– 2024. – Т. 2. – №. 5. – С. 12-14.
22.
Erkinovna K. Z., Rustamovna R. G., Suratovna Н. F. LABORATORY
MARKERS OF PERINATAL HYPOXIC DAMAGE TO THE CENTRAL
NERVOUS SYSTEM IN NEWBORNS //Наука, техника и образование. – 2020. –
№. 10 (74). – С. 102-104.
23.
Mukhamadieva L. A., Rustamova G. R., Kudratova Z. E. IMMEDIATE
RESULTS OF COMPLEX TREATMENT OF CHILDREN WITH CHRONIC
TONSILLITIS AND CHRONIC ADENOIDITIS ASSOCIATED WITH CMV AND
EBV //Western European Journal of Medicine and Medical Science. – 2024. – Т. 2. –
№. 5. – С. 20-24.
24.
Umarova T. A., Kudratova Z. E., Norxujayeva A. Etiopathogenesis and modern
laboratory diagnosis of prostatitis //International Conference on Modern Science and
Scientific Studies. – 2024. – С. 6-10.
