Quantificação objetiva de fibrose/processo inflamatório em pacientes com tuberculose pulmonar utilizando exames de raios x de tórax
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Data
2017-04-17
Autores
Oliveira, Marcela de [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A tuberculose (TB) é uma das doenças infecciosas de grande preocupação mundial. Seu agente etiológico, a Mycobacterium tuberculosis, é a espécie de micobactéria mais importante do ponto de vista da saúde pública. Seu agente etiológico, tem aumentado sua resistência frente as drogas de tratamento, ocasionando mudança nos esquemas terapêuticos. Desde 2009, a TB passou a ser tradada com quatro drogas em um único comprimido com dose combinada de rifampicina, isoniazida, pirazinamida e etambutol (esquema II). Antes desse período, o tratamento era realizado através da combinação de três drogas: rifampicina, isoniazida e pirazinamida (esquema I). O exame de raios X é o método de diagnóstico por imagem mais realizado no acompanhamento de pacientes diagnosticados com TB. Esta pesquisa teve como objetivo a quantificação objetiva das áreas pulmonares acometidas pela tuberculose utilizando exames de raios X e associá-la aos exames séricos (índices de proteína C-reativa, velocidade de hemossedimentação e albumina) e esforço pulmonar, em estágios de pré e pós-tratamento de tuberculose. Este procedimento de associação entre os exames abordados foi realizado com dois esquemas anti-tuberculose (esquemas I e II). A quantificação objetiva do comprometimento pulmonar foi realizada utilizando um algoritmo computacional previamente desenvolvido. A correlação entre a quantificação objetiva do comprometimento pulmonar e os exames séricos comprovou que durante o processo inflamatório da doença a região pulmonar acometida era de maior extensão e tiveram uma redução do comprometimento pulmonar de 73,23±11,57% e 69,52±17,06% para os esquema I e II, respectivamente. Os dois esquemas de medicação utilizados no tratamento dos pacientes com tuberculose apresentaram a mesma eficácia, não mostrando diferença estatística significativa para a redução do comprometimento pulmonar entre ambos (p>0,05). O grau de lesão pulmonar funcional (esforço pulmonar) mostrou-se diretamente proporcional a quantificação objetiva do comprometimento pulmonar. Esta pesquisa apresentou inovação científica em aplicar um algoritmo computacional de modo a quantificar objetivamente o comprometimento pulmonar dos pacientes com tuberculose com esquemas de tratamento distintos, e a correlação destes resultados com exames séricos e esforço pulmonar.
Tuberculosis (TB) is an infectious disease of great concern worldwide. Its etiological agent, Mycobacterium tuberculosis, is the most important mycobacteria species concerning public health. Its etiological agent has increased its resistant to drug treatments, leading to a change in the therapeutic regimens. Since 2009, TB has been treated with four drugs: rifampicin, isoniazid, pyrazinamide and ethambutol (scheme II). Prior to this time, treatment was performed through combination of three drugs: rifampicin, isoniazid, and pyrazinamide (scheme I). X ray exam is the most used diagnostic imaging method to follow-up patients with TB. The objective of this research was the objective quantification of the pulmonary areas affected by tuberculosis using X ray exams and to associate it with serum exams (albumin, erythrocyte sedimentation rate and C-reactive protein) and pulmonary effort in the pre and post-treatment stages of tuberculosis. This procedure of association between the examinations was performed with two anti-tuberculosis regimens (scheme I and II). The objective quantification of pulmonary involvement was performed using a computational algorithm previously developed. The correlation between the objective quantification of pulmonary involvement and serum exams has shown that during the inflammatory process of the disease there is an increase in the pulmonary region affected and had a reduction in lung impairment of 73.23±11.57% and 69.52±17.06% for schemes I and II, respectively. The two medication regimens used in the treatment have the same efficacy, showing no statistically significant difference for the reduction of pulmonary compromise (p>0.05). The degree of functional lung damage (pulmonary effort) was directly proportional to the objective quantification of pulmonary involvement. This research presented a scientific innovation in applying a computational algorithm to objectively quantify the pulmonary involvement of patients with tuberculosis in different treatment regimens and to correlate these results with serum exams and pulmonary effort.
Tuberculosis (TB) is an infectious disease of great concern worldwide. Its etiological agent, Mycobacterium tuberculosis, is the most important mycobacteria species concerning public health. Its etiological agent has increased its resistant to drug treatments, leading to a change in the therapeutic regimens. Since 2009, TB has been treated with four drugs: rifampicin, isoniazid, pyrazinamide and ethambutol (scheme II). Prior to this time, treatment was performed through combination of three drugs: rifampicin, isoniazid, and pyrazinamide (scheme I). X ray exam is the most used diagnostic imaging method to follow-up patients with TB. The objective of this research was the objective quantification of the pulmonary areas affected by tuberculosis using X ray exams and to associate it with serum exams (albumin, erythrocyte sedimentation rate and C-reactive protein) and pulmonary effort in the pre and post-treatment stages of tuberculosis. This procedure of association between the examinations was performed with two anti-tuberculosis regimens (scheme I and II). The objective quantification of pulmonary involvement was performed using a computational algorithm previously developed. The correlation between the objective quantification of pulmonary involvement and serum exams has shown that during the inflammatory process of the disease there is an increase in the pulmonary region affected and had a reduction in lung impairment of 73.23±11.57% and 69.52±17.06% for schemes I and II, respectively. The two medication regimens used in the treatment have the same efficacy, showing no statistically significant difference for the reduction of pulmonary compromise (p>0.05). The degree of functional lung damage (pulmonary effort) was directly proportional to the objective quantification of pulmonary involvement. This research presented a scientific innovation in applying a computational algorithm to objectively quantify the pulmonary involvement of patients with tuberculosis in different treatment regimens and to correlate these results with serum exams and pulmonary effort.
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Palavras-chave
Comprometimento pulmonar, Esforço pulmonar, Exames séricos, Quantificação objetiva, Tuberculose