New diagnostic criteria for assessing homeostasis in patients with respiratory tuberculosis

The search for available informative criteria for diagnosing the state and dynamics of the homeostatic equilibrium of the organism, which began at the end of the XIXth century, continues to the present. Scientific research establishes the priorities for the study of homeostasis in the clinic and its control over the supra-segmental regulatory centers of the autonomic nervous system. The proposed functional, instrumental, immunological, biochemical and hormonal methods for evaluating it in phthisiology for various reasons, including economic ones, cannot be used fully. The modern clinic needs accessible and informative criteria for homeostasis. The theoretical basis for their development was the doctrine of the general adaptation syndrome, which revealed the reaction of «stress» to extreme irritants. The subsequent discovery of changes in the body’s homeostasis to the effect of strong, medium strength, and weak stimuli has made it possible to identify three more types of adaptation reactions: the training reaction, the activation reaction, and the re-activation reaction. At the Department of Phthisiopulmonology of the FirstSt. PetersburgStateMedicalUniversity named after Acad. I.P. Pavlov proposed and tested new diagnostic criteria for homeostasis. They were developed on the basis of quantitative and qualitative characteristics of the formed elements of peripheral blood. Among them, in addition to these types of adaptive reactions of the body, leukocyte- lymphocyte index, indices of monocytogram, degree of disturbance of homeostasis and types of reactivity of the organism were introduced. These criteria allowed us to determine not only the state of homeostatic equilibrium of the organism, but also to assess the depth of its disturbance and the types of reactivity of the organism. Their use in daily clinical work provides an opportunity to monitor the course of the disease and carry out a personified correction by means of pathogenetic therapy.

homeostasis, autonomic nervous system, suprasegmental adjusting apparatus, adaptive response, reactivity, outcome of the disease