<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">tiblj</journal-id><journal-title-group><journal-title xml:lang="ru">Туберкулез и болезни легких</journal-title><trans-title-group xml:lang="en"><trans-title>Tuberculosis and Lung Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2075-1230</issn><issn pub-type="epub">2542-1506</issn><publisher><publisher-name>Медицинские знания и технологии</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21292/2075-1230-2017-95-2-59-63</article-id><article-id custom-type="elpub" pub-id-type="custom">tiblj-977</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ДИСКУССИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DISCUSSION</subject></subj-group></article-categories><title-group><article-title>ВНЕЛЕГОЧНЫЙ ТУБЕРКУЛЕЗ - ВОПРОСОВ БОЛЬШЕ, ЧЕМ ОТВЕТОВ</article-title><trans-title-group xml:lang="en"><trans-title>EXTRAPULMONARY TUBERCULOSIS - MORE QUESTIONS THAN ANSWERS</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кульчавеня</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kulchavenya</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, главный научный сотрудник,</p><p>630040, г. Новосибирск, ул. Охотская, д. 81А</p></bio><bio xml:lang="en"><p>Doctor of Medical Sciences, Professor, Head Researcher,</p><p>81a, Okhotskaya St., Novosibirsk, 630040</p></bio><email xlink:type="simple">urotub@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жукова</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhukova</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, заведующая отделением внелегочного туберкулеза,</p><p>630075, г. Новосибирск, ул. Александра Невского, д. 9/1</p></bio><bio xml:lang="en"><p>Candidate of Medical Sciences, Head of Extrapulmonary Tuberculosis Department,</p><p>9/1, Aleksandra Nevskogo St., Novosibirsk, 630075</p></bio><email xlink:type="simple">urotub@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Новосибирский НИИ туберкулеза» МЗ РФ; ГБОУ ВПО «Новосибирский государственный медицинский университет» МЗ РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novosibirsk Tuberculosis Research Institute;&#13;
Novosibirsk State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Новосибирский областной противотуберкулезный диспансер</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novosibirsk Regional TB Dispensary</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>01</day><month>02</month><year>2017</year></pub-date><volume>95</volume><issue>2</issue><fpage>59</fpage><lpage>63</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кульчавеня Е.В., Жукова И.И., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Кульчавеня Е.В., Жукова И.И.</copyright-holder><copyright-holder xml:lang="en">Kulchavenya E.V., Zhukova I.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.tibl-journal.com/jour/article/view/977">https://www.tibl-journal.com/jour/article/view/977</self-uri><abstract><p>Несмотря на позитивные тенденции в эпидемической ситуации по туберкулезу в целом, динамика заболеваемости внелегочным туберкулезом (ВЛТ) нестабильна.</p><sec><title>Материалы и методы</title><p>Материалы и методы. Проанализирована структура заболеваемости изолированным ВЛТ в зависимости от сопутствующей ВИЧ-инфекции, а также структура заболеваемости ВЛТ с сопутствующим туберкулезом (ТБ) других локализаций по данным Новосибирского областного противотуберкулезного диспансера за 2015 г.</p></sec><sec><title>Результаты</title><p>Результаты. Изолированный ВЛТ диагностирован у 95 пациентов. В целом с одинаковой частотой регистрировали туберкулез костей и суставов (КСТ) и центральной нервной системы (ЦНС) - по 31,6%. Однако на долю ТБ ЦНС среди иммунокомпетентных лиц пришлось всего 4,1%, а у ВИЧ-инфицированных этот показатель составил 60,9%, больных КСТ более чем в 2 раза было больше среди иммунокомпетентных лиц. ТБ периферических лимфатических узлов диагностирован у 14,7%, урогенитальный суммарно - у 13,9%. Выявлены значительные расхождения по спектру ВЛТ по классификации Всемирной организации здравоохранения и РФ. Сочетанные формы ТБ выявлены у 97 пациентов, из них ВИЧ-инфицированных было 57,7%. Среди сочетанных форм преобладают ТБ органов дыхания и ЦНС, ТБ органов дыхания и КСТ.</p></sec><sec><title>Вывод</title><p>Вывод. Необходимо пересмотреть структуру отчетных документов по ВЛТ для получения верных статистических данных.</p></sec></abstract><trans-abstract xml:lang="en"><p>Despite the positive trends in the tuberculosis epidemic situation in general, changes in the extrapulmonary tuberculosis incidence are still unstable.</p><sec><title>Materials and methods</title><p>Materials and methods. The incidence structure of certain forms of tuberculosis has been analyzed depending on the concurrent HIV infection including analysis of the incidence structure of extrapulmonary tuberculosis with concurrent tuberculosis of other localizations as per the data of Novosibirsk Regional TB Dispensary for 2015.</p></sec><sec><title>Results</title><p>Results. 95 patients were diagnosed with isolated extrapulmonary tuberculosis. In general the equal numbers of bone and joint tuberculosis and central nervous system tuberculosis were registered – 31.6% of each. However those suffering from central nervous system tuberculosis without compromised immunity made only 4.1%, while among the HIV infected this rate made 60.9%; those suffering from bone and joint tuberculosis prevailed more than twice among the HIV negative. Tuberculosis of peripheral lymph nodes was diagnosed in 14.7%, urogenital tuberculosis all together – in 13.9%. Significant differences in extrapulmonary tuberculosis classification between World Health Organisation and RF have been found out. Concurrent forms of tuberculosis were detected in 97 patients, of them 57.7% were HIV positive. Tuberculosis of respiratory organs and central nervous system, tuberculosis of respiratory organs and bones and joints prevailed among concurrent forms.</p></sec><sec><title>Conclusion</title><p>Conclusion: It is necessary to review the structure of reports on extrapulmonary tuberculosis in order to provide true statistic data. </p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>уберкулез</kwd><kwd>внелегочный туберкулез</kwd><kwd>ВИЧ-инфекция</kwd><kwd>заболеваемость</kwd><kwd>структура</kwd><kwd>сочетанные формы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>tuberculosis</kwd><kwd>extrapulmonary tuberculosis</kwd><kwd>HIV infection</kwd><kwd>incidence</kwd><kwd>structure</kwd><kwd>concurrent forms</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Жукова И. И., Кульчавеня Е. В., Холтобин Д. П. и др. Туберкулез мочеполовой системы сегодня // Урология. - 2013. - № 1. - С. 13-16.</mixed-citation><mixed-citation xml:lang="en">Zhukova I.I., Kulchavenya E.V., Kholtobin D.P. et al. Tuberkulyoz mochepolovoy sistemy segodnya. [Tuberculosis of genitourinary system nowadays]. Urologiya, 2013, no. 1, pp. 13-16. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Кульчавеня Е. В., Краснов В. А., Скорняков С. Н. и др. Современные тенденции эпидемической ситуации по внеторакальному туберкулезу // Туб. и болезни легких. - 2013. - № 12.- С. 34-38.</mixed-citation><mixed-citation xml:lang="en">Kulchavenya E.V., Krasnov V.А., Skornyakov S.N. et al. Current tendencies of epidemiological situation of extrapulmonary tuberculosis. Tuberculosis and Lung Diseases, 2013, no. 12, pp. 34-38. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Молдобекова Э. М. Эпидемиология внелегочного туберкулеза // Наука и новые технологии. - 2011. - № 9. - С. 63.</mixed-citation><mixed-citation xml:lang="en">Moldobekova E.M. Epidemiology of extrapulmonary tuberculosis. Nauka i Novye Tekhnologii, 2011, no. 9, pp. 63. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Мордык А. В., Пузырева Л. В., Ситникова С. В., Иванова О. Г. Туберкулез в сочетании с ВИЧ-инфекцией на территории Омской области за период с 2008 по 2012 г. // ВИЧ-инфекция и иммуносупрессиии. - 2014. - Т. 6, № 2. - С. 106-109.</mixed-citation><mixed-citation xml:lang="en">Mordyk А.V., Puzyreva L.V., Sitnikova S.V., Ivanova O.G. Tuberculosis with concurrent HIV infection in Omsk Region from 2008 to 2012. VICH-Infektsiya i Immunosupressii. 2014, vol. 6, no. 2, pp. 106-109. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Мордык А. В., Яковлева А. А., Николаева И. Н., Леонтьев В. В. Актуальность проблемы внелегочного туберкулеза в современных эпидемиологических условиях // Тихоокеанский медицинский журнал. - 2015. - № 3 (61). - С. 19-21.</mixed-citation><mixed-citation xml:lang="en">Mordyk А.V., Yakovleva А.А., Nikolaeva I.N., Leontiev V.V. Criticality of extrapulmonary tuberculosis issue under current epidemiological conditions. Tikhookeansky Meditsinsky Journal, 2015, no. 3 (61), pp. 19-21. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Мушкин А. Ю., Белиловский Е. М., Першин А. А. Внелегочный туберкулез в Российской Федерации: сопоставление некоторых официальных данных и результатов анкетного скрининга // Мед. альянс. - 2013. - № 1. - С. 80-85.</mixed-citation><mixed-citation xml:lang="en">Mushkin А.Yu., Belilovsky E.M., Pershin А.А. Extrapulmonary tuberculosis in the Russian Federation: comparison of official data and results of questionnaire screening. Med. Alyans, 2013, no. 1, pp. 80-85. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Нгхиитвиква Д., Беляева А. Ю. Туберкулез и меры борьбы с ним в Намибии / Bulletin of Medical Internet Conferences (ISSN 2224-6150), 2015. - Vol. 5. - Issue 12. - P. 1714 (www.medconfer.com).</mixed-citation><mixed-citation xml:lang="en">Ngkhiitvikva D., Belyaeva А.Yu. Tuberculosis and its control in Namibia. Bulletin of Medical Internet Conferences (ISSN 2224-6150), 2015, vol. 5, issue 12, pp. 1714 (www.medconfer.com). (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Петренко В. И., Тодорико Л. Д., Бойко А. В. Актуальные вопросы диагностики и лечения внелегочного туберкулеза // Туб., легочные болезни, ВИЧ-инфекция. - 2013. - № 3 (14). - С. 86-89.</mixed-citation><mixed-citation xml:lang="en">Petrenko V.I., Todoriko L.D., Boyko А.V. Actual issues of detection, diagnostics and treatment of extrapulmonary tuberculosis. Tub., Legochnye Bbolezni, VICH-Infektsiya, 2013, no. 3 (14), pp. 86-89. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Тарасенко Л. Ю., Уртенов Р. Х., Вышеславцев В. В., Харчев С. И. Эпидемиология туберкулеза внелегочных локализаций в Ставропольском крае // Туб. и болезни легких. - 2011. - № 5 - С. 182.</mixed-citation><mixed-citation xml:lang="en">Tarasenko L.Yu., Urtenov R.Kh., Vysheslavtsev V.V., Kharchev S.I. Epidemiology of extrapulmonary tuberculosis in Stavropol Region. Tuberculosis and Lung Diseases, 2011, no. 5, pp. 182. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Туктамышева Л. В., Азаматова М. М., Ягафарова Р. К. и др. Эпидемиология внелегочного туберкулеза в Республике Башкортостан // Туб. и болезни легких. - 2011. - № 5 - С. 192.</mixed-citation><mixed-citation xml:lang="en">Tuktamysheva L.V., Аzamatova M.M., Yagafarova R.K. et al. Epidemiology of extrapulmonary tuberculosis in Bashkortostan Republic. Tuberculosis and Lung Diseases, 2011, no. 5, pp. 192. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Яблонский П. К., Мушкин А. Я., Белиловский Е. М. и др. Туберкулез в Российской Федерации до 2010 г. Аналитический обзор статистических показателей, используемых в России. Раздел 6. Внелегочный туберкулез. - М., 2011. - С. 111-114.</mixed-citation><mixed-citation xml:lang="en">Yablonsky P.K., Мushkin А.Ya., Belilovsky Е.М. et al. Tuberkulez v Rossiyskoy Federatsii, 2010 g. Analitichesky obzor statisticheskhy pokazateley po tuberkulezu, ispolzuemykh v Rossiyskoy Federatsii. [Tuberculosis in the Russian Federation in 2010. Analytic review of tuberculosis statistic rates used in the Russian Federation]. Part 6, Extrapulmonary tuberculosis. Moscow, 2011. pp. 111-114. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Al-Hajoj S., Shoukri M., Memish Z. et al. Exploring the sociodemographic and clinical features ofextrapulmonary tuberculosis in Saudi Arabia // PLoS One. - 2015. - 10(2):e0101667. doi: 10.1371/journal.pone.0101667. eCollection 2015.</mixed-citation><mixed-citation xml:lang="en">Al-Hajoj S., Shoukri M., Memish Z. et al. Exploring the sociodemographic and clinical features ofextrapulmonary tuberculosis in Saudi Arabia. PLoS One, 2015, 10(2):e0101667. doi: 10.1371/journal.pone.0101667. eCollection 2015.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Boulahbal F. Bacteriological aspects of extrarespiratory tuberculosis // Arch. Inst. Pasteur Alger. - 1977. - Vol. 52. - Р. 37-53.</mixed-citation><mixed-citation xml:lang="en">Boulahbal F. Bacteriological aspects of extrarespiratory tuberculosis. Arch. Inst. Pasteur Alger., 1977, vol. 52, pp. 37-53.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Cheng X. H., Bian S. N., Zhang Y. Q. et al. Diagnostic value of T-cell interferon-γ release assays on synovial fluid for articular tuberculosis: a pilot study // Chin. Med. J. (Engl). - 2016. - Vol. 129, № 10. - Р. 1171-1178. doi: 10.4103/0366-6999.181958.</mixed-citation><mixed-citation xml:lang="en">Cheng X.H., Bian S.N., Zhang Y.Q. et al. Diagnostic value of T-cell interferon-γ release assays on synovial fluid for articular tuberculosis: a pilot study. Chin. Med. J. (Engl.), 2016, vol. 129, no. 10, pp. 1171-1178. doi: 10.4103/0366-6999.181958.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">D'Alfonso G., Bariffi F. Extrarespiratory tuberculosis in Italy and in the world. Statistical findings // Arch. Tisiol. Mal. Appar Respir. - 1968. - Vol. 23, № 11. - Р. 843-924.</mixed-citation><mixed-citation xml:lang="en">D'Alfonso G., Bariffi F. Extrarespiratory tuberculosis in Italy and in the world. Statistical findings. Arch. Tisiol. Mal. Appar Respir., 1968, vol. 23, no. 11, pp. 843-924.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Didilescu C., Tănăsescu M. Proportion and site distribution of extrarespiratory tuberculosis in 2007-2010 in Romania // Pneumologia. - 2012. - Vol. 61, № 1. - Р. 10-14.</mixed-citation><mixed-citation xml:lang="en">Didilescu C., Tănăsescu M. Proportion and site distribution of extrarespiratory tuberculosis in 2007-2010 in Romania. Pneumologia, 2012, vol. 61, no. 1, pp. 10-14.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Garcia de Viedma D., Lorenzo G., Cardona P. J. et al. Association between the infectivity of Mycobacterium tuberculosis strains and their efficiency for extrarespiratory infection // J. Infect. Dis. - 2005. - Vol. 192, № 12. - Р. 2059-2065. Epub 2005 Nov 15.</mixed-citation><mixed-citation xml:lang="en">Garcia de Viedma D., Lorenzo G., Cardona P.J. et al. Association between the infectivity of Mycobacterium tuberculosis strains and their efficiency for extrarespiratory infection. J. Infect. Dis., 2005, vol. 192, no. 12, pp. 2059-2065. Epub 2005 Nov 15.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Korzeniewska-Koseła M. Tuberculosis in Poland in 2013. PRZEGL EPIDEMIOL 2015; 69. - Р. 277-282.</mixed-citation><mixed-citation xml:lang="en">Korzeniewska-Koseła M. Tuberculosis in Poland in 2013. PRZEGL EPIDEMIOL 2015; 69. – Р. 277-282.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Peto H. M., Pratt R. H., Harrington T. A. et al. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006 // Clin. Infect. Dis. - 2009. - Vol. 49, № 9. - P. 1350-1357.</mixed-citation><mixed-citation xml:lang="en">Peto H.M., Pratt R.H., Harrington T.A. et al. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin. Infect. Dis., 2009, vol. 49, no. 9, pp. 1350-1357.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Sanches I., Carvalho A., Duarte R. Who are the patients with extrapulmonary tuberculosis? // Rev. Port. Pneumol. (2006). - 2015. - Vol. 21, № 2. - Р. 90-93. doi: 10.1016/j.rppnen.2014.06.010. Epub 2015 Feb 7.</mixed-citation><mixed-citation xml:lang="en">Sanches I., Carvalho A., Duarte R. Who are the patients with extrapulmonary tuberculosis? Rev. Port. Pneumol., (2006). 2015, vol. 21, no. 2, pp. 90-93. doi: 10.1016/j.rppnen.2014.06.010. Epub 2015 Feb 7.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
