Бронхообструктивний синдром у хворих на туберкульоз легень: сучасний стан актуальної проблеми

Abstract

A review of modern scientific literature is presented ; features of pathogenesis, diagnosis and clinical course of bronchial obstruction syndrome in patients with pulmonary tuberculosis are studied. Aim. To analyze literature sources, which cover modern views on the pathogenesis, features of clinical manifestation and diagnostics in patients with tuberculosis of the lungs with bronchial obstruction syndrome for verification of its origin. Materials and Methods. A review of scientific publications and a generalization of literature data for the period from 2009 to 2019 were conducted. Thirty-six primary sources most fully reflecting the current views on the problem were selected. Results and Discussion. The analysis of modern scientific literature shows the increased attention of researchers towards the peculiarities of pathomorphosis of tuberculosis during the epidemic; the rapid evolution in the usage of functional and endoscopic diagnostics in the examination of patients with tuberculosis, which made it possible to draw the attention of doctors to the new features in the course of the disease. Bronchologists have paid attention to the significant changes in the frequency and nature of bronchial changes in tuberculosis, namely the increase in the frequency of detection of nonspecific endobronchitis, and the presence of "paraspecific" endobronchitis complicating the course of tuberculosis. Imbalance of immunological status indicators and activation of lipid peroxidation processes were ascertained. Bronchial obstruction syndrome compromises the effectiveness of tuberculosis treatment, which is associated both with the disruption of sanogenesis of destructive changes in the pulmonary parenchyma, creating conditions for long-term MBT persistence; and insufficient concentration of AMBT in areas of active inflammatory process. The issues of verifying the genesis of BOS remain relevant today and require a scientific basis for diagnosis. Conclusions. The results of the analyzed literature indicate the relevance of early verification of the genesis of bronchial obstruction syndrome, which will increase treatment effectiveness by reducing the complications of the underlying disease. Key words: pulmonary tuberculosis, bronchial obstruction syndrome, chronic obstructive pulmonary disease, bronchial asthma, immunological reactivity