СТРУКТУРНО-ФУНКЦИОНАЛЬНАЯ ХАРАКТЕРИСТИКА БРОНХИОЛИТОВ, ВЫЗВАННЫХ БЫСТРОРАСТУЩИМИ ШТАММАМИ НЕТУБЕРКУЛЕЗНЫХ МИКОБАКТЕРИЙ

Abstract

The relevance of the research is associated with the need to study changes in the lungs caused by rapidly growing strains of nontuberculous mycobacteria (NTM). Objective: to analyze results obtained by the complex study of the lungs for evaluation of the frequency and nature of terminal bronchiole lesions in patients with nontuberculous mycobacterial (NTM)infection caused by rapidly growing strains. Materials and methods. We carried out clinical, radiological, morphological, and spirometric studies of the lungs of 35 patients with rapidly growing NTM strains isolated by real-time PCR. All the patients underwent multislice CT (MSCT) of the chest using the Somatom Emotion 16 scanner (Siemens, Germany) based on the high resolution computed tomography (HRCT) algorithm with 0.8 mm slice thickness and 1.5 mm slice increment. Lung ventilation was studied using the standard spirometry. Morphological studies were performed using resection samples from 11 patients with pulmonary TB comorbidity and 7 patients with only TB (the comparison group). Results. Rapidly growing strains of NTM cause exudative lymphocytic bronchiolitis, cell infiltration of the peribronchial tissue, which is not typical for TB infection. Later, lymphocytic bronchiolitis of terminal bronchioles develops into chronic constrictive bronchiolitis accompanied by the development of bronchiolectasis, atelectasis, and emphysema confirmed by HRCT results. They show prevailing bronchogenic lesions of small airways, accompanied by obstructive-type pulmonary ventilation disorders in 80% of cases (FEV1 is more than 70% of the predicted values). The results of the complex study should be considered in diagnosis and treatment of patients with NTM infection of the lungs.