ПОСТТУБЕРКУЛЕЗНАЯ ОБСТРУКТИВНАЯ БОЛЕЗНЬ ЛЕГКИХ (обзор зарубежной литературы)

Abstract

Abstract. Introduction. Post-tuberculous obstructive pulmonary disease has been considered as a chronic disease for the last decade. Despite successful clinical cure of tuberculosis, up to 50% of patients have post-tuberculous obstructive pulmonary disease, defined as the “signs of chronic respiratory distress, with or without symptoms, at least partially attributable to prior pulmonary tuberculosis”. Aim. To consider the epidemiological and pathophysiological relationships between chronic airway obstruction in COPD and tuberculosis and to highlight the diagnostic and therapeutic approaches to managing patients with post-tuberculous obstructive pulmonary disease. Materials and Methods. We searched available information databases up to June 2023 using key terms, i.e. COPD, tuberculosis associated with COPD, post-tuberculous obstructive pulmonary disease. Results and Discussion. Post-tuberculous obstructive pulmonary disease is one of the many TB complications that significantly affects the economic, social, and psychological well- being of individuals, families, and communities. Post-tuberculous obstructive pulmonary disease includes a group of heterogeneous conditions affecting the large and small airways, such as bronchiectasis or obstructive airways; lung parenchyma, pleura, and/or pulmonary vasculature, and may present with symptoms partly associated with past pulmonary tuberculosis. Post-tuberculous obstructive pulmonary disease results from a complex interaction between human immune reactivity, pathogens, and environmental factors that affects long-term respiratory health. Major risk factors for post-tuberculous obstructive pulmonary disease include smoking, low socioeconomic status, vitamin D deficiency, and diabetes mellitus. People with post-tuberculous obstructive pulmonary disease have a reduced life expectancy and an increased risk of TB recurrence. Conclusions. Currently, due to the lack of controlled clinical trials, there are no generally accepted recommendations for the diagnosis and treatment of post-tuberculous obstructive pulmonary disease. The management of patients with post-tuberculous obstructive pulmonary disease mainly includes adjuvant therapy used in other chronic obstructive pulmonary diseases and in pulmonary rehabilitation. Early diagnosis and timely treatment are essential to limit lung damage.