Features of the course of chronic obstructive pulmonary disease in patients with respiratory tuberculosis in modern conditions

Abstract

Abstrаct. The features of the course of chronic obstructive pulmonary disease are considered. It was established that this pathology is widespread in patients with tuberculosis and is determined in one third of patients. Moreover, the combination of respiratory tuberculosis and chronic obstructive pulmonary disease have a mutual aggravating effect, and the patients serious condition can be caused by both exacerbation of chronic obstructive pulmonary disease and progression of the tuberculosis process. The severity of the comorbid state is associated with a decrease in adaptive-adaptive mechanisms and a violation of the state of the homeostasis of the body. Patients with a combination of pulmonary tuberculosis and chronic obstructive pulmonary disease are characterized by intense types of adaptive reactions, with their extreme manifestations, a deep and pronounced disturbance in homeostatic balance and a decrease in the reactivity of the body. Such changes are combined with functional disorders of the respiratory system (changes in spirometric indicators, impaired airway, impaired ventilation function and diffusion capacity of lung tissue). The combined course of pulmonary tuberculosis and chronic obstructive pulmonary disease affects the effectiveness of the treatment and its outcome. In patients with comorbid pathology, there is a decrease in the frequency of abacillation and closure of decay cavities, the formation of pronounced residual tuberculous changes in the lungs. At the same time, in patients with pulmonary tuberculosis, chronic obstructive disease has a more severe course, with a pronounced symptom complex and a high probability of frequent exacerbations. In more than half of cases, chronic obstructive pulmonary disease is characterized by an unfavorable course with a high risk of exacerbations, more than twice a year, which is an extremely unfavorable factor for predicting the course of chronic obstructive pulmonary disease and the development of complications. Identified violations impair the quality of life of patients suffering from comorbidity. Therefore, it is diagnostically important to assess the initial state of chronic obstructive pulmonary disease in patients with tuberculosis, to predict its course and the risks of exacerbations.