Assesment of premarure death in patients with pulmonary tuberculosis and chronic obstructive pulmonary disease

Abstract

The risk of developing cardiovascular pathology and premature death from it in patients with pulmonary tuberculosis in combination with chronic obstructive pulmonary disease is assessed. It has been established that more than 80% of patients with pulmonary tuberculosis are regular tobacco users. Chronic tobacco intoxication leads to the formation of chronic obstructive pulmonary disease, affecting the course of the tuberculosis process. In patients with tuberculosis on the background of smoking and chronic obstructive pulmonary disease, pronounced clinical manifestations of the disease are determined, which are accompanied by a common tuberculosis process, decomposition in the lung tissue and bacterial excretion. Patients suffering from comorbid pathology revealed deep disturbances in the homeostatic balance of the body and changes in the reactivity of the body. Changes in the proteinogram were determined, with the predominance of g γ- и α-2 fractions, an increase in C-reactive protein and fibrinogen, which confirms a pronounced systemic inflammatory response. The pathological state of homeostatic equilibrium of the body is accompanied by the development of hypoxemia, oxidative stress, systemic inflammation, endothelial dysfunction and dyslipidemia. In a third of patients, changes in the lipid profile are determined against the background of a lack of body weight, which is an unfavorable prognostic sign during chronic obstructive pulmonary disease. Such phenomena contribute to the development of multifocal atherogenesis, systemic arterial hypertension, cardiac remodeling and the rapid development of cardiovascular pathology. In patients with comorbidity, changes in the electrocardiogram are characterized by remodeling of the myocardium, a change in the position of the electrical axis of the heart, overload of the right heart, hypertrophy of the left heart. These patients are characterized by a decrease in exercise tolerance, a moderate and high risk of developing cardiovascular complications and premature death from them. Identified changes are predictors of early disability and premature death of patients with tuberculosis, contribute to a decrease in the quality and life expectancy of patients.

Keywords

pulmonary tuberculosis / smoking / chronic obstructive pulmonary disease / homeostatic equilibrium of the body / drug resistance / comorbid pathology / risk of cardiovascular complications / dyslipidemia / quality of life / modified questionnaire

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RIGHTS & PERMISSIONS

Katicheva A.V., Brazhenko N.A., Brazhenko O.N., Chuikova A.G., Zheleznyak S.G., Tsygan N.V., Nikolau A.V.