STUDY OF PATHOLOGICAL CHANGES IN THE CARDIOVASCULAR SYSTEM IN PULMONARY TUBERCULOSIS

Аннотация

Study of pathological changes in the cardiovascular system in pulmonary tuberculosis and development of modern therapeutic solutions. Keywords: pulmonary tuberculosis, ventricular diastolic dysfunction, stress, smoking, anticholinergic drugs, b2-agonists. ИЗУЧЕНИЕ ПАТОЛОГИЧЕСКИХ ИЗМЕНЕНИЙ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ ПРИ ТУБЕРКУЛЕЗЕ ЛЕГКИХ Аннотация. Изучение патологических изменений сердечно-сосудистой системы при туберкулезе легких и разработка современных терапевтических решений. Ключевые слова: туберкулез легких, желудочковая диастолическая дисфункция, стресс, курение, антихолинергические препараты, b2-агонисты. Relevance. It is known that in tuberculosis and other chronic inflammatory processes in the lungs, inflammatory epithelial growth, squamous metaplasia and cancer in situ are not uncommon, which is considered a conditio sine qua non of malignant neoplasm. At the same time, inflammatory and cancerous epithelial growth are different entities. Although they may be “pre-neoplastic” from the point of view of histological differentiation, they do not necessarily become cancerous; rather, they are “conditionally precancerous” changes. They are interconnected, as the inflammatory growth of the epithelium, in no way capable of autonomously growing cancer cells, is 308diameter. On the other hand, the phenotypic diversity of lung cancer in patients with tuberculosis (their localization in the central and even peripheral departments, histological features, etc.), as well as the significant time interval between the development of both, do not allow Tuberculosis remains the leading cause of morbidity and mortality worldwide. Every year, 8.8 million cases of tuberculosis are recorded worldwide. At the same time, 1.61 million people are diagnosed with lung cancer worldwide. In some countries, the number of patients with malignant lung diseases admitted to tuberculosis hospitals is increasing, which makes it difficult to accurately diagnose tuberculosis and malignant neoplasms. There are many similarities between these two diseases, both are widespread, affect the lung parenchyma, and are primarily characterized by similar symptoms. However, there are many differences between these two nosologies: the consequences of different etiologies and the management of patients in general are different. 1829 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 4 Currently, special attention is paid to the study of risk factors for pulmonary tuberculosis, including urban air pollution, increased industrial dust, age, tobacco smoking, respiratory tract infections, their frequent exacerbations, and exacerbation of obstructive pulmonary disease. Thus, tobacco smoking is associated not only with the occurrence of pathological processes in the lungs, but also with the development of systemic inflammatory reactions, oxidative stress, vascular endothelial dysfunction, increased activity of procoagulant factors, increased expression of oncogenes, and other systemic effects [1-7]. Left ventricular dysfunction and the occurrence of ventricular arrhythmias in patients with pulmonary tuberculosis have been relatively poorly studied. Researchers Incalzi RA, Pistelli R et al. There is a correlation between left ventricular function and cardiac rhythm disturbances in patients with pulmonary tuberculosis. Ventricular arrhythmias were monitored for 24 hours and the study was repeated because the clinical manifestations of respiratory failure improved. Left ventricular diastolic dysfunction is one of the factors contributing to the development of ventricular arrhythmias. The authors found a direct relationship between the degree of respiratory failure and the manifestation of left ventricular diastolic dysfunction, while blood gas parameters did not correlate with the clinical manifestations of arrhythmic episodes. In clinical practice, a detailed diagnostic assessment of episodes of ventricular arrhythmia that occurred against the background of left ventricular diastolic dysfunction is recommended, since this clinic can be hidden myocardial ischemia, painless forms of angina pectoris, and right ventricular overload during the formation of cor pulmonale [1]. It is worth noting that with the development of arrhythmia, the clinical manifestations of respiratory failure also worsen, i.e., a syndrome of mutual overload is formed. Thus, the main morphological sign of ventricular tachycardia, the discreteness of the "P" wave with different P- P, P-R, RR intervals in leads I, II, III of the ECG, is mainly associated with the development and occurrence of respiratory failure. The prognosis for pulmonary tuberculosis with the development of this type of cardiac arrhythmia is considered unfavorable [10-12]. Studies of arrhythmia in patients with pulmonary tuberculosis are clearly insufficient - there are many unresolved problems, in particular, the role of secondary pulmonary hypertension has been practically not studied [14,17]. The role of drugs