urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.5.43GWMWIFurmj-1603Research ArticleОригинальные статьи | Original articlesOriginal articlesФункциональные нарушения легких у курящих больных с туберкулезом легкихFunctional Lung Disorders in Smoking Patients with Pulmonary Tuberculosishttps://orcid.org/0000-0001-8745-7940ЧумоватовН. В.ChumovatovN. V.

Никита Владимирович Чумоватов — кандидат медицинских наук, младший научный сотрудник отдела фтизиатрии

Москва

Nikita V. Chumovatov - Candidate of Sciences (Medicine), Junior Researcher of the Department of Phthisiology

Moscow

Necro5412@mail.ruhttps://orcid.org/0000-0001-6787-2362ЧерныхН. А.ChernyhN. A.

Наталья Александровна Черных — кандидат медицинских наук, старший научный сотрудник отдела фтизиатрии

Москва

Natalya A. Chernyh - Candidate of Sciences (Medicine), Senior Researcher of the Department of Phthisiology

Moscow

natadok@inbox.ruhttps://orcid.org/0000-0003-4427-3804КомиссароваО. Г.KomissarovaO. G.

Оксана Геннадьевна Комиссарова — доктор медицинских наук, доцент, заместитель директора по научной и лечебной работе; профессор кафедры фтизиатрии

Москва

Oksana G. Komissarova - Doctor of Sciences (Medicine), Associate Professor, Deputy Director for Scien‑ tific and Medical Work, Central Tuberculosis Research Institute; Professor of the Department of Phthisiology, N. I. Pirogov Russian National Research Medical University

Moscow

oksana.komissarova.72@mail.ruЦентральный научно‑исследовательский институт туберкулезаРоссияCentral Tuberculosis Research InstituteRussian FederationЦентральный научно‑исследовательский институт туберкулеза; Российский национальный исследовательский медицинский университет имени Н. И. ПироговаРоссияCentral Tuberculosis Research Institute; N. I. Pirogov Russian National Research Medical UniversityRussian Federation20241710202423543–51Copyright © Чумоватов Н.В., Черных Н.А., Комиссарова О.Г., 20242024Чумоватов Н.В., Черных Н.А., Комиссарова О.Г.Chumovatov N.V., Chernyh N.A., Komissarova O.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1603

Введение. Табакокурение широко распространено среди населения. Имеются доказательства, что эта привычка влияет на течение и эффективность лечения больных туберкулезом легких. При этом табакокурение и туберкулез являются значимыми факторами риска в развитии функциональных нарушений легких.Цель исследования — изучить характер изменений показателей спирометрии и особенности течения туберкулезного процесса у курящих больных туберкулезом легких.Материалы и методы. Проведено ретроспективное когортное исследование на базе Центрального научно-исследовательского института туберкулеза, в которое включено 102 больных туберкулезом легких. Пациенты разделены на две группы: 1 — курящие больные (47 человек), 2 — некурящие больные (55 человек).Результаты. Проведенное исследование демонстрирует некоторые различия в течении туберкулезного процесса среди курящих и некурящих больных. Показано, что среди первых достоверно чаще встречаются мужчины, тогда как среди вторых — женщины (p = 0,001). Среди курильщиков чаще встречаются двусторонние поражения легочной ткани по сравнению с некурящими. Особый интерес вызывает структура функциональных нарушений легких среди больных. Показано, что снижение объема форсированного выдоха за первую секунду (ОФВ1) крайне тяжелой степени достоверно чаще наблюдается среди курильщиков (p = 0,028). При этом легкая степень встречается чаще среди некурящих (p = 0,039).Обсуждение. Таким образом, важнейшей проблемой в проведении противотуберкулезного лечения среди курящих и некурящих больных являются нарушения функциональных показателей легких. В настоящее время существует необходимость поиска оптимальных подходов для предотвращения снижения функциональных показателей легких.Заключение. Показано, что снижение функциональных показателей легких наблюдается чаще среди курящих больных. Также среди курящих чаще наблюдается респираторная симптоматика по сравнению с некурящими. В структуре клинических форм заболевания среди некурящих чаще регистрируется инфильтративный туберкулез легких. Необходимо отметить, что среди курильщиков чаще встречаются двусторонние поражения легочной ткани.

Introduction. There is evidence that smoking affects the course and effectiveness of treatment of patients with pulmonary tuberculosis. At the same time, tobacco smoking and pulmonary tuberculosis are significant risk factors in the development of functional lung disorders.The purpose of the study to study the nature of changes in spirometry parameters and the peculiarities of the course of the tuberculosis process in smoking patients.Materials and methods. A retrospective cohort study, which included 102 patients with pulmonary tuberculosis. The patients were divided into two groups: 1 — smoking patients (47 people), 2 — non-smoking patients (55 people).Results. It is shown that men are significantly more common among the former, while women are more common among the latter (p = 0.001). Bilateral lung tissue lesions are more common among smokers compared to non-smokers. It is shown that a decrease in the volume of forced exhalation in the first second (OFV1) of an extremely severe degree is significantly more often observed among smokers (p = 0.028). At the same time, a mild degree is more common among non-smokers (p = 0.039).Discussion. Thus, the most important problem among smokers and non-smokers is a violation of the functional parameters of the lungs. Currently, there is a need to find optimal approaches to prevent a decrease in lung function. Conclusion. It has been shown that a decrease in lung function is observed more often among smoking patients. Also, respiratory symptoms and infiltrative pulmonary tuberculosis are more common among smokers compared to non-smokers.

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The authors declare that there are no conflicts of interest present.