PATHOMORPHOSIS OF CLINICAL, RADIOLOGIC AND BRONCHOSCOPIC SIGNS OF BRONCHIAL TREE INFLAMMATION IN PULMONARY TUBERCULOSIS COMBINED WITH CHRONIC BRONCHITIS

Aim - to examine the features of pre-clinical manifestations and clinical course of non-specific inflammation in destructive pulmonary tuberculosis. Material and Methods. The study involved 300 patients with destructive pulmonary tuberculosis at the age of 15 to 78 years. Among these 93 (31.0%) patients with tuberculosis combined with chronic bronchitis were selected; these formed the first study group. The second study group included 207 (69.0%), pulmonary tuberculosis patients without chronic bronchitis. Clinical laboratory, radiological and bronchoscopic methods were used in the study. Results and Discussion. Analysis of the examination of the newly diagnosed patients with destructive tuberculosis using clinical, laboratory, radiological and bronchoscopic methods found a high proportion of chronic bronchitis occurring prior tothe development of specific inflammation. The results of endoscopic studies revealed that, in destructive pulmonary tuberculosis,the type of endobronchial changes depended on the duration and prevalence of specific inflammation and had two course variants: a nonspecific diffuse inflammation of the bronchial tubes as a result of the manifestation of chronic bronchitis, and the so-called "paraspecific" endobronchitis, a result of toxico-allergic impact of tuberculosis. Conclusions. In destructive pulmonary tuberculosis two variants of endobronchitis are seen: the nonspecific chronic bronchitis existing before the development of tuberculous inflammation, an independent nosological form; the socalled reactive " paraspecific" endobronchitis caused by tuberculosis intoxication, irritant and allergic influence of mucus secreted from the cavity of decay. Key words: tuberculosis, chronic bronchitis, clinical, radiographic and endoscopic study