Сочетание туберкулёза лёгких и бронхообструктивной патологии остаётся серьёзной клинической проблемой, поскольку значительная часть пациентов после завершения противотуберкулёзной терапии сохраняет стойкие структурные и функциональные нарушения дыхательной системы. Целью настоящего обзорного исследования является систематизация современных научных данных о распространённости посттуберкулёзной бронхообструкции, особенностях её патогенеза, факторах риска, диагностических подходах и возможностях терапевтической коррекции. Материалы исследования были отобраны путём анализа научных публикаций, индексированных в базах данных PubMed, Scopus, Web of Science и Google Scholar за период с января 2019 года по октябрь 2025 года. В ходе первичного поиска было выявлено 420 источников, из которых после последовательного отбора по критериям методологической обоснованности, полноты представленных данных и наличия объективной оценки функции дыхания в анализ включено 40 публикаций, отражённых в списке литературы. Анализ показал, что формирование бронхообструктивной патологии после перенесённого туберкулёза обусловлено сочетанием хронического воспаления, ремоделирования бронхиального дерева, фиброзных изменений лёгочной ткани и сохранения остаточных структурных повреждений. Установлено, что выраженность функциональных нарушений усугубляется наличием модифицируемых факторов риска, включая курение, метаболические нарушения и воздействие продуктов сгорания биомассы. Также отмечена клиническая значимость раннего выявления нарушений дыхательной функции и применения комплексного подхода к лечению и реабилитации пациентов. Таким образом, посттуберкулёзные изменения дыхательной системы должны рассматриваться как самостоятельная клиническая категория, требующая стандартизированных диагностических и терапевтических стратегий.
The combination of pulmonary tuberculosis and bronchial obstructive pathology remains a serious clinical issue, as a substantial proportion of patients continue to experience persistent structural and functional respiratory impairments even after completion of anti-tuberculosis therapy. The aim of this review is to systematize current scientific data on the prevalence of post-tuberculosis bronchial obstruction, its pathogenetic mechanisms, associated risk factors, diagnostic approaches, and therapeutic options. The materials for the review were selected through analysis of scientific publications indexed in the PubMed, Scopus, Web of Science, and Google Scholar databases covering the period from January 2019 to October 2025. The initial search yielded 420 sources, of which 40 publications were included in the final analysis after sequential selection based on methodological reliability, completeness of data, and availability of objective respiratory function assessment. The analysis demonstrated that the development of bronchial obstructive pathology after tuberculosis is associated with chronic inflammation, bronchial remodeling, fibrotic changes of lung tissue, and persistent residual structural damage. The severity of functional impairment was shown to increase in the presence of modifiable risk factors such as smoking, metabolic disorders, and exposure to biomass combustion products. The review highlights the importance of early detection of respiratory dysfunction and the implementation of comprehensive therapeutic and rehabilitation strategies. Therefore, post-tuberculosis respiratory changes should be regarded as a distinct clinical entity requiring standardized diagnostic and therapeutic approaches.
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