pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2024-34-1-115-120pulmo-4469Research ArticleОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯHEALTHCARE MANAGEMENTЭффективность раннего назначения антифибротической терапии как отражение правильной организации медицинской помощи пациентам с прогрессирующим легочным фиброзомThe effectiveness of early administration of antifibrotic therapy as a reflection of properly organized medical care for patients with progressive pulmonary fibrosishttps://orcid.org/0000-0002-0877-6554ИгнатоваГ. Л.IgnatovaG. L.

Игнатова Галина Львовна – д. м. н., профессор, заведующая кафедрой терапии Института дополнительного профессионального образования, директор Института пульмонологии

454092, Челябинск, Воровского, 64

Galina L. Ignatova, Doctor of Medicine, Professor, Head of the Departmentof Therapy, Institute of Additional Professional Education, Director of theInstitute of Pulmonology

ul. Vorovskogo 64, Chelyabinsk, 454092

iglign@mail.ruhttps://orcid.org/0000-0002-3531-3491АнтоновВ. Н.AntonovV. N.

Антонов Владимир Николаевич – д. м. н., профессор кафедры терапии Института дополнительного профессионального образования, главный научный сотрудник Института пульмонологии

454092, Челябинск, Воровского, 64

Vladimir N. Antonov, Doctor of Medicine, Professor, Department of Therapy, Institute of Additional Professional Education, Chief Researcher, Institute of Pulmonology

ul. Vorovskogo 64, Chelyabinsk, 454092

ant-vn@yandex.ruhttps://orcid.org/0000-0003-2507-5941БлиноваЕ. В.BlinovaE. V.

Блинова Елена Владимировна – к. м. н., доцент кафедры терапии Института дополнительного профессионального образования, ведущийнаучный сотрудник Института пульмонологии

454092, Челябинск, Воровского, 64

Elena V. Blinova, Candidate of Medicine, Associate Professor, Department of Therapy, Institute of Additional Professional Education; Leading Researcher, Institute of Pulmonology

ul. Vorovskogo 64, Chelyabinsk, 454092

blinel@mail.ruhttps://orcid.org/0000-0003-2295-609XБельснерМ. С.BelsnerM. S.

Бельснер Мария Сергеевна – к. м. н., доцент кафедры терапии Института дополнительного профессионального образования, научный сотрудник Института пульмонологии

454092, Челябинск, Воровского, 64

Mariya S. Belsner, Candidate of Medicine, Associate Professor, Department of Therapy, Institute of Additional Professional Education, Researcher, Institute of Pulmonology

ul. Vorovskogo 64, Chelyabinsk, 454092

mariika_04@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Южно-Уральский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “South-Ural State Medical University” of the Ministry of Healthcare of the Russian FederationRussian Federation202426012024341115120Copyright © Игнатова Г.Л., Антонов В.Н., Блинова Е.В., Бельснер М.С., 20242024Игнатова Г.Л., Антонов В.Н., Блинова Е.В., Бельснер М.С.Ignatova G.L., Antonov V.N., Blinova E.V., Belsner M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/4469

Вопросы организации медицинской помощи и раннего назначения антифибротической терапии (АФТ) пациентам с прогрессирующим фибротическим фенотипом (ПФФ) требуют углубленного изучения и внедрения в реальную клиническую практику.

Целью работы явилось обоснование целесообразности раннего назначения антифибротических препаратов пациентам с различными формами интерстициальных заболеваний легких (ИЗЛ).

Результаты

Результаты. Рассмотрены организационные вопросы оказания медицинской помощи пациентам с ПФФ ИЗЛ. Также затронуты актуальные эпидемиологические проблемы, в частности, высокая смертность при данном заболевании и основные факторы риска. Проанализированы диагностические маркеры прогрессирования фиброза. Приводятся данные масштабных исследований о раннем назначении АФТ и ее влиянии на исходы заболевания.

Заключение

Заключение. Обоснованы основные факторы раннего начала АФТ при наличии ПФФ: неблагоприятный прогноз, непредсказуемый характер течения, прогрессирующее снижение форсированной жизненной емкости легких (ФЖЕЛ), связь изменения ФЖЕЛ с увеличением смертности. Рассмотрена модель оказания помощи пациентам с ИЗЛ на примере Челябинской области, представлены краткие результаты анализа эффективности АФТ, ее раннего назначения и влияния на смертность пациентов с данной нозологией.

The issues of organization of medical care and early administration of antifibrotic therapy in patients with progressive fibrotic phenotype require in-depth study and implementation in real clinical practice.

The aim of this paper is to provide a rationale for the early administration of antifibrotic drugs in patients with various forms of interstitial lung disease.

Results

Results. The article addresses organizational issues in the medical care for interstitial lung disease with a progressive fibrotic phenotype. Topical epidemiological problems are also addressed, in particular the high mortality rate in this disease. The main risk factors of the disease are considered. Diagnostic markers for the fibrosis progression are analyzed. Data from large-scale studies on the early initiation of antifibrotic therapy and its effect on disease outcomes are presented.

Conclusion

Conclusion. The main reasons for early initiation of therapy in a progressive fibrotic phenotype are presented: an unfavorable prognosis, an unpredictable course, a progressive decrease in forced vital capacity, and the association of changes in FVC with an increase in mortality. Using the Chelyabinsk region as an example, a model of care for patients with interstitial lung diseases is considered, with a brief analysis of the effectiveness of antifibrotic therapy, its early initiation and the impact on mortality in patients with this disease.

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