pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2016-26-2-153-179pulmo-697Research ArticleКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИCLINICAL GUIDELINESХроническая обструктивная болезнь легких: профилактика обострений. Клинические рекомендации Американской коллегии торакальных врачей и Канадского торакального общества (часть 1 я)Therapeutic strategy to prevent acute exacerbations of chronic obstructive pulmonary disease: clinical guidelines of American College of Chest Physicians and Canadian Thoracic Society Guideline (Part 1)РедакционнаястатьяEditorialArticle201624062016262153179Copyright © Редакционная с., 20162016Редакционная с.Editorial a.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/697

Хроническая обструктивная болезнь легких (ХОБЛ) является одной из основных причин заболеваемости и летальности в США и в ми ре. Обострения ХОБЛ (периодическое усиление кашля, одышки и продукции мокроты) вносят серьезный вклад в снижение легочной функции, качества жизни, повышение потребности в неотложной помощи и госпитализациях, а также в стоимость лечения больных. В последние десятилетия выполнены исследования, по результатам которых существенно углубилось понимание патогенеза ХОБЛ и расширились терапевтические возможности. Накоплен также большой объем публикаций по предотвращению обострений ХОБЛ. Материалы и методы. Для разъяснения важности предотвращения обострений ХОБЛ Американской коллегией торакальных врачей (American College of Chest Physicians – CHEST) и Канадским торакальным обществом (Canadian Thoracic Society Guideline – CTS) раз работаны совместные Клинические рекомендации, в которых описан существующий сегодня подход к профилактике обострений ХОБЛ. Выделены 3 основных клинических проблемы профилактики обострений ХОБЛ на основе принципов PICO (Population, Intervention, Comparator, Outcome – Популяция, Вмешательства, Сравнение, Исходы) – немедикаментозное лечение, ингаляционная и пероральная терапия. Использована общепринятая система отбора соответствующих клинических исследований и оценки класса ре комендаций. Результаты. Особенность Клинических рекомендаций по профилактике обострений ХОБЛ заключается не только в их те матике, но также в том, что они стали первым результатом сотрудничества 2 крупных торакальных обществ Северной Америки. Наме рение Надзорного комитета по созданию клинических рекомендаций CHEST в сотрудничестве с Клинической ассамблеей по ХОБЛ CTS заключается в том, чтобы на основе систематического обзора и критической оценки опубликованной литературы, сделанных кли ническими экспертами и исследователями в области ХОБЛ, разработать клинические рекомендации с целью помочь клиницистам в ве дении пациентов с этим заболеванием. Заключение. В данных Рекомендациях содержится современный доказательный анализ опубли кованных результатов рандомизированных контролируемых исследований по профилактике обострений ХОБЛ. 

Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide. An acute exacerbation of COPD great ly contributes to worsening lung function, impairment in quality of life, need for urgent care, and use of medical utilities. Last decade, our under standing of the pathogenesis and treatment of COPD has significantly improved. The guideline accumulated recent information about the prevention of acute exacerbations of COPD. Methods. The American College of Chest Physicians and Canadian Thoracic Society developed evidence based guideline to describe the current knowledge on the prevention of acute exacerbations in a clinically useful manner. The PICO approach (population, intervention, comparator, and outcome) was used which involved nonpharmacologic therapies, inhaled therapies, and oral therapies. To select the most appropriate studies, to extract evidence based data and to grade the level of evidence, evidence based document assessment tools were applied. Results. The guideline was designed as a systematic review and critical evaluation of the published literature by clinical experts and researchers in the field of COPD and recommendations were developed to help clinicians in their management of the patient with COPD. Conclusion. This guideline provides an up to date, rigorous, evidence based analysis of current randomized controlled trials on the prevention of COPD exacerbations. 

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