pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2016-26-5-604-609pulmo-769Research ArticleОБЗОРЫREVIEWМАКСИМАЛЬНАЯ БРОНХОДИЛАТАЦИЯ СО СТАРТА ТЕРАПИИ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ: ВЛИЯНИЕ НА ТЕЧЕНИЕ ЗАБОЛЕВАНИЯMAXIMAL BRONCHODILATION WITH STARTING THERAPY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: AN INFLUENCE ON THE COURSE OF THE DISEASEАвдеевС. Н.AvdeevS. N.

д. м. н., профессор, член-корр. РАН, руководитель клинического отдела

serg_avdeev@list.ruАйсановЗ. Р.AisanovZ. R.

д. м. н., профессор, заведующий отделом клинической физиологии и клинических исследований

aisanov@mail.ruФГБУ «НИИ пульмонологии» ФМБА России: 105077, Россия, Москва, ул. 11-я Парковая, 32, корп. 4РоссияFederal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia: 32, build. 4, 11th Parkovaya str., Moscow, 105077, RussiaRussian Federation201620122016265604609Copyright © Авдеев С.Н., Айсанов З.Р., 20162016Авдеев С.Н., Айсанов З.Р.Avdeev S.N., Aisanov Z.R.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/769

Прогрессирующее экспираторное ограничение воздушного потока – кардинальный признак хронической обструктивной болезни легких (ХОБЛ), следствием которого является гиперинфляция легких, приводящая к прогрессирующей одышке в ответ на физическую нагрузку, уменьшению повседневной физической активности, детренированности и существенному снижению качества жизни (КЖ). Этот феномен имеет клиническое значение уже на ранних стадиях ХОБЛ. Современная терапия с использованием комбинаций длительно действующих бронходилататоров, в частности с применением фиксированной комбинации тиотропий / олодатерол, благодаря уменьшению бронхиальной обструкции и легочной гиперинфляции позволяет добиться значимых результатов в отношении клинического улучшения, прерывания порочного круга в развитии и прогрессировании диспноэ, ограничения активности, усугубления детренированности, снижения КЖ. Представляется логичным, что при раннем прерывании данного порочного круга существенно улучшится клинический исход. В связи с этим назначение эффективной терапии комбинацией длительно действующих бронходилататоров уже на ранних стадиях болезни является наиболее перспективным подходом.

Progressive airflow limitation is a principal sign of chronic obstructive pulmonary disease (COPD) which leads to pulmonary hyperinflation, progressive exertional breathlessness, reducing physical activity in daily life, deconditioning and significant decrease in quality of life. This phenomenon is noted in early stage of COPD. The earliest disruption of this 'vicious circle' is thought to result in better clinical outcome. Current combined bronchodilator therapy, such as a fixed combination of tiotropium/olodaterol, can significantly improve clinical status, dyspnea, physical limitation, deconditioning and quality of life of the patients due to improvement in bronchial obstruction and pulmonary hyperinflation. Therefore, the most promising approach today and in the nearest future is to start the optimal combined dual bronchodilator therapy at earlier stage of the disease.

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