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Идиопатический легочный фиброз: новые международные клинические рекомендации

https://doi.org/10.18093/0869-0189-2019-29-5-525-552

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Аннотация

Данныеклиническиерекомендацииподиагностикеидиопатическоголегочногофиброза (ИЛФ)  явилисьрезультатомсовместной  работыАмериканскоготоракального (American Thoracic Society – ATS), Европейскогореспираторного (European Respiratory Society – ERS), Японскогореспираторного (Japanese Respiratory Society – JRS) иЛатиноамериканскоготоракального (Latin American Thoracic Society – ALAT) обществ.  Методы. Экспертами многопрофильного комитета  по ИЛФ  обсуждена  доказательная база и сформулированы рекомендации. Проанализированные  доказательства   и  рекомендации  сформулированы,  написаны  и  оценены   по  системе  GRADE.   Результаты. Экспертами Рабочей группы обновлены  диагностические критерии  ИЛФ.  Ранее описанные паттерны  обычной  интерстициальной пневмонии  (ОИП) уточнены и обозначены как паттерны  ОИП, вероятной ОИП, неопределенный и альтернативный диагнозы.  Для больных с впервые выявленным интерстициальным заболеванием легких (ИЗЛ) с паттернами  вероятной ОИП, неопределенного или альтернативного диагнозов  по данным компьютерной томографии легких высокого разрешения (КТВР)  разработана условная рекомендация выполнения бронхоальвеолярного лаважа (БАЛ) и хирургической биопсии  легких. Рекомендации «за» или «против» выполнения трансбронхиальной биопсии  (ТББЛ)  или криобиопсии (КБЛ) легких не разработаны по причине  недостаточности доказательств. Напротив, для больных с впервые выявленным ИЗЛ и паттерном ОИП по данным КТВР выработана сильная рекомендация НЕ выполнять хирургическую биопсию, ТББЛ и КБЛ; выработана условная рекомендация против использования БАЛ. Дополнительные рекомендации включают условную рекомендацию по многопрофильному обсуждению и сильную рекомендацию против измерения сывороточных биомаркеров с целью дифференциации ИЛФ от других ИЗЛ. Заключение. Экспертами Рабочей группы разработаны рекомендации по диагностике ИЛФ.

Об авторах

С. Н. Авдеев
Первый Московский государственный медицинский университет имени И.М.Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Научно-исследовательский институт пульмонологии Федерального медико-биологического агентства
Россия

Авдеев Сергей Николаевич – доктор медицинских наук, член-корреспондент Российской академии наук, профессор, заведующий кафедрой пульмонологии Первого МГМУ им.И.М.Сеченова (Сеченовский Университет); руководитель  клинического отдела НИИ пульмонологии ФМБА.

119991,  Москва,  ул. Трубецкая, 8, стр. 2; 115682,  Москва,  Ореховый бульвар, 28.

тел.: (495) 708-35-76



С. Ю. Чикина
Первый Московский государственный медицинский университет имени И.М.Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)
Россия

Чикина Светлана Юрьевна – кандидат медицинских наук, ассистент  кафедры пульмонологии.

119991,  Москва,  ул. Трубецкая, 8, стр. 2.

тел.: (916) 116-04-03



О. В. Нагаткина
Самарская областная клиническая больница им. В.Д.Середавина
Россия

Нагаткина Ольга Владимировна – кандидат медицинских наук, врач-пульмонолог I категории.

443095,  Самара, ул. Ташкентская, 159.

тел.: (846) 956-23-61



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Для цитирования:


Авдеев С.Н., Чикина С.Ю., Нагаткина О.В. Идиопатический легочный фиброз: новые международные клинические рекомендации.  Пульмонология. 2019;29(5):525-552. https://doi.org/10.18093/0869-0189-2019-29-5-525-552

For citation:


Avdeev S.N., Chikina S.Y., Nagatkina O.V. Idiopathic pulmonary fibrosis: a new international clinical guideline. Russian Pulmonology. 2019;29(5):525-552. (In Russ.) https://doi.org/10.18093/0869-0189-2019-29-5-525-552

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