Идиопатический легочный фиброз: новые международные клинические рекомендации
https://doi.org/10.18093/0869-0189-2019-29-5-525-552
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. АвдеевРоссия
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
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
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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Рецензия
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.Yu., Nagatkina O.V. Idiopathic pulmonary fibrosis: a new international clinical guideline. PULMONOLOGIYA. 2019;29(5):525-552. (In Russ.) https://doi.org/10.18093/0869-0189-2019-29-5-525-552