Ингаляционные провокационные тесты для диагностики профессиональной бронхиальной астмы: рекомендации Европейского респираторного общества
https://doi.org/10.18093/0869-0189-2015-25-1-19-31
Аннотация
В данном документе содержатся клинические рекомендации по проведению ингаляционных тестов для диагностики профессиональной бронхиальной астмы (ПБА). Представленные Рекомендации разработаны на основе систематического обзора литературы, исследований, проводившихся в крупных медицинских центрах Европы, материалов конференций и мнений экспертов. В статье подробно описана пошаговая процедура выполнения специфических ингаляционных провокационных тестов (СИПТ), в т. ч. требования безопасности, способы ингаляционной доставки провоцирующего вещества и методы оценки результатов. Также обсуждаются недостатки этой процедуры. Ингаляционные провокационные тесты должны выполняться только в условиях медицинских учреждений, где имеется опыт подобного тестирования. В тестах также должны использоваться контрольные провокационные вещества, доза провоцирующего вещества должна повышаться постепенно при тщательном наблюдении пациента во время исследования и как минимум в течение 6 ч после его окончания. При соблюдении всех требований побочные эффекты СИПТ встречаются редко. Положительным результатом теста считается снижение объема форсированного выдоха за 1-ю секунду на #> 15 %исх. Иногда положительный результат может объясняться неспецифической бронхиальной гиперреактивностью, эозинофилией мокроты или повышением содержания оксида азота в выдыхаемом воздухе. Ингаляционные провокационные тесты обладают высокой чувствительностью и специфичностью, поэтому считаются решающим методом диагностики ПБА.
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Рецензия
Для цитирования:
Ингаляционные провокационные тесты для диагностики профессиональной бронхиальной астмы: рекомендации Европейского респираторного общества. Пульмонология. 2015;25(1):19-31. https://doi.org/10.18093/0869-0189-2015-25-1-19-31
For citation:
Challenge inhalation tests in the diagnosis of occupational asthma: the guidelines of European Respiratory Society. PULMONOLOGIYA. 2015;25(1):19-31. (In Russ.) https://doi.org/10.18093/0869-0189-2015-25-1-19-31
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