ПРОФИЛАКТИКА ОБОСТРЕНИЙ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ


https://doi.org/10.18093/0869-0189-2016-26-5-591-603

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Аннотация

Характерной чертой течения хронической обструктивной болезни легких (ХОБЛ) является развитие обострений. Обострение ХОБЛ является одной из самых частых причин обращения больных за неотложной медицинской помощью. Частое развитие обострений у больных ХОБЛ приводит к длительному (до нескольких недель) ухудшению показателей функции дыхания и газообмена, более быстрому прогрессированию заболевания, значимому снижению качества жизни больных и сопряжено с существенными экономическими расходами на лечение. С помощью современной терапии возможно значительно снизить риск развития обострений ХОБЛ. Влияние поддерживающей терапии на обострения зависит от разных факторов, таких так причины обострений (например, инфекции, спонтанное усиление воспаления, бронхоспазм и т. п.), тяжести заболевания (обычно снижение риска обострений на фоне терапии более выражено у тяжелых пациентов), фенотипа ХОБЛ и т. п. Необходимо подчеркнуть, что результаты исследований по снижению риска обострений также зависят от многих факторов: популяции пациентов, включенных в исследование; количества обострений у них до включения в исследование; определения обострений; длительности исследования и т. д. Эффективность различных методов терапии по снижению риска обострений в разных исследованиях составляет от 15 до 50 %, хотя ни один из методов сегодня не позволяет полностью избавить пациента с ХОБЛ от обострений. Условно все виды терапии, направленные на снижение риска обострений, можно разделить на фармакологические и нефармакологические. Для улучшения качества ведения пациентов с ХОБЛ необходим поиск более целенаправленных (или таргетных) фармакологических способов профилактики обострений, даже с учетом уже доступных препаратов.


Об авторе

С. Н. Авдеев
ФГБУ «НИИ пульмонологии» ФМБА России: 105077, Россия, Москва, ул. 11-я Парковая, 32, корп. 4
Россия
д. м. н., профессор, член-корр. РАН, руководитель клинического отдела


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Для цитирования: Авдеев С.Н. ПРОФИЛАКТИКА ОБОСТРЕНИЙ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ.  Пульмонология. 2016;26(5):591-603. https://doi.org/10.18093/0869-0189-2016-26-5-591-603

For citation: Avdeev S.N. PREVENTION OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Russian Pulmonology. 2016;26(5):591-603. (In Russ.) https://doi.org/10.18093/0869-0189-2016-26-5-591-603

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