Дифференциальная диагностика хронической сердечной недостаточности и хронической дыхательной недостаточности у пациентов с хронической обструктивной болезнью легких

2022 том 6, №2

Д.В. Лапицкий

Государственное учреждение «432 Главный военный клинический медицинский центр МО ВС Республики Беларусь»

Главной причиной смертности пациентов с хронической обструктивной болезнью легких (ХОБЛ) традиционно считалась хроническая дыхательная недостаточность (ХДН). Однако современные эпидемиологические исследования показали, что ведущими причинами, уносящими жизни пациентов с ХОБЛ, являются ишемическая болезнь сердца (ИБС) и хроническая сердечная недостаточность (ХСН).
Цель: изучить распространенность ХДН и ХСН у пациентов с ХОБЛ, определить информативность клинических симптомов в их диагностике, выработать алгоритм дифференциальной диагностики ХСН и ХДН.
Методы: объект исследования – 100 мужчин с ХОБЛ. Медиана возраста – 67 лет. Проведено клинико-лабораторное обследование. Синдром ХСН диагностирован по результатам ЭхоКГ и NT-proBNP. Синдром ХДН устанавливался по результатам нагрузочного тестирования с одновременным измерением насыщения гемоглобина артериальной крови кислородом.

ключевые слова: хроническая обструктивная болезнь легких, хроническая сердечная недостаточность, хроническая дыхательная недостаточность.

для цитирования: Д.В. Лапицкий. Дифференциальная диагностика хронической сердечной недостаточности и хронической дыхательной недостаточности у пациентов с хронической обструктивной болезнью легких. Неотложная кардиология и кардиоваскулярные риски, 2022, Т. 6, № 2, С. 1644–1660.

Differential diagnosis of chronic heart failure and chronic respiratory failure in patients with chronic obstructive pulmonary disease

D. Lapitski

Chronic respiratory failure (CRF) has traditionally been considered to be the main cause of death in patients with chronic obstructive pulmonary disease (COPD). However, modern epidemiological studies have shown that the leading causes of death in patients with COPD are CHD and chronic heart failure (CHF). Aim: to study the prevalence of CRF and CHF in patients with COPD, to determine the informative value of clinical symptoms in their diagnosis, to work out an algorithm of differential diagnosis of CRF and CHF. Methods: subjects – 100 men with COPD. The median age was 67 years. We performed clinical and laboratory examinations. COPD syndrome was diagnosed upon EchoCG and NT-proBNP results. CRF syndrome was diagnosed by the results of exercise testing with simultaneous measurement of arterial blood hemoglobin oxygen saturation.

keywords: chronic obstructive pulmonary disease, chronic heart failure, chronic respiratory failure.

for references: D. Lapitski, A. Ryapolov, V. Pupkevich, I. Dvorakovski, T. Chirikova, A. Goncharik, G. Ibragimova, N. Mitkovskaya. Differential diagnosis of chronic heart failure and chronic respiratory failure in patients with chronic obstructive pulmonary disease. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2022, vol. 6, no. 2, pp. 1644–1660.

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