Стратификация кардиоваскулярного риска у пациентов с хронической обструктивной болезнью легких
Д.В. Лапицкий
Государственное учреждение «432 Главный военный клинический медицинский центр Вооруженных сил Республики Беларусь», Минск, Беларусь
У лиц с хронической обструктивной болезнью легких (ХОБЛ) провести стратификацию кардиоваскулярного риска, оценку общего коморбидного фона, выяснить влияние нагрузочной десатурации на сердечно-сосудистую систему, и, основываясь на полученных данных, усовершенствовать подходы к выбору тактики ведения таких коморбидных пациентов, как пациенты с ХОБЛ.
ключевые слова: хроническая обструктивная болезнь легких, стратификация сердечно-сосудистого риска, коморбидный фон, нагрузочная десатурация
для цитирования: Д.В. Лапицкий. Стратификация кардиоваскулярого риска у пациентов с хронической обструктивной болезнью легких. Неотложная кардиология и кардиоваскулярные риски. 2018, Т. 2. № 2. С. 364-372
[1] Li V.V., Zadionchenko V.S., Adasheva T.V., Pavlov S.V., Shachray N.B. Chronicheskaya obstruktivnaya bolezn’ legkich i arterial’naya gipertoniya - metafizika i dialektika [Chronic obstructive pulmonary disease and arterial hypertension: metaphysics and dialectics]. KardioSomatika, 2013, № 1, pp. 5-1 0 (in Russian).
[2] Fabbri L.M., Ferrari R. Chronic disease in the elderly: back to the future of internal medicine. Breathe, 2006, vol. 3, № 1, pp. 40-49.
[3] Holguin F., Folch E., Redd S.C., Mannino D.M. Comorbidity and mortality in COPD-related hospitalizations in the United States, 1979 to 2001. Chest, 2005, vol. 128, № 4, pp. 2005-2011.
[4] Mullerova H., Agusti A., Erqou S., Mapel D.W. Cardiovascular Comorbidity in Chronic Obstructive Pulmonary Disease: Systematic Literature Review. Chest, 2013, vol. 144, № 10, pp. 1163-1176. doi: 10.1378/chest.12-2847.
[5] Finkelstein J., Cha E., Scharf S.M. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obstruct Pulmon Dis, 2009, vol. 4, pp. 337-349.
[6] Kawut S.M. COPD: Cardiopulmonary Disease? EurRespir J, 2013, vol. 41, № 6, pp. 1241-1243. doi: 10.1183/09031936.00009413.
[7] Klinicheskiy protocol diagnostic i lecheniya chronicheskoy obstruktivnoy bolezni legkich: prikaz M -vazdravoochraneniya Resp. Belarus’, 5 iyulya 2012 g. № 768 [Clinical Protocol for the diagnosis and treatm ent of chronic obstructive pulmonary disease: order of M-va health Rep. Belarus, July 5, 2012 № 768]. Available at: http://m inzdrav.gov.by/ru/static/ spavochnoinfirm/protocoly_lechenia/protokoly_2012. (accessed 28.11.2016). (in Russian).
[8] Manak N.A., Atroschenko E.S., Karpova I.S., Stel’mashok V.I. Diagnostika I lechenie stabil ’noy stenokardii. Nazional’nye rekomendazii [Diagnosis and treatment of stable angina pectoris. National recommendations]. Minsk, 2010, 86 p. (in Russian).
[9] Task F.M., Montalescot G., Sechtem U., Achenbach S., Andreotti F., Arden C., Budaj A., Bugiardini R., Crea F., Cuisset T., Di Mario C., Ferreira J.R., Gersh B.J., Gitt A.K., Hulot J.S., Marx N., Opie L.H., Pfisterer M. et al. ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J, 2013, vol. 34, № 38, pp. 2949-3003. doi: 10.1093/eurheartj/eht296.
[10] Belevskogo A.S. ed. Global’naya strategiya diagnostic, lecheniya I profilaktiki chronicheskoy obstruktivnoy bolezni legkich (peresmotr 2014 g.) [Global strategy for the diagnosis, treatment and prevention of chronic obstructive pulmonary disease (revision 2014)]. Moscow: Rossiyskoe respiratornoe obschestvo, 2015, 90 p. (in Russian).
[11] Mancia G., Fagard R., Narkiewicz К., Redon J., Zanchetti A., Bohm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., Galderisi M., Grobbee D.E., Jaarsma T., Kirchhof P., Kjeldsen S.E., Laurent S., Manolis A.J., Nilsson P.M., Ruilope L.M., Schmieder R.E., Sirnes P.A., Sleight P., Viigimaa M., Waeber B., Zannad F., Task F.M. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens, 2013, vol. 31, № 7, pp. 1281-1357.
[12] Charlson M.E., Pompei P., Ales K.L., MacKenzie C.R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis, 1987, vol. 40, № 5, pp. 373-383.
[13] Levey A.S., Stevens L.A., Schmid C.H., Zhang Y.L., Castro A.F., Feldman H. I., Kusek J.W., Eggers P., Van Lente F., Greene T., Coresh J. A new equation to estimate glomerular filtration rate. Ann Intern Med, 2009, vol. 150, № 9, pp. 604-612.
[14] Seino Y., Ogawa A., Yamashita T., Fukushima M., Ogata K., Fukumoto H., Takano T. Application of NT-proBNP and BNP measurements in cardiac care: a more discerning marker for the detection and evaluation of heart failure. Eur J Heart Fail, 2004, vol. 6, № 3, pp. 295-300.
[15] Lapitski D.V., Ryapilov A.N., Yermolkevich R.F., Metelski S.M., Manichev I. A., Scherbitski V.G., Mitkovskaya N.P. Vliyanie kislorodnogo statusa arterialnoy krovi na strukturnie I funktsionalnie harakteristiki kamer serdtsa i uroven‘ NT-proBNP u patsientov s hronicheskoy obstruktivnoy bolezn‘yu legkih [Influence of hypoxemia on structural and functional conditions of heart chambers and NT-proBNP level in patients suffering with chronic obstructive pulmonary disease]. Kardioiogiya vBelarusi 2016, № 3, pp. 354-365. (in Russian).
[16] ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med, 2002, vol. 166, № 1, pp. 111-117.
[17] Makarov L.M. Cholterovskoe monitorirovanie [Cholterovskoe monitorirova- nie]. Moscow: Medpraktika, 2011,456 p. (in Russian).
[18] Chalafyan A.A. Statistica 6. Matematicheskaya statistika s elementami teorii veroyatnostey[Statistica 6. Mathematical statistics with elements of probability theory]. Moscow: Binom, 2010, 496 p. (in Russian).
[19] Fedotova I.N., Belopolskiy A.A., Sturov N.V. Diagnosticheskaya znachimoct‘ NT-proBNP u kardiologocheskih bolnih [Diagnostic value of NT-proBNP in cardiac patients]. Trudniy patsient, 2013, № 7, pp. 32-35. (in Russian).
[20] Manak N.A., Solovey S.P. Mikrovaskuliarnaya stenokardiya [Microvascular angina pectoris]. Zdravoohraneniye, 2015, № 12, pp. 36-39. (in Russian).