Статья посвящена проблеме организации кардиореабилитации в Российской Федерации. Представлены результаты клинических исследований и метаанализов, оценивающих клиническую эффективность кардиореабилитации. Обозначены преимущества кардиореабилитации, как клинические, так и экономические. Проанализирована проблема медленных темпов организации инфраструктуры кардиореабилитации в стране.
The article is devoted to the problem of organizing cardio rehabilitation in the Russian Federation. The results of clinical studies and meta-analyzes assessing the clinical effectiveness of cardiac rehabilitation are presented. The advantages of cardiac rehabilitation, both clinical and economic, are indicated. The problems of slow pace of organization of the cardio rehabilitation infrastructure in the country are analyzed.
1. Pack OR, Goel K, Lahr BD et al. Participation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community-based study. Circulation 2013; 128 (6): 590–7.
2. Бубнова М.Г., Аронов Д.М., Бойцов С.А. и др. Организация кардиореабилитации в России. Результаты пилотного проекта «Развитие системы реабилитации больных с сердечно-сосудистыми заболеваниями в лечебных учреждениях субъектов Российской Федерации». CardioСоматика. 2016; 7 (3–4): 72–81. / Bubnova M.G., Aronov D.M., Boytsov S.A. et al. Cardiorehabilitation organization in Russia. The results of the pilot project "Development of the system of rehabilitation of patients with cardiovascular diseases in medical institutions of the Russian Federation". Cardiosomatics. 2016; 7 (3–4): 72–81. [in Russian]
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5. Аронов Д.М., Бубнова М.Г., Барбараш О.Л. и др. Острый инфаркт миокарда с подъемом сегмента ST электрокардиограммы: реабилитация и вторичная профилактика. CardioСоматика. 2014; 1 (Прил.). / Aronov D.M., Bubnova M.G., Barbarash O.L. i dr. Ostryi infarkt miokarda s pod"emom segmenta ST elektrokardiogrammy: reabilitatsiia i vtorichnaia profilaktika. Cardiosomatics. 2014; 1 (Suppl.). [in Russian]
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8. Аронов Д.М., Красницкий В.Б., Бубнова М.Г. и др. Влияние физических тренировок на физическую работоспособность, гемодинамику, липиды крови, клиническое течение и прогноз у больных ишемической болезнью сердца после острых коронарных событий при комплексной реабилитации и вторичной профилактике на амбулаторно-поликлиническом этапе (Российское кооперативное исследование). Кардиология. 2009; 3: 49–56. / Aronov D.M., Krasnitskii V.B., Bubnova M.G. i dr. Vliianie fizicheskikh trenirovok na fizicheskuiu rabotosposobnost', gemodinamiku, lipidy krovi, klinicheskoe techenie i prognoz u bol'nykh ishemicheskoi bolezn'iu serdtsa posle ostrykh koronarnykh sobytii pri kompleksnoi reabilitatsii i vtorichnoi profilaktike na ambulatorno-poliklinicheskom etape (Rossiiskoe kooperativnoe issledovanie). Kardiologiia. 2009; 3: 49–56. [in Russian]
9. Piepoli MF, Davos C, Francis DP, Coats AJ; ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004; 328 (7433): 189.
10. Massinger-Rapport BJ, Sprecher D. Prevention of cardiovascular diseases. Coronary artery disease, congestive heart failure, and stroke. Clin Geriatr Med 2002; 18 (3): 463–83.
11. Goel K, Lennon RJ, Tibury RT et al. rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community. Circulation 2011; 123 (21): 2344–52.
12. Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation 2010; 121 (1): 63–70.
13. Schuler G, Hambrecht R, Schliert G et al. Regular physical exercise and low-fat diet. Effects on progression of coronary artery disease. Circulation 1992; 86 (1): 1–11.
14. Hambrecht R, Walther C, Mobius-Winkler S et al. Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial. Circulation 2004; 109: 1371–8.
15. Hippisly-Cox J, Coupland C. Effect of combinated of drugs on all-cause mortality: nested case-control analysis. BMJ 2005; 330: 1059–63.
16. Приказ Министерства экономического развития РФ, Министерства здравоохранения и социального развития РФ, Минфина РФ и Федеральной службы государственной статистики от 10 апреля 2012 г. №192/ 323н/45н/113 «Об утверждении Методологии расчета экономических потерь от смертности, заболеваемости и инвалидизации населения». / Prikaz Ministerstva ekonomicheskogo razvitiia RF, Ministerstva zdravookhraneniia i sotsial'nogo razvitiia RF, Minfina RF i Federal'noi sluzhby gosudarstvennoi statistiki ot 10 aprelia 2012 g. №192/323n/ 45n/113 "Ob utverzhdenii Metodologii rascheta ekonomicheskikh poter' ot smertnosti, zabolevaemosti i invalidizatsii naseleniia". [in Russian]
17. World Health Organization. Making choices in health: WHO guide to cost-effectiveness analysis. Ed. by T.Tan-Torres Edejer et al. 2003. http://www.who.int/choice/publications/p_2003_generalised_cea.pdf
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1. Pack OR, Goel K, Lahr BD et al. Participation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community-based study. Circulation 2013; 128 (6): 590–7.
2. Bubnova M.G., Aronov D.M., Boytsov S.A. et al. Cardiorehabilitation organization in Russia. The results of the pilot project "Development of the system of rehabilitation of patients with cardiovascular diseases in medical institutions of the Russian Federation". Cardiosomatics. 2016; 7 (3–4): 72–81. [in Russian]
3. Martsevich S.Iu., Ginzburg M.L., Kutishenko N.P. i dr. Liuberetskoe issledovanie smertnosti (issledovanie LIS): faktory, vliiaiushchie na otdalennyi prognoz zhizni posle perenesennogo infarkta miokarda. Profilakticheskaia meditsina. 2013; 2: 32–8. [in Russian]
4. Bokeriya L.A., Aronov D.M., Barbarash O.L. et al. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics. 2016; 7 (3–4): 5–71. [in Russian]
5. Aronov D.M., Bubnova M.G., Barbarash O.L. i dr. Ostryi infarkt miokarda s pod"emom segmenta ST elektrokardiogrammy: reabilitatsiia i vtorichnaia profilaktika. Cardiosomatics. 2014; 1 (Suppl.). [in Russian]
6. Taylor RS, Brown A, Ebrahim S et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116 (10): 682–92.
7. Martin BJ, Hauer T, Arena R et al. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation 2012; 126 (6): 677–87.
8. Aronov D.M., Krasnitskii V.B., Bubnova M.G. i dr. Vliianie fizicheskikh trenirovok na fizicheskuiu rabotosposobnost', gemodinamiku, lipidy krovi, klinicheskoe techenie i prognoz u bol'nykh ishemicheskoi bolezn'iu serdtsa posle ostrykh koronarnykh sobytii pri kompleksnoi reabilitatsii i vtorichnoi profilaktike na ambulatorno-poliklinicheskom etape (Rossiiskoe kooperativnoe issledovanie). Kardiologiia. 2009; 3: 49–56. [in Russian]
9. Piepoli MF, Davos C, Francis DP, Coats AJ; ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004; 328 (7433): 189.
10. Massinger-Rapport BJ, Sprecher D. Prevention of cardiovascular diseases. Coronary artery disease, congestive heart failure, and stroke. Clin Geriatr Med 2002; 18 (3): 463–83.
11. Goel K, Lennon RJ, Tibury RT et al. rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community. Circulation 2011; 123 (21): 2344–52.
12. Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation 2010; 121 (1): 63–70.
13. Schuler G, Hambrecht R, Schliert G et al. Regular physical exercise and low-fat diet. Effects on progression of coronary artery disease. Circulation 1992; 86 (1): 1–11.
14. Hambrecht R, Walther C, Mobius-Winkler S et al. Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial. Circulation 2004; 109: 1371–8.
15. Hippisly-Cox J, Coupland C. Effect of combinated of drugs on all-cause mortality: nested case-control analysis. BMJ 2005; 330: 1059–63.
16. Prikaz Ministerstva ekonomicheskogo razvitiia RF, Ministerstva zdravookhraneniia i sotsial'nogo razvitiia RF, Minfina RF i Federal'noi sluzhby gosudarstvennoi statistiki ot 10 aprelia 2012 g. №192/323n/ 45n/113 "Ob utverzhdenii Metodologii rascheta ekonomicheskikh poter' ot smertnosti, zabolevaemosti i invalidizatsii naseleniia". [in Russian]
17. World Health Organization. Making choices in health: WHO guide to cost-effectiveness analysis. Ed. by T.Tan-Torres Edejer et al. 2003. http://www.who.int/choice/publications/p_2003_generalised_cea.pdf
Авторы
Д.М.Аронов*1, Л.В.Козлова2, М.Г.Бубнова1
1 ФГБУ «Национальный медицинский исследовательский центр профилактической медицины» Минздрава России. 101990, Россия, Москва, Петроверигский пер., д. 10, стр. 3;
2 Совет Федерации Федерального Собрания Российской Федерации. 103426, Россия, Москва, ул. Большая Дмитровка, д. 26 *aronovdm@mail.ru
________________________________________________
D.M.Aronov*1, L.V.Kozlova2, M.G.Bubnova1
1 State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation. 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3;
2 The Council of the Federation of the Federal Assembly of the Russian Federation. 103426, Russian Federation, Moscow, ul. Bolshaya Dmitrovka, d. 26 *aronovdm@mail.ru