Нужна ли спирометрия при сердечно-сосудистых заболеваниях? - Журнал Системные Гипертензии Том 10, №2

Нужна ли спирометрия при сердечно-сосудистых заболеваниях?

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Аннотация

В последние десятилетия происходит неуклонный рост распространенности сердечно-сосудистых (ССЗ) и бронхообструктивных заболеваний во всем мире, что привело к высокой частоте встречаемости пациентов с сочетанной патологией, в первую очередь артериальной гипертонией и хронической обструктивной болезнью легких (ХОБЛ) и/или бронхиальной астмой (БА). Рост числа пациентов с этой патологией обусловлен как повышением заболеваемости артериальной гипертонией, ХОБЛ и БА, так и увеличением гериатрической популяции больных, у которых эти заболевания весьма распространены. В эпидемиологических исследованиях показано, что ухудшение функции легких является столь же сильным предиктором сердечно-сосудистой летальности, как и основные сердечно-сосудистые факторы риска. Однако спирометрия у пациентов с ССЗ проводится недостаточно. Недостаточная диагностика ХОБЛ и БА, особенно у пациентов с ССЗ, отрицательно влияет на клиническое течение обоих заболеваний, приводит к неадекватному лечению и ухудшению прогноза для пациента. Необходимость широкого скринингового проведения спирометрии всем пациентам с ССЗ пока не доказана. Отсутствуют референсные значения спирометрических показателей у пациентов с ССЗ, что делает практически невозможным их использование при стратификации сердечно-сосудистого риска. Это диктует необходимость проведения дальнейших исследований, позволяющих уточнить взаимосвязь между тяжестью, особенностями течения разных ССЗ и различными спирометрическими показателями.

Ключевые слова: спирометрия, сердечно-сосудистые заболевания, хроническая обструктивная болезнь легких, бронхиальная астма.

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In recent decades cardiovascular (CVD) and COPD diseases are widespread around the world, leading to a high prevalence of patients with comorbidity, especially arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) and/or bronchial asthma (BA). The growing number of patients with this comorbidity is due to increased hypertension, COPD, and asthma comorbidities, with the increase of the geriatric population of patients with these pathologies. Epidemiological studies have shown that the deterioration of lung function is as strong a predictor of cardiovascular mortality, as well as major cardiovascular risk factors. However, spirometry in patients with CVD is carried out infrequently. Inadequate spirometric diagnostics of COPD and asthma, especially in patients with cardiovascular disease, affects the clinical course of both diseases, leading to inappropriate treatment and poor prognosis for the patient. The need for extensive screening spirometry in all patients with CVD is not proven. Thera are no spirometry reference values in patients with CVD, which makes it almost impossible to use these parameters in stratification of CV risk. This dictates the need for further research to clarify the relationship between the severity and characteristics of the various CVD and spirometric parameters.

Key words: spirometry, cardiovascular disease, chronic obstructive pulmonary disease, bronchial asthma.

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Авторы

Б.М.Назаров1, К.А.Зыков2, Л.Г.Ратова1, О.Ю.Агапова2, Ю.А.Долгушева1, И.Е.Чазова1

1 ИКК им. А.Л.Мясникова ФГБУ РКНПК Минздрава РФ, Москва;
2 ГБОУ ВПО МГМСУ им. А.И.Евдокимова Минздрава РФ

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B.M.Nazarov, К.А.Zykov, L.G.Ratova, O.Yu.Agapova, Yu.A.Dolgusheva, I.E.Chazova

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