ПРОБЛЕМЫ ДИАГНОСТИКИ ЛЕГОЧНОЙ ГИПЕРТЕНЗИИ, АССОЦИИРОВАННОЙ С СИСТЕМНОЙ СКЛЕРОДЕРМИЕЙ
DOI:
https://doi.org/10.31082/1728-452X-2020-215-216-5-6-15-23Ключевые слова:
системная склеродермия, легочная гипертензия, скрининг, алгоритм DETECT, катетеризация правых камер сердцаАннотация
Системная склеродермия представляет собой наиболее частое аутоиммунное заболевание, ассоциируемое с легочной гипертензией. Легочная гипертензия является потенциальным предиктором раннего летального исхода, в связи с чем в последнее время интерес к комплексному изучению вопросов диагностики легочной гипертензии, ассоциированной с системной склеродермией, возрастает среди исследователей.
Цель. Рассмотрение актуальных вопросов диагностики, а также принципов использования диагностических алгоритмов с целью верификации легочной гипертензии, ассоциированной с системной склеродермией, применяемых в ежедневной клинической практике.
Материал и методы. С целью изучения литературных данных был осуществлен поиск информации касательно данной проблемы глубиной до 10 лет в Web of Science, PubMed/MEDLINE. В процессе поиска были использованы следующие термины по отдельности и в комбинации: «системная склеродермия», «легочная гипертензия», «алгоритм DETECT», «катетеризация правых камер сердца». Основным условием поиска являлись исследования, основанные на изучении пациентов с легочной гипертензией, ассоциированных с системной склеродермией: метаанализы, оригинальные исследования, ретроспективные и когортные исследования.
Результаты и обсуждение. Клинические симптомы легочной гипертензии могут быть неспецифичными, что значительно усложняет диагностику заболевания на ранних этапах. Отсутствие специфической клинической картины до развития развернутой стадии легочной гипертензии приводит к поздней верификации диагноза. Ключевые алгоритмы, используемые в ежедневной практике врача, дают возможность минимизировать количество недиагностированных случаев легочной гипертензии.
Выводы. Диагностика легочной гипертензии, ассоциированной с системной склеродермией, зачастую вызывает сложности в практике врача. Ранняя диагностика и, следовательно, лечение легочной гипертензии имеют первостепенное значение, поскольку они улучшают показатели выживаемости у больных системной склеродермией.
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