Ингаляционные глюкокортикостероиды в лечении хронической обструктивной болезни легких: дискуссия продолжается


DOI: https://dx.doi.org/10.18565/pharmateca.2019.5.10-16

А.В. Емельянов, Е.В. Лешенкова, Г.Р. Сергеева

Кафедра пульмонологии, Северо-Западный государственный медицинский университет им. И.И. Мечникова, Санкт-Петербург, Россия
Хроническая обструктивная болезнь легких (ХОБЛ) – распространенное заболевание, характеризующееся персистирующей бронхиальной обструкцией. Важное значение в ее развитии и прогрессировании имеет хроническое воспаление дыхательных путей, возникающее под влиянием табачного дыма и поллютантов. Одним из наиболее дискутабельных вопросов в последние годы является место ингаляционных глюкокортикостероидов (ИГКС) в лечении ХОБЛ. В настоящей статье обсуждается роль ИГКС в комплексной терапии ХОБЛ. Имеющиеся результаты клинических исследований позволяют рекомендовать эти препараты при сочетании бронхиальной астмы и ХОБЛ. Они также показаны пациентам с частыми обострениями ХОБЛ, несмотря на терапию длительно действующими бронхолитиками и их комбинациями. Наиболее вероятным предиктором эффективности ИГКС в составе двойной (ИГКС/длительно действующие β2-агонисты [ДДБА]) и тройной терапии (ИГКС/ДДБА/длительно действующие антихолинергические препараты [ДДАХ]) является частота обострений и уровень эозинофилов крови. При назначении этих препаратов необходимо учитывать соотношение их эффективности и безопасности.
Ключевые слова: хроническая обструктивная болезнь легких, ингаляционные глюкокортикостероиды, β2-адреномиметики длительного действия, длительно действующие антихолинергические препараты

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Об авторах / Для корреспонденции


Автор для связи: А.В. Емельянов, д.м.н., профессор, зав. кафедрой пульмонологии СЗГМУ им. И.И. Мечникова, Санкт-Петербург, Россия;
тел. +7 (812) 970-71-88, e-mail: aleksandr.emelyanov@szgmu.ru
Адрес: 191015, Россия, Санкт-Петербург, ул. Кирочная, 41


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