Журнал Сердечная Недостаточность 2014 год Пневмония у госпитализированных пациентов с декомпенсацией кровообращения (Регистр Павловской больницы)


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2014/№3

Пневмония у госпитализированных пациентов с декомпенсацией кровообращения (Регистр Павловской больницы)

Арутюнов А. Г., Рылова А. К., Арутюнов Г. П.
ГБОУ ВПО «РНИМУ им. Н. И. Пирогова» МЗ РФ, 117997, Москва, ул. Островитянова, д. 1

Ключевые слова: декомпенсация кровообращения, пневмония, регистр

DOI: 10.18087 / rhfj.2014.3.1955

Актуальность. Наблюдаемое повсеместно постарение населения, успехи медицины в лечении сердечно-сосудистых заболеваний и продление жизни, привели к превалированию пациентов с высокой коморбидностью. Сочетание двух и более заболеваний, например, сочетание ХСН и пневмонии, значимо увеличивает негативный прогноз относительно жизни. Цель. Изучение влияния сочетания ХСН и пневмонии на ранний и отдаленный прогноз в реальной клинической практике. Материалы и методы. Анализировались данные больных с декомпенсированной ХСН и пневмонией, включенных в Регистр Павловской больницы. Результаты. Пневмония была диагностирована у 317 пациентов с ХСН. У 301 пациента пневмония была внегоспитальной, у 16 – нозокомиальной, причем у женщин пневмония диагностировалась вдвое чаще, чем у мужчин. У значительного числа пациентов отсутствовали типичные признаки дебюта пневмонии – лейкоцитоз и температурная реакция, тяжесть состояния была в первую очередь обусловлена выраженной коморбидностью. Смертность в группе пациентов с пневмонией составила 45,7 % в течение 1 года. Наиболее высоким риск летального исхода был при фенотипах: пневмония + хроническая болезнь почек (ХБП), пневмония +анемия + ХБП, пневмония + дефицит тощей массы тела, пневмония + смена антибактериального препарата. Заключение. Пневмония у пациентов с декомпенсацией кровообращения всегда протекает тяжело, ухудшает течение ХСН и значимо повышает риск летального исхода.
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Арутюнов А. Г., Рылова А. К., Арутюнов Г. П. Пневмония у госпитализированных пациентов с декомпенсацией кровообращения (Регистр Павловской больницы). Журнал Сердечная Недостаточность. 2014;84 (3):146–159

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