Лекарственно-индуцированное интерстициальное заболевание легких: подходы к диагностике и лечению

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Лекарственно-индуцированное интерстициальное заболевание легких (Л-ИЗЛ) может быть вызвано различными препаратами, включая антибиотики, амиодарон, противоопухолевые, ревматологические и нестероидные противовоспалительные средства. Л-ИЗЛ включает реакции гиперчувствительности, организующуюся и неспецифическую интерстициальную пневмонии, эозинофильные заболевания легких, диффузное альвеолярное повреждение и альвеолярную гиповентиляцию. Для исключения других причин легочных заболеваний необходима оценка анамнеза, физикальных данных и результатов обследования, которые могут включать рентгенографию/мультиспиральную компьютерную томографию (МСКТ) грудной клетки, исследование функции легких и бронхоскопию с бронхоальвеолярным лаважом. Диагностика Л-ИЗЛ затруднена вследствие неоднородности клинических, рентгенологических и гистологических данных. Рентгенопатологический фенотип Л-ИЗЛ различается, не выявлено специфичного МСКТ-паттерна. Лечение включает отмену препарата и в некоторых случаях терапию глюкокортикоидами, хотя нет проспективных исследований по их влиянию на исход болезни. В этой статье приводятся различные лекарственные средства, которые вызывают ИЗЛ, подходы к их диагностике и лечению.

Об авторах

Эльдар Хусеевич Анаев

ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России

Автор, ответственный за переписку.
Email: el_anaev@hotmail.com
ORCID iD: 0000-0003-3672-9242

д.м.н., проф. каф. пульмонологии фак-та дополнительного профессионального образования

Россия, Москва

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