urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2021-20-3-90-98urmj-836Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSУльтразвуковое исследование легких в диагностике и дифференциальной диагностике застойных явлений при сердечной недостаточностиPulmonary ultrasound in the diagnosis and differential diagnosis of congestion in heart failurehttps://orcid.org/0000-0001-7826-9657ИзможероваН. В.IzmozherovaN. V.

Изможерова Надежда Владимировна, д.м.н.

г. Екатеринбург

Nadezhda V. Izmozherova, PhD

Ekaterinburg

nadezhda_izm@mail.ruhttps://orcid.org/0000-0001-6216-2468ПоповА. А.PopovA. A.

Попов Артем Анатольевич, д.м.н.

г. Екатеринбург

Artem A. Popov, PhD

Ekaterinburg

art_popov@mail.ruhttps://orcid.org/0000-0002-2623-2657КадниковЛ. И.KadnikovL. I.

Кадников Леонид Игоревич

г. Екатеринбург

Leonid I. Kadnikov

Ekaterinburg

kadn-leonid@mail.ruЛеухненкоИ. Н.LeukhnenkoI. N.

Леухненко Иван Николаевич, к.м.н.

г. Екатеринбург

Ivan N. Leukhnenko, MD

Ekaterinburg

leuhnenko@mail.ruhttps://orcid.org/0000-0001-7907-2629БахтинВ. М.BakhtinV. M.

Бахтин Виктор Михайлович

г. Екатеринбург

Viktor M. Bakhtin

Ekaterinburg

bakhtin.v95@mail.ruФГБОУ ВО «Уральский государственный медицинский университет» Минздрава РоссииРоссияUral State Medical UniversityRussian FederationФГБОУ ВО «Уральский государственный медицинский университет» Минздрава России; ГБУЗ СО «Центральная городская клиническая больница № 6»РоссияUral State Medical University; Central City Clinical Hospital № 6Russian Federation2021111120212039098Copyright © Изможерова Н.В., Попов А.А., Кадников Л.И., Леухненко И.Н., Бахтин В.М., 20212021Изможерова Н.В., Попов А.А., Кадников Л.И., Леухненко И.Н., Бахтин В.М.Izmozherova N.V., Popov A.A., Kadnikov L.I., Leukhnenko I.N., Bakhtin V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/836

Введение. В последние годы активно обсуждается вопрос информативности использования ультразвукового исследования легких для диагностики, дифференциальной диагностики и определения прогноза у пациентов кардиологического профиля, особенно при декомпенсации сердечной недостаточности. Актуальность данного метода заключается в отсутствии инвазивности, лучевой нагрузки и возможности проведения сонографии легких у постели пациента. Целью данного обзора явились оценка и анализ имеющихся литературных данных по данной проблематике. Материалы и методы. Поиск и отбор научных публикаций проводился в поисковых системах PubMed, Google Scholar за период с 1982 по 2020 гг. Результаты и обсуждение. Ультразвуковое исследование легких может использоваться как точный инструмент определения и дифференциальной диагностики внесосудистой жидкости у пациентов с сердечной недостаточностью. Анализ литературных данных свидетельствует о высокой про- гностической ценности метода, а также о возможном его использовании для динамического наблюдения в режиме реального времени. Сонография легких показывает более высокую чувствительность и специфичность метода, нежели рентгенография органов грудной клетки, физикальное обследование, уровень натрийуретического пептида. В отдельности данный метод имеет более низкую специфичность, чем чувствительность, но при дополнении метода определением уровня натрийуретического пептида и выполнением эхокардиографии увеличивается точность и скорость постановки диагноза. Заключение. Ультразвуковое исследование легких обладает достаточной доказательной базой и хорошим потенциалом для применения в клинической практике в качестве дополняющего компонента к традиционным способам определения застойных явлений при сердечной недостаточности.

Introduction. In recent years, the issue of informative value of lung ultrasound for diagnosis, differential diagnosis and prognosis determination in cardiac patients, especially in decompensated heart failure, has been actively discussed. The relevance of this method lies in the absence of invasiveness, radiation exposure and the possibility to perform lung sonography at the patient's bedside. The purpose of this review was to assess and analyze the available literature on this issue. Materials and methods. Scientific publications were searched and selected from PubMed and Google Scholar from 1982 to 2020. Results and Discussion. Pulmonary ultrasound can be used as an accurate tool for detection and differential diagnosis of extravascular fluid in patients with heart failure. Literature analysis indicates high prognostic value of the method, as well as its possible use for dynamic monitoring in real time. Lung sonography shows higher sensitivity and specificity of the method than chest radiography, physical examination, natriuretic peptide level. In isolation, this method has lower specificity than sensitivity, but when complemented by natriuretic peptide levels and echocardiography, it increases accuracy and speed of diagnosis. Conclusion. Lung ultrasound has a sufficient evidence base and good potential for use in clinical practice as a complementary component to traditional methods of determining congestion in heart failure.

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The authors declare that there are no conflicts of interest present.