БЛОКАДА ЦИТОКИНОВОГО ШТОРМА ПРИ ТЯЖЕЛОМ ТЕЧЕНИИ ИНФЕКЦИИ, ВЫЗВАННОЙ SARS-COV-2: МЕДИКАМЕНТОЗНАЯ СУПРЕССИЯ ИЛИ ЭКСТРАКОРПОРАЛЬНАЯ ЭЛИМИНАЦИЯ?

  • Р. Э. Якубцевич УО "Гродненский государственный медицинский университет", Гродно, Беларусь http://orcid.org/0000-0002-8699-8216
Ключевые слова: Sars-CoV-2, коронавирус, COVID-19, пневмония, острый респираторный дистресс-синдром, цитокины, экстракорпоральное очищение крови, гемосорбция, плазмаферез

Аннотация

Введение. Актуальность проблемы лечения тяжелой формы COVID-19 обусловлена высокой летальностью как в общей популяции пациентов (6,4%), так и у пациентов отделений интенсивной терапии (25,8%). Цитокиновый шторм – патологическое состояние, приводящее к высокой летальности. Известны 2 подхода к снижению воспалительных цитокинов в крови: блокада их выработки медикаментозными препаратами и экстракорпоральное удаление. Однако выбор того или иного подхода остается предметом дискуссий.
Цель. Провести анализ литературы по современным подходам к назначению лекарственных средств и экстракорпоральной детоксикации для блокады цитокинового шторма при тяжелой инфекции COVID-19.
Материал и методы. Проанализировано 47 литературных источников.
Результаты. Получены сведения о современных методах блокады цитокинового шторма при тяжелой инфекции COVID-19, указывающих как на эффективность тоцилизумаба, так и селективной антицитокиновой гемосорбции, плазмафереза, методов почечно-заместительной терапии.
Выводы. На основе клинических наблюдений установлено, что не только медикаментозная супрессия воспалительных цитокинов может быть эффективна в лечении тяжелых COVID-19 пневмоний, эффективны также и методы экстракорпорального очищения крови.

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2021-04-05
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Якубцевич РЭ. БЛОКАДА ЦИТОКИНОВОГО ШТОРМА ПРИ ТЯЖЕЛОМ ТЕЧЕНИИ ИНФЕКЦИИ, ВЫЗВАННОЙ SARS-COV-2: МЕДИКАМЕНТОЗНАЯ СУПРЕССИЯ ИЛИ ЭКСТРАКОРПОРАЛЬНАЯ ЭЛИМИНАЦИЯ?. Журнал ГрГМУ (Journal GrSMU) [Интернет]. 5 апрель 2021 г. [цитируется по 11 апрель 2021 г.];18(5):505-12. доступно на: http://journal-grsmu.by/index.php/ojs/article/view/2458