Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum92847ArticlesСтатьиResearch ArticleOsobennosti khronicheskoy obstruktivnoy bolezni legkikh u zhenshchinОсобенности хронической обструктивной болезни легких у женщинOvcharenkoS. IОвчаренкоС. И

Кафедра факультетской терапии №1 лечебного факультета

KapustinaV. AКапустинаВ. А

Кафедра факультетской терапии №1 лечебного факультета

ММА им. И.М.Сеченова15032009113VOL 11, NO3 (2009)ТОМ 11, №3 (2009)51328122021Copyright ©; 2009, Consilium MedicumCopyright ©; 2009, ООО "Консилиум Медикум"2009Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/92847

Долгие годы при упоминании ХОБЛ у большинства врачей всплывал образ пожилого мужчины, курящего, страдающего кашлем и одышкой, регулярно переносящего сезонные обострения хронического бронхита. Если на прием к терапевту или пульмонологу приходил курящий мужчина с респираторными симптомами, в первую очередь появлялась мысль о ХОБЛ, в то время как при консультации женщины с достаточным стажем курения и жалобами со стороны органов дыхания подозрение на это заболевание, к сожалению, возникало не сразу. Однако в последнее время стереотип больного ХОБЛ начал меняться. Этот диагноз все чаще ставится женщинам среднего возраста, умеренно курящим, а в ряде стран и вовсе не курящим, имеющим контакт с продуктами сгорания биоорганического топлива. В последнее время все больше внимания уделяют изучению различий в течении и лечении ХОБЛ у пациентов мужского и женского пола. В литературе накоплено уже достаточно данных, чтобы говорить о влиянии генетических, физиологических, социальных, экологических, культурных и других особенностей личности на течение заболевания.

Mannino D.M., Buist A.S. Global burden of COPD: risk factors, prevalence, and future Trends. Lancet 2007; 370: 765–73.Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Updated 2007 (www. goldcopd.com).The global burden of disease. Update 2004 (www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index).Чучалин А.Г. Белая книга. Пульмонология. Россия 2003. М., 2003.National Heart, Lung, and Blood Institute. Morbidity and mortality chartbook on cardiovascular, lung and blood diseases. Bethesda, Maryland: US Department of Health and Human Services, Public Health Service, National Institutes of Health, 2004.Mannino D.M., Homa D.M., Akinbami L.J. et al. Chronic obstructive pulmonary disease surveillance: United States, 1971–2000. MMWR Surveill Summ 2002; 51 (6): 1–16.Soriano J.R., Maier W.C., Egger P et al. Recent trends in physician diagnosed COPD in women and men in the UK. Thorax 2000; 55: 789–94.Feenstra T.L., van Genugten M.L., Hoogenveen R.T.et al. The impact of ageing and smoking on the future burden of chronic obstructive pulmonary disease: a model analysis in the Netherlands. Am J Respir Crit Care Med 2001; 164: 590–6.Mathers D.M., Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006; 3: e442.Chapman K.R. Chronic obstructive pulmonary disease: are women more susceptible than men? Clin Chest Med 2004; 25: 331–41.Vestbo J. Epidemiology. In: Voelkel N.F., Mac Nee W., eds. Chronic obstructive lung disease. Hamilton, Canada, BC Decker Inc 2002; 41–55.World Health Organization. Gender, health, and tobacco. Geneva, Switzerland: World Health Organization; 2003 (www.who.int).Esson K, Leeder S.R. The millennium development goals and tobacco control: an opportunity for global partnership. Geneva, Switzerland: World Health Organization; 2004.Ernster V. Women and the tobacco epidemic: challenges for the 21st century. Geneva, Switzerland: World Health Organization; 2001.Mackay J, Amos A. Women and tobacco. Respirology 2003; 8: 123–30.The European Tobacco Control Report 2007. World Health Organization 2007; 153.Xu X, Li B, Wang L. Gender difference in smoking effects on adult pulmonary function. Eur Respir J 1994; 7: 477–83.Xu X, Weiss S.T., Rijcken B, Shouten J.P. Smoking, changes in smoking habits, and rates of decline in FEV1: new insight into gender differences. Eur Respir J 1994; 7: 1056–61.Carter R, Nicotra B, Huber G. Differing effects of airway obstruction on physical work capacity and ventilation in men and women with COPD. Chest 1994; 106 (6): 1730–9.Prescott E, Bjerg A.M., Andersen P.K. et al. Gender difference in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal study. Eur Respir J 1997; 10 (4): 822–7.Han W, Pentecost B.T., Pietropaolo R.L. et al. Estrogen receptor alpha increases basal and cigarette smoke extract - induced expression of CYP1A1 and CYP1B1, but not GSTP1, in normal human bronchial epithelial cells. Mol Carcinog 2005; 44: 202–11.Ramirez-Venegas A, Sansores R.H., Perez-Padilla R et al. Survival of patients with chronic obstructive pulmonary disease due to biomass smoke and tobacco. Am J Respir Crit Care Med 2006; 173: 393–7.Dockery D.W., Pope C.A., Xu X et al. An association between air pollution and mortality in six US cities. N EngI J Mod 1993; 329: 1753–9.Tao X, Hong C.J., Yu S et al. Priority among air pollution factors for preventing chronic obstructive pulmonary disease in Shanghai. Sci Total Environ 1992; 127: 57–67.Pandey M.R. Domestic smoke pollution and chronic bronchitis in a rural community of the Hill Region of Nepal. Thorax 1984; 39: 337–9.Amoli K. Bronchopulmonary disease in Iranian housewives chronically exposed to indoor smoke. Eur Respir J 1998; 11: 659–63.Dossing M, Khan J, al-Rabiah F. Risk factors for chronic obstructive lung disease In Saudi Arabia. Respir Med 1994; 88: 519–22.Perez-Padilla R, Regalado U, Vedal S et al. Exposure to biomass smoke and chronic airway disease in Mexican women. Am J Respir Crit Care Med 1996; 154: 701–6.Kanner R.E., Connett J.E., Altose M.D. et al. Gender difference in airway hyperresponsiveness in smokers with mild COPD: the Lung Health Study. Am J Respir Crit Care Med 1994; 150: 956–61.Paoletti P, Carrozzi L, Viegi G et al. Distribution of bronchial responsiveness in a general population: effect of sex, age, smoking, and level of pulmonary function. Am J Respir Crit Care Med 1995; 151: 1770–7.Becklake M.R., Kauffmann F. Gender differences in airway behaviour over a human life span. Thorax 1999; 54: 1119–38.Kelly R.W., Illingworth P, Baldie G et al. Progesteron control of interleukin - 8 production in endometrium and chorio - decidual cells underlines the role of the neutrophil in menstruation and parturition. Hum Reprod 1994; 9: 253–8.Saetta M, Turato G, Maestrelli P et al. Cellular and structural bases of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 163: 1304–9.Stoller J.K., Aboussouan L.S. Alpha - 1 - antitripsin deficiency. Lancet 2005; 365 (9478): 2225–36.Lee P, Gildea T.R., Stoller J.K. Emphysema in nonsmokers: alpha 1 - antitrypsin deficiency and other causes. Cleve Clin J Med 2002; 69: 928–46.Wilson D.O., Rogers R.M., Wright E.C. et al. Body weight in chronic obstructive pulmonary disease. The National Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis 1989; 139: 1435–8.Lawlor D.A., Ebrahim S, Davey Smith G. Association of birth weight with adult lung function. Thorax 2005; 60 (10): 851–8.Varkey A. Cronic obstructive pulmonary disease in women: exploring gender differences. Curr Opin Pulm Med 2004; 10: 98–103.Torday J.S., Nielsen H.C. The sex difference in fetal lung surfactant production. Exp Lung Res 1987; 1: 1–19.Fleisher B, Kulovich M.V., Hallman M, Gluck L. Lung profile: sex differences in normal pregnancy. Obstet Gyn 1985; 66: 327–30.Thurlbeck W.M. Postnatal human lung growth. Thorax 1982; 37: 564–71.Quanjer P.H., Borsboom G.J., Brunekreff B et al. Spirometric reference values for white European children and adolescents: Polgar revisited. Pediatr Pulmonol 1995; 19: 135–42.Clausen J.L., Coates A.L., Quanjer P.H. Measurement of lung volumes in humans: review and recommendations from an ATS/ERS workshop. Eur Respir J 1997; 10: 1205–6.American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir Dis 1991; 144: 1202–18.Хроническая обструктивная болезнь легких. (Федеральная программа). Практическое руководство для врачей. Издание 2-е, переработанное и дополненное. Под ред. А.Г.Чучалина. М., 2004.Chapman K.R., Tachkin D.P., Pye D.J. Gender bias in the diagnosis of COPD. Chest 2001; 119: 1691–5.Watson L, Vestbo J, Postma D.S. et al. Gender differenses in the management and experience of chronic obstructive pulmonary disease. Respir Med 2004; 98: 1203–7.Pat G, Camp and Sarah M. Goring. Gender and the diagnosis, management, and surveillance of chronic obstructive pulmonary disease. Proc Am Thorac Soc 2007; 4: 686–91.de Torres J.P., Casanova C, Hernandez C et al. Gender and COPD in patients attending a pulmonary clinic. Chest 2005; 128: 2012–6.Di Marco F, Verga M, Reggente M et al. Anxiety and depression in COPD patients: the roles of gender and disease severity. Respir Med 2006; 100: 1767–74.Watson L, Vonk J.M., Lofdahl C.G. et al. Predictors of lung function and its decline in mild to moderate COPD in association with gender: results from the EUROSCOP study. Respir Med 2006; 100: 746–53.Cydulka R.K., Rowe B.H., Clark S et al. Gender differences in emergency department patients with chronic obstructive pulmonary disease exacerbations. Acad Emerg Med 2005; 12: 1173–9.Gift A.G., Shepard C.E. Fatigue and other symptoms in patients with chronic obstructive pulmonary disease: do women and men differ? J Obstet Gynecol Neonatal Nurs 1999; 28: 201–8.Martinez F.J., Curtis J.L., Sciurba F et al. Sex differences in severe pulmonary emphysema. Am J Respir Crit Care Med 2007; 176: 243–52.Renkema T.E., Schouten J.P., Koeter G.H., Postma D.S. Effects of long - term treatment with corticosteroids in COPD. Chest 1996; 109: 1156–62.Lee T.A., Weiss K.B. Fracture risk associated with inhaled corticosteroid use in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004; 169: 855–9.Katsura H, Kida K. A comparison of bone mineral density in elderly female patients with COPD and bronchial asthma. Chest 2002; 122: 1949–55.Scharf D, Shiffman S. Are there gender differences in smoking cessation, with and without bupropion? Pooledand meta - analysis of clinical trials of bupropion SR. Addiction 2004; 99: 1462–9.Krzyzanowski M, Robbins D.R., Lebowitz M.D. Smoking cessation and changes in respiratory symptoms in two populations followed for 13 years. Int J Epidemiol 1993; 22: 666–73.Anthonisen N, Connet J, Kiley J et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study. JAMA 1994; 272: 1497–505.Scanlon P.D., Connett J.E., Waller L.A. et al. Smoking cessation and lung function in mild - to - moderate chronic obstructive pulmonary disease. The Lung Health Study. Am J Respir Crit Care Med 2000; 161: 381–90.Gritz E.R., Nielsen I.R., Brooks L.A. Smoking cessation and gender: the influence of physiological, psychological, and behavioral factors. J Am Med Womens Assoc 1996; 51: 35–42.Bjornson W, Rand C, Connett JE et al. Gender differences in smoking cessation after 3 years in the Lung Health Study. Am J Public Health 1995; 85: 223–30.Panday S, Reddy S.P., Ruiter R et al. Nicotine dependence and withdrawal symptoms among occasional smokers. J Adolesc Health 2007; 40: 144–50.O\'Hara P, Connett J.E., Lee W.W. et al. Early and late weight gain following smoking cessation in the Lung Health Study. Am J Epidemiol 1998; 148 (9): 821–30.Dales R.E., Mehdizadeh A, Aaron S.D. et al. Sex differences in the clinical presentation and management of airflow obstruction. Eur Respir J 2006; 28: 319–22.Ленней Дж., Иннс Дж.А., Кромптон Дж.К. Неправильное использование ингаляторов: оценка ингаляционной техники и предпочтений пациентов при сравнении семи различных ингаляционных устройств. Пульмонология. 2005; 4: 80–4.Goodman D.E., Israel E, Rosenberg M et al. The influence of age, diagnosis and gender on proper use of metered dose inhalers. Am J Respir Crit Care Med 1994; 150: 1256–61.Vestbo J, Soriano J.B., Anderson J.A. et al. Gender does not influence the response to the combination of salmeterol and fluticasone proprionate in COPD. Respir Med 2004; 98: 1045–50.O\'Donnell D.E., Fluge T, Gerken F et al. Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD. Eur Respir J 2004; 23: 832–40.Convery R.P., Leitch D.N., Bromly C et al. Effect of inhaled fluticasone propionate on airway responsiveness in treatment - naive individuals - a lesser benefit in females. Eur Respir J 2000; 15: 19–24.Decramer M, Celli B, Tashkin D.P. et al. Clinical trial design considerations in assessing long - term functional impacts of tiotropium in COPD: The Uplift Trial. COPD 2004; 1: 303–12.Tashkin D.P., Celli B, Senn S et ak. for the UPLIFT Study Investigators. A 4 - year trial of tiotropium in chronic obstructive pulmonary disease. N Engl J Med 2008; 359: 1543–54.Decramer M, Rutten van Molken M. Dekhuijzen P.N. et al. Effect of N - acetylcysteine on outcomes in chronic obstructive pulmonary disease: a randomized placebo - controlled trial. Lancet 2005; 365 (9470): 1552–60.Cooper J.D., Trulock E.P., Triantafillou A.N. et al. Bilateral pneumonectomy (volume reduction) for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg 1995; 109: 106–19.National Emphysema Treatment Trial Research Group. Patients at high risk of death after lung volume reduction surgery. N Engl J Med 2001; 345: 1075–82.Haggerty M.C., Stockdale-Woolley R, Zuwallack R. Functional status in pulmonary rehabilitation participants. J Cardiopulm Rehabil 1999; 19: 35–42.Foy C.G., Rejeski W.J., Berry M.J. et al. Gender moderates the effects of exercise therapy on health - related quality of life among COPD patients. Chest 2001; 119: 70–6.