logging in or signing up Терапия астмы Arkhipov Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 147 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: June 15, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript ???????? ??????? ????? : ???????? ??????? ????? 15 ???? 2009 ?. ??????? ????? : ??????? ????? ???????? : ???????? Slide 4: ?????? ?????? ???????? ??? ?? ? ???????? ??????? ??? ?????????? ???????? ??? ?? ?????????? ???????? ??? ?? ????? ??????? : ????? ??????? ???????? ????? ??????? ???????? ?????????????? ????? ??????? ?? 1 ??? «????» ????????? ???????? ??????? ?? 1 ??? «????» ??? ?????????? ??????? ????????? ???????????????? ????? ??????? ?? 1 ??? «????» ?????????? ????? ??????? ?????????? Slide 6: ???????? ??????? ?? ????? ??????? ????: ??????? ????: ???????? ???? ??? ?????: ???????? ???? ??? ?????: ???? ?????? ???? ???? ?????? ???? + LABA ???? ?????./ ??????? ???? + LABA ??? ?????? ???? ?????./ ??????? ???? ???? – IgE ???? – LT ???? – LT ???? ????. ???? + ???? – LT ???? ????. ???? + ????????? ????????? SL ??? 1 ??? 2 ??? 3 ??? 4 ??? 5 SABA ?? ??????????? ??? ??????????? ????????? ?????????? ????? ??????? ?????????? GINA, 2006 Slide 7: ???????? ??????? ?? ????? ??????? ????: ??????? ????: ???????? ???? ??? ?????: ???????? ???? ??? ?????: ???? ?????? ???? ???? ?????? ???? + LABA ???? ?????./ ??????? ???? + LABA ??? ?????? ???? ?????./ ??????? ???? ???? – IgE ???? – LT ???? – LT ???? ????. ???? + ???? – LT ???? ????. ???? + ????????? ????????? SL ??? 1 ??? 2 ??? 3 ??? 4 ??? 5 SABA ?? ??????????? ??? ??????????? ????????? ?????????? ????? ??????? ?????????? GINA, 2006 ???????? ?????? ??????? : ???????? ?????? ??????? ??????? ?????? ????: ???????-??????? ????: ?? 50% ?????? 3 ???. (?) ?????? ????: ???? ???????? ????????? ????? ??????? ?? ????? 1 ??? ? ???? (?) ????+LABA: ???? ???? ????????? ?? 50% ???? LABA ???????? ??????? (B) ???? ???????? ??????????? – ??????? ?? ?????? ???? ???? ? ???????? LABA (D) ????????????: ????+LABA 1 ??? ? ???? ?????? LABA ??? ?????????? ???? ???? ??????? ????? ?????????? ???? ??????? ???????? ??????????? ???? ????????? ? ? ??????? ???? ???????? ?????????? ????????? (D) ?????????? ?????? ??????? : ?????????? ?????? ??????? ???????? ???? ???? ? ??????? ? ????????????? ????????? ???? ?????????? ? ????? ?? ????????????? (A) ?????????? ???? ???? ? 4 ???? ??????????? ?? ????????????? ? ???????? ?????? ??? ?????? (?) ????????????? ??????????/??????????? ? ?????? «?? ??????????» (SMART). ????????????? : ????????????? ????????????? (vs ???????) ???????????? ? ???? ????-??????? 75 ??????????? ???????????? ??? ?? ?????? ???????????? ????????????? vs ????????????????? ???????? ?????????? ??????????: ?????????? ??????? ???? ?????? ?????????????? ? ?????????? ???????? ???????? Abramson MJ, Puy RM, Weiner JM. Allergen immunotherapy for asthma. Cochrane Database Syst Rev 2003(4):CD001186 ???????????? ??????????? : ???????????? ??????????? ??????? ???????????? ??? ?????? 7,5 ?? ? ?????? >6 ???. ??????? ? ????????? ??? ?????? ????? 5 ?? >3 ???. ????? ??????? ?? ? ???????? ????????? ?????? ? ???????? ??????????????????: ??????? ? ?????????, ?????????? ???? >2000 ??? ??? ????? ???????, ??????? ????? ??????????? ??? ?????? ?????????? ????????????: 1 ??? ? 2 ???? ? ??????? ??? ??????????? 1 ??? ? ??? ? ??????? ???????????? ??????? ?????????? : SABA ??????? ?????????? ??? ???????: 2-4 ???. ?????? 20 ????? ?????? ??? ?????? ??????????: 2-4 ???. ?????? 3-4 ???? ??????? ??????????: 6-10 ???. ?????? 1-2 ???? ? ?????????? ??? 0,5-1 ?? ???????????? /?? ??? ?????????? – 1 ??? ? ????. ?????????: ??????? SABA ??- ??? ?????????????? ?????????? ????????? ???????? ?? ??, ??? ??????? ??? ???????? ??? ?????????????? ?????????? ????????? ?????????? ??? ?????? ??????? ?????????? ?? : ??????? ?????????? ?? ??????? ?????????? ?? : ??????? ?????????? ?? ???????????: ????????????? ?????????? ? ????????????? ??????????? ??????????????? (?) ???????????? ?????????? ??????? ???? ?????????????? (?): ? ????? NNT = 12 (95% CI 8, 32) ? ??????? ? ??????? ?????? NNT = 7 (95% CI 5,20) Cochrane Review (??? 2001) – 8 ??? ?????????????? ???????? ????? ?????????? ?? ????????? ? ??????? ????????: : ?????????????? ???????? ????? ?????????? ?? ????????? ? ??????? ????????: ????????? ???* (RR 0.46 (0.26, 0.81)) ?????????? ???? ????????* (RR 0.23 (0.07, 0.71)) ????? ??????????? ????? ???????? ??? ??????????? ????? ???????? ????? ????? ??????? ?????? ????????? ?????????? ???? ???? ????? ??????? ?????????? ?? ??????????? ???????? ?????????? ?????? ???????? ??????????** (???? ?????????? ??? 63% (p=0.002), ????? ??????????? ?????? ??????? ?????????? (p=0.01)) * - Gibson P Thorax 2004;59:94–9. ** - Green RH et al. Lancet 2002;360:1715–21. ????????? ??????? ??????????:???????? ???? ???? : ????????? ??????? ??????????:???????? ???? ???? FitzGerald JM 2003; Harrison TW 2004; Rice-McDonald G 2005 ??? ??? ????????, ??? ?????? ?????? ???????????????: 0.95 (95% CI 0.55 - 1.64), p=0.8 (Harrison TW 2004) FitzGerald JM, Thorax 2004;59:550–556 ????????? ??????? ??????????:??????????? ?????????? ????? ??????? ??? : ????????? ??????? ??????????:??????????? ?????????? ????? ??????? ??? Rodrigo G? AJRCCM Vol 171. pp. 1231-1236, (2005) ????????? ????????? ????????? ??? ? «???????? ?????». 5 ??? (???? ?? 5-7 ??? ???). ??????????? ?????????? ??? ? ??????? ?????. 3 ??? (??? 2400-3200 ???). ?????????????? ??????????, ??????????? ?????? ??????????????? ???????. ?????? Foresi : ?????? Foresi Foresi ?, Catena E. CHEST 2000; 117:440–446 ????????? 800 ???/??? ????????? 200 ???/??? ????????? 200 ???/??? + 800 ??? ????????? 800 -1 0 6 ?????? ???? ??????? ??? ?????????? : ???? ??????? ??? ?????????? Foresi ?, Catena E. CHEST 2000; 117:440–446 ????????? ??????? ??????????: ?????????? ???? ? 4 ? ????? ??? ?? 2-7 ???? : ????????? ??????? ??????????: ?????????? ???? ? 4 ? ????? ??? ?? 2-7 ???? ???? ?????????? ?????????? ??? ??????????? ?????????? ?? ? ????? : ???? ?????????? ?????????? ??? ??????????? ?????????? ?? ? ????? ?????? ????????????????? ????????????: ?????????? ????????? (8 ????????????) ?????????? ?????????? (1 ????????????) ????????? ???????????? ???????? + ??????? (1 ????????????). ???? ? ???????? ?? 3-? ???. ??????????: ??????? ??????? ?????????? ?? (5 ????????????). ???1 ??????? ? 35% ?? ???????? (??? ??? =100 ?/???.). ?? ???? ????????????? ? ????? ??????? ??????????? ???????????? ? ???????????? ??????????? ??? ?????? ??? ? ???? ????????. Singhi et al, 1999; Tsai et al, 2001; Sekerel et al, 2005; Sung et al, 1998; Nuhoglu et al, 2005; Volovitz et al, 1998; Devidayal et al, 1999; Milani et al, 2004; Sano et al, 2000; Matthews et al. 1999 ??????? ???????????? ?????????: : ??????? ???????????? ?????????: Volovitz B et al. J Allergy Clin Immunol 1998;102:605–9. ????????? ????? ?????????????? ? ????? ? ??????????? ?? ????????? ????????????????? ?????????????? ?????????? ???????? ?????????? ???????, ??? ??? ????????????? ????????? ??? ?????????? ???????????? ? ?????????? ??? ????? ???????? ???1 ?????? : ?????? ? ????? ? ??????? ??????????? ?? ????????? ?? 2 ?? ?????? 8 ????? ?? ????? ??????????, ??? ??????????? ?????? ?? 2 ??/??/???. ? ????? ????????? ? ???? 1 ?? 2 ???? ? ???? ????? ?? ?????????? ??????????? ???, ??? ? ??????????? ?? 2 ??/?? ? ????. Acta Pædiatr 1999; 88: 841-3. Eur Respir J 1995; 8 (Su??l 19): 470s ?????????? vs ????????????????????? ???? ??? : ?????????? vs ????????????????????? ???? ??? ?? ????????????? ?????????? (???1) ? ????? 4 ?? ?????? 8-18 ????? ?? ?????????? ?? ???????????? ?? 40 ?? ? ???? (Higenbottam et al., 2000; Mitchell et al., 1995). ?? ??????? ????????? ??????? ????????? ?????????? ?? ?????????? ?? ???????????? ??? ???? ??????????? ??? (Fitzgerald et al., 2000; Rowe et al., 1999). ?????????? ???????? ??????????? ???????, ??? ??????????? (Rodrigo G., 2006) ????????????? ??? ??? ?????????? ??:???????????? EPR-3 ? GINA 2006 : ????????????? ??? ??? ?????????? ??:???????????? EPR-3 ? GINA 2006 ??????? ???? ????????????? ??? ????? ??????????? ? ????????? ?????????? ??????, ???? ?? ??????????? ???? ???????????? ?????????????, ??????????? ??????? ?????????? ? ???, ??? ????????????? ??? ? ???? ????? ????? ???????????????, ??? ??? ??? ?????? ?????? (??????? ??????????????? ?). ?????????????? ?????????? ???? ????????????? ??? [7-14 ????] ? ??????? ? ?????????? ??????? ?? ???????????? ????????? ????? ??? ?????? (??????? ??????????????? ?). EPR-3, August 28, 2007: p. 395 GINA 2006: p. 65 Reddel HK, Barnes DJ. Eur Respir J 2006;28(1):182-99. ???????????? ??????????: ?????????? ?????????? : ???????????? ??????????: ?????????? ?????????? FitzGerald JM. Can Respir J. 2003 Nov-Dec;10(8):427-34. ????? ?????????? ??1 ???????? ? ??? : ????? ?????????? ??1 ???????? ? ??? * - ???? ? ????????? ?? ??? SMART STEAM STEP STAY SMILE COMPASS AHEAD ???? 500 1000 2000 1000 250 1000 1000 500 500 ????* 0,08 0,4 0,3 0,2 0,1 0 0,18 0,25 0,19 0,24 0,19 You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Терапия астмы Arkhipov Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 147 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: June 15, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript ???????? ??????? ????? : ???????? ??????? ????? 15 ???? 2009 ?. ??????? ????? : ??????? ????? ???????? : ???????? Slide 4: ?????? ?????? ???????? ??? ?? ? ???????? ??????? ??? ?????????? ???????? ??? ?? ?????????? ???????? ??? ?? ????? ??????? : ????? ??????? ???????? ????? ??????? ???????? ?????????????? ????? ??????? ?? 1 ??? «????» ????????? ???????? ??????? ?? 1 ??? «????» ??? ?????????? ??????? ????????? ???????????????? ????? ??????? ?? 1 ??? «????» ?????????? ????? ??????? ?????????? Slide 6: ???????? ??????? ?? ????? ??????? ????: ??????? ????: ???????? ???? ??? ?????: ???????? ???? ??? ?????: ???? ?????? ???? ???? ?????? ???? + LABA ???? ?????./ ??????? ???? + LABA ??? ?????? ???? ?????./ ??????? ???? ???? – IgE ???? – LT ???? – LT ???? ????. ???? + ???? – LT ???? ????. ???? + ????????? ????????? SL ??? 1 ??? 2 ??? 3 ??? 4 ??? 5 SABA ?? ??????????? ??? ??????????? ????????? ?????????? ????? ??????? ?????????? GINA, 2006 Slide 7: ???????? ??????? ?? ????? ??????? ????: ??????? ????: ???????? ???? ??? ?????: ???????? ???? ??? ?????: ???? ?????? ???? ???? ?????? ???? + LABA ???? ?????./ ??????? ???? + LABA ??? ?????? ???? ?????./ ??????? ???? ???? – IgE ???? – LT ???? – LT ???? ????. ???? + ???? – LT ???? ????. ???? + ????????? ????????? SL ??? 1 ??? 2 ??? 3 ??? 4 ??? 5 SABA ?? ??????????? ??? ??????????? ????????? ?????????? ????? ??????? ?????????? GINA, 2006 ???????? ?????? ??????? : ???????? ?????? ??????? ??????? ?????? ????: ???????-??????? ????: ?? 50% ?????? 3 ???. (?) ?????? ????: ???? ???????? ????????? ????? ??????? ?? ????? 1 ??? ? ???? (?) ????+LABA: ???? ???? ????????? ?? 50% ???? LABA ???????? ??????? (B) ???? ???????? ??????????? – ??????? ?? ?????? ???? ???? ? ???????? LABA (D) ????????????: ????+LABA 1 ??? ? ???? ?????? LABA ??? ?????????? ???? ???? ??????? ????? ?????????? ???? ??????? ???????? ??????????? ???? ????????? ? ? ??????? ???? ???????? ?????????? ????????? (D) ?????????? ?????? ??????? : ?????????? ?????? ??????? ???????? ???? ???? ? ??????? ? ????????????? ????????? ???? ?????????? ? ????? ?? ????????????? (A) ?????????? ???? ???? ? 4 ???? ??????????? ?? ????????????? ? ???????? ?????? ??? ?????? (?) ????????????? ??????????/??????????? ? ?????? «?? ??????????» (SMART). ????????????? : ????????????? ????????????? (vs ???????) ???????????? ? ???? ????-??????? 75 ??????????? ???????????? ??? ?? ?????? ???????????? ????????????? vs ????????????????? ???????? ?????????? ??????????: ?????????? ??????? ???? ?????? ?????????????? ? ?????????? ???????? ???????? Abramson MJ, Puy RM, Weiner JM. Allergen immunotherapy for asthma. Cochrane Database Syst Rev 2003(4):CD001186 ???????????? ??????????? : ???????????? ??????????? ??????? ???????????? ??? ?????? 7,5 ?? ? ?????? >6 ???. ??????? ? ????????? ??? ?????? ????? 5 ?? >3 ???. ????? ??????? ?? ? ???????? ????????? ?????? ? ???????? ??????????????????: ??????? ? ?????????, ?????????? ???? >2000 ??? ??? ????? ???????, ??????? ????? ??????????? ??? ?????? ?????????? ????????????: 1 ??? ? 2 ???? ? ??????? ??? ??????????? 1 ??? ? ??? ? ??????? ???????????? ??????? ?????????? : SABA ??????? ?????????? ??? ???????: 2-4 ???. ?????? 20 ????? ?????? ??? ?????? ??????????: 2-4 ???. ?????? 3-4 ???? ??????? ??????????: 6-10 ???. ?????? 1-2 ???? ? ?????????? ??? 0,5-1 ?? ???????????? /?? ??? ?????????? – 1 ??? ? ????. ?????????: ??????? SABA ??- ??? ?????????????? ?????????? ????????? ???????? ?? ??, ??? ??????? ??? ???????? ??? ?????????????? ?????????? ????????? ?????????? ??? ?????? ??????? ?????????? ?? : ??????? ?????????? ?? ??????? ?????????? ?? : ??????? ?????????? ?? ???????????: ????????????? ?????????? ? ????????????? ??????????? ??????????????? (?) ???????????? ?????????? ??????? ???? ?????????????? (?): ? ????? NNT = 12 (95% CI 8, 32) ? ??????? ? ??????? ?????? NNT = 7 (95% CI 5,20) Cochrane Review (??? 2001) – 8 ??? ?????????????? ???????? ????? ?????????? ?? ????????? ? ??????? ????????: : ?????????????? ???????? ????? ?????????? ?? ????????? ? ??????? ????????: ????????? ???* (RR 0.46 (0.26, 0.81)) ?????????? ???? ????????* (RR 0.23 (0.07, 0.71)) ????? ??????????? ????? ???????? ??? ??????????? ????? ???????? ????? ????? ??????? ?????? ????????? ?????????? ???? ???? ????? ??????? ?????????? ?? ??????????? ???????? ?????????? ?????? ???????? ??????????** (???? ?????????? ??? 63% (p=0.002), ????? ??????????? ?????? ??????? ?????????? (p=0.01)) * - Gibson P Thorax 2004;59:94–9. ** - Green RH et al. Lancet 2002;360:1715–21. ????????? ??????? ??????????:???????? ???? ???? : ????????? ??????? ??????????:???????? ???? ???? FitzGerald JM 2003; Harrison TW 2004; Rice-McDonald G 2005 ??? ??? ????????, ??? ?????? ?????? ???????????????: 0.95 (95% CI 0.55 - 1.64), p=0.8 (Harrison TW 2004) FitzGerald JM, Thorax 2004;59:550–556 ????????? ??????? ??????????:??????????? ?????????? ????? ??????? ??? : ????????? ??????? ??????????:??????????? ?????????? ????? ??????? ??? Rodrigo G? AJRCCM Vol 171. pp. 1231-1236, (2005) ????????? ????????? ????????? ??? ? «???????? ?????». 5 ??? (???? ?? 5-7 ??? ???). ??????????? ?????????? ??? ? ??????? ?????. 3 ??? (??? 2400-3200 ???). ?????????????? ??????????, ??????????? ?????? ??????????????? ???????. ?????? Foresi : ?????? Foresi Foresi ?, Catena E. CHEST 2000; 117:440–446 ????????? 800 ???/??? ????????? 200 ???/??? ????????? 200 ???/??? + 800 ??? ????????? 800 -1 0 6 ?????? ???? ??????? ??? ?????????? : ???? ??????? ??? ?????????? Foresi ?, Catena E. CHEST 2000; 117:440–446 ????????? ??????? ??????????: ?????????? ???? ? 4 ? ????? ??? ?? 2-7 ???? : ????????? ??????? ??????????: ?????????? ???? ? 4 ? ????? ??? ?? 2-7 ???? ???? ?????????? ?????????? ??? ??????????? ?????????? ?? ? ????? : ???? ?????????? ?????????? ??? ??????????? ?????????? ?? ? ????? ?????? ????????????????? ????????????: ?????????? ????????? (8 ????????????) ?????????? ?????????? (1 ????????????) ????????? ???????????? ???????? + ??????? (1 ????????????). ???? ? ???????? ?? 3-? ???. ??????????: ??????? ??????? ?????????? ?? (5 ????????????). ???1 ??????? ? 35% ?? ???????? (??? ??? =100 ?/???.). ?? ???? ????????????? ? ????? ??????? ??????????? ???????????? ? ???????????? ??????????? ??? ?????? ??? ? ???? ????????. Singhi et al, 1999; Tsai et al, 2001; Sekerel et al, 2005; Sung et al, 1998; Nuhoglu et al, 2005; Volovitz et al, 1998; Devidayal et al, 1999; Milani et al, 2004; Sano et al, 2000; Matthews et al. 1999 ??????? ???????????? ?????????: : ??????? ???????????? ?????????: Volovitz B et al. J Allergy Clin Immunol 1998;102:605–9. ????????? ????? ?????????????? ? ????? ? ??????????? ?? ????????? ????????????????? ?????????????? ?????????? ???????? ?????????? ???????, ??? ??? ????????????? ????????? ??? ?????????? ???????????? ? ?????????? ??? ????? ???????? ???1 ?????? : ?????? ? ????? ? ??????? ??????????? ?? ????????? ?? 2 ?? ?????? 8 ????? ?? ????? ??????????, ??? ??????????? ?????? ?? 2 ??/??/???. ? ????? ????????? ? ???? 1 ?? 2 ???? ? ???? ????? ?? ?????????? ??????????? ???, ??? ? ??????????? ?? 2 ??/?? ? ????. Acta Pædiatr 1999; 88: 841-3. Eur Respir J 1995; 8 (Su??l 19): 470s ?????????? vs ????????????????????? ???? ??? : ?????????? vs ????????????????????? ???? ??? ?? ????????????? ?????????? (???1) ? ????? 4 ?? ?????? 8-18 ????? ?? ?????????? ?? ???????????? ?? 40 ?? ? ???? (Higenbottam et al., 2000; Mitchell et al., 1995). ?? ??????? ????????? ??????? ????????? ?????????? ?? ?????????? ?? ???????????? ??? ???? ??????????? ??? (Fitzgerald et al., 2000; Rowe et al., 1999). ?????????? ???????? ??????????? ???????, ??? ??????????? (Rodrigo G., 2006) ????????????? ??? ??? ?????????? ??:???????????? EPR-3 ? GINA 2006 : ????????????? ??? ??? ?????????? ??:???????????? EPR-3 ? GINA 2006 ??????? ???? ????????????? ??? ????? ??????????? ? ????????? ?????????? ??????, ???? ?? ??????????? ???? ???????????? ?????????????, ??????????? ??????? ?????????? ? ???, ??? ????????????? ??? ? ???? ????? ????? ???????????????, ??? ??? ??? ?????? ?????? (??????? ??????????????? ?). ?????????????? ?????????? ???? ????????????? ??? [7-14 ????] ? ??????? ? ?????????? ??????? ?? ???????????? ????????? ????? ??? ?????? (??????? ??????????????? ?). EPR-3, August 28, 2007: p. 395 GINA 2006: p. 65 Reddel HK, Barnes DJ. Eur Respir J 2006;28(1):182-99. ???????????? ??????????: ?????????? ?????????? : ???????????? ??????????: ?????????? ?????????? FitzGerald JM. Can Respir J. 2003 Nov-Dec;10(8):427-34. ????? ?????????? ??1 ???????? ? ??? : ????? ?????????? ??1 ???????? ? ??? * - ???? ? ????????? ?? ??? SMART STEAM STEP STAY SMILE COMPASS AHEAD ???? 500 1000 2000 1000 250 1000 1000 500 500 ????* 0,08 0,4 0,3 0,2 0,1 0 0,18 0,25 0,19 0,24 0,19