medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-479medsovet-8757Research ArticleCOVID-19Роль легочного сурфактанта в патогенезе бронхолегочной патологии и перспективы терапии сурфактантом при COVID-19The role of pulmonary surfactant in the pathogenesis of bronchopulmonary diseases and the prospects of surfactant therapy in COVID-19https://orcid.org/0009-0003-1864-9115БлизноваИ. В.BliznovaI. V.

Близнова Ирина Валентиновна - заведующая инфекционным отделением №3 инфекционного центра.

309500, Белгородская обл., Старый Оскол, Южная объездная дорога, д. 9А

Irina V. Bliznova - Head of the Infectious Diseases Department No. 3 of the Infection Center, Starooskolsky District Hospital of St. Luke of the Crimea.

9A, Yuzhnaya Obezdnaya Doroga St., Stary Oskol, Belgorod Region, 309500

bliznova_i@mail.ruhttps://orcid.org/0009-0005-4852-4641ТолмачеваЛ. Н.TolmachevaL. N.

Толмачева Лолита Николаевна - заведующая инфекционным центром.

309500, Белгородская обл., Старый Оскол, Южная объездная дорога, д. 9А

Lolita N. Tolmacheva - Head of the Infectious Diseases Center, Starooskolsky District Hospital of St. Luke of the Crimea.

9A, Yuzhnaya Obezdnaya Doroga St., Stary Oskol, Belgorod Region, 309500

tolmacheva.lolita@mail.ruhttps://orcid.org/0009-0000-1656-6517ДаниловаМ. С.DanilovaM. S.

Данилова Марина Сергеевна – студент.

424000, Республика Марий Эл, Йошкар-Ола, площадь Ленина, д. 1

Marina S. Danilova - Student, Mari State University.

1, Lenin Square, Yoshkar-Ola, Republic of Mari El, 424002

67cloud40@gmail.comhttps://orcid.org/0000-0002-9328-3905БонцевичР. A.BontsevichR. A.

Бонцевич Роман Александрович - к.м.н., доцент кафедры внутренних болезней №2, МарГУ; доцент кафедры фармакологии и клинической фармакологии, НИУ БелГУ; доцент кафедры клинической фармакологии и фармакотерапии, КГМА - филиал РМАНПО.

424000, Республика Марий Эл, Йошкар-Ола, площадь Ленина, д. 1; 308015, Белгород, ул. Победы, д. 85; 420012, Республика Татарстан, Казань, ул. Бутлерова, д. 36

Roman A. Bontsevich - Cand. Sci, (Med.), Associate Professor of the Department of Internal Diseases No. 2, Mari State University; Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Belgorod State University; Associate Professor of the Department of Clinical Pharmacology and Pharmacotherapy, Kazan State Medical Academy - a branch of the Russian Medical Academy of Continuing Professional Education.

1, Lenin Square, Yoshkar-Ola, Republic of Mari El, 424002; 85, Pobedy St., Belgorod, 308015; 36, Butlerov St., Kazan, Republic of Tatarstan, 420012

dr.bontsevich@gmail.comСтарооскольская окружная больница Святителя Луки КрымскогоРоссияStarooskolsky District Hospital of St Luke of the CrimeaRussian FederationМарийский государственный университетРоссияMari State UniversityRussian FederationМарийский государственный университет; Белгородский государственный национальный исследовательский университет; Казанская государственная медицинская академия - филиал Российской медицинской академии непрерывного профессионального образованияРоссияMari State University; Belgorod State University; Kazan State Medical Academy - a branch of the Russian Medical Academy of Continuing Professional EducationRussian Federation202411122024020116122Copyright © Близнова И.В., Толмачева Л.Н., Данилова М.С., Бонцевич Р.A., 20242024Близнова И.В., Толмачева Л.Н., Данилова М.С., Бонцевич Р.A.Bliznova I.V., Tolmacheva L.N., Danilova M.S., Bontsevich R.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8757

Рассмотрены современные представления об основных функциях сурфактанта, данные о его составе и роли в дисфункции и патогенезе бронхолегочной патологии. В работе представлены новые сведения о результатах и перспективах ингаляционной терапии сурфактантом при бронхолегочной патологии. Исследовано применение сурфактанта при остром респираторном дистресс-синдроме у взрослых. Проведен анализ состава коммерческих лекарственных средств и предоставлен имеющийся в настоящий момент опыт ингаляционной терапии препаратом экзогенного сурфактанта Сурфактант-БЛ (МНН Таурактант) при инфекции, вызванной вирусом SARS-CoV-2 (COVID-19). Также приводится личный опыт применения лекарственного препарата Сурфактант-БЛ для лечения пациентов с COVID-19 в условиях реальной клинической практики на примере 8 человек. Все пациенты (мужчины и женщины) были старше 18 лет, имели подтвержденный диагноз «COVID-19», наличие изменений на КТ органов грудной клетки (КТ-2+), потребность в кислородотерапии, СРБ > 30 мг/л. Сурфактант-БЛ вводился всем пациентам в виде эмульсии для ингаляционного введения по 75-150 мг. Повышение сатурации через 1 сут. после ингаляционного введения препарата Сурфактант-БЛ наблюдалось у 1 (12,5%) пациента, на 2-е сут. - у 4 (50%) пациентов, на 7-е сут. - у 3 (12,5%) пациентов. Средняя продолжительность кислородотерапии составила 4 дня, а проведение ИВЛ - 7 дней. Средняя продолжительность госпитализации пациентов - 25 дней, после препарата Сурфактант-БЛ - 20 дней. Препарат Сурфактант-БЛ продемонстрировал эффективность, однако необходимы дальнейшие исследования, поскольку авторы имеют ограниченное число изученных случаев применения препарата.

The current understanding of the main functions of surfactant, data on its composition, and its role in dysfunction and pathogenesis of bronchopulmonary pathology are discussed. The paper presents new information about the results and prospects of surfactant therapy for bronchopulmonary pathology. The use of surfactant in acute respiratory distress syndrome (ARDS) in adults has been studied. An analysis of the composition of commercial drug products is conducted, and the current experience of replacement therapy with the exogenous surfactant preparation Surfactant-BL in infection caused by the SARS-CoV-2 virus (COVID-19) is provided. Personal experience in the use of the drug Surfactant-BL for treating patients with COVID-19 infection in real clinical practice is also presented using the example of 8 individuals. All patients (male and female) were over 18 years old, had a confirmed diagnosis of COVID-19, showed changes on chest CT scans (CT-2+), were undergoing oxygen therapy by any method, and had CRP > 30 mg/L. Surfactant-BL was administered to all patients as an inhaled emulsion at doses of 75-150 mg. An increase in oxygen saturation was observed in 1 (12.5%) patient 1 day after inhalation of the drug Surfactant-BL, in 4 (50%) patients on the 2nd day, and in 3 (12.5%) patients on the 7th day. The average duration of oxygen therapy was 4 days, and mechanical ventilation was 7 days. The average hospital stay of the patients was 25 days, which was reduced to 20 days after the use of Surfactant-B L. The drug Surfactant-BL demonstrated effectiveness; however, further research is needed as the authors have a limited number of cases studied.

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