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},
"code": "M94.1",
"name": "Рецидивирующий полихондрит",
"icd_name": "Рецидивирующий полихондрит",
"gender": 0,
"age_min": 40,
"age_max": 60,
"cause": [
"0"
],
"periodicity": 1,
"slug": "m94.1_recidiviruyuschiy_polihondrit",
"lead": "воспалительное заболевание, поражающее хрящевые структуры и соединительную ткань различных органов и систем",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Рецидивирующий полихондрит – заболевание, характеризующееся приступами болей, а также деструктивным воспалением хряща и других соединительных тканей в ушных раковинах, суставах, носу, гортани, трахее, бронхах, глазах, сердечных клапанах, почках и кровеносных сосудах.</span></p>",
"etiology": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причины, провоцирующие факторы и механизмы развития пока неизвестны, однако, характерные изменения уровня антител в крови позволяют предположить, что болезнь имеет аутоиммунный характер.</span></p>",
"pathogenesis": "",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">С помощью лабораторных исследований выявляются лишь незначительные изменения, касающиеся повышения СОЭ и анемии, снижения количества альбуминов и так далее.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для диагностики, кроме общего анализа крови, могут понадобиться и такие методы, как рентгенографическое исследование и КТ, в отдельных случаях специалист может назначить МРТ. Рекомендована также биопсия хрящевых структур.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Весьма эффективна и допплерография с цветовым картированием основных сосудов, эхокардиография.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Как правило, при диагностике требуются консультации нескольких специалистов, таких как офтальмолог, кардиолог, ортопед и некоторых других.</span></p>",
"treatment": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При легких поражениях и воспалительных процессах средней тяжести применяются невысокие дозы глюкокортикоидов (15-20 мг). В тяжелых случаях (поражение аорты, сердца, сосудов, дыхательных путей, почек, глаз и внутреннего уха) дозу глюкокортикоидов увеличивают до 40-60 мг. Возможна пульс-терапия, а также комбинация с цитостатическими иммунодепрессантами. При тяжелых поражениях бронхов, трахеомаляции, стенозах гортани и трахеи необходимы хирургические вмешательства: трахеоборонхиальное стентирование, сегментарная резекция бронхов или трахеостомия. Развитие аортальной недостаточности является показанием для протезирования клапана либо участка аорты.</span></p>",
"prevention": "",
"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Как правило, первоначально регистрируют воспалительный процесс в области ушных раковин (58% случаев).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Они краснеют, опухают, до них невозможно дотронуться из-за резкой боли. Наружный слуховой проход опухает также, и это становится причиной снижения слуха. Вследствие фиброзных изменений происходит деформация ушных раковин.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Кроме этого, процесс затрагивает и хрящевую перегородку носа (82% больных), нос приобретает седловидную форму.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Данное изменение может проявляться уже во время первого приступа, но чаще всего случается в период обострений. При этом не всегда будет присутствовать болевой синдром.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Первые приступы полихондрита часто сопровождаются лихорадкой (более 80 % случаев).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Пациента также тревожит и суставный синдром, который проявляется как артралгия, полиартрит. Его проявления похожи на признаки ревматоидного артрита. На рентгенограммах видны эрозивные изменения.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Поражаются хрящевые структуры гортани и трахеи (70% случаев). Данные области болезненны во время пальпации.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если это тяжелое проявление, то оно может дублироваться затрудненным дыханием, требующим трахеотомии.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В патологический процесс могут вовлекаться бронхи: развивается их коллапс. А значит резко активируются инфекционные процессы, в некоторых случаях возможна асфиксия.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">У 60% пациентов будут регистрироваться такие отклонения зрительной системы, как ирит, эписклерит, конъюнктивит.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В очень редких случаях могут вовлекаться в процесс также хрящи ребер, клапаны и дуга аорты, вестибулярный аппарат. </span><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Что касается течения, то обычно оно имеет острый характер, а затем приобретает хроническую форму с обострениями. Они могут тревожить пациента как несколько дней, так и в течение полугода.</span></p>",
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"standard_type": 0,
"danger": 50,
"published": 1,
"parent": 6862,
"block_rubric": 145,
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},
{
"id": 12747,
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{
"id": 12510,
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