avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2025-15-4-252-261LASKIOavk-2043Research ArticleЛЕКЦИИLECTURESТерапия геморрагической лихорадки с почечным синдромом: патофизиологическое обоснование и практическое применениеTreatment of Hemorrhagic Fever with Renal Syndrome: Pathophysiologic Rationale and Practical Applicationhttps://orcid.org/0000-0002-3025-0866МалининО. В.MalininO. V.

Малинин Олег Витальевич — к.м.н., заведующий кафедрой инфекционных болезней и эпидемиологии

Ижевск

Oleg V. Malinin — Cand. Sci. (Med.), Head of the Department of Infectious Diseases and Epidemiology

Izhevsk

igma.030@yandex.ruФГБОУ ВО «Ижевская государственная медицинская академия» МЗ РФРоссияIzhevsk State Medical AcademyRussian Federation202529072025154252261Copyright © Малинин О.В., 20252025Малинин О.В.Malinin O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/2043

Современная терапия геморрагической лихорадки с почечным синдромом (ГЛПС) преимущественно основывается на мнении экспертов и данных небольших обсервационных исследований, результаты которых не всегда воспроизводятся в клинической практике. В связи с отсутствием эффективных противовирусных средств лечения ГЛПС продолжается поиск оптимальной патогенетической терапии. Клиническое течение ГЛПС характеризуется последовательным развитием периодов лихорадки, гипотензии, олигурии, полиурии и реконвалесценции. Для каждого из периодов свойственны определенные патофизиологические механизмы, знание которых необходимо для правильной организации лечения больных ГЛПС. В данной работе рассмотрены патогенетическое обоснование и опыт практического применения используемых при ГЛПС методов лечения, таких как противовоспалительная терапия, коррекция водно-электролитных, гемодинамических и гемокоагуляционных нарушений, экстракорпоральная детоксикация и симптоматическая терапия.

Current treatment of hemorrhagic fever with renal syndrome (HFRS) is primarily based on expert opinion and data from small observational studies, the results of which are not always confirmed in clinical practice. Due to the lack of effective antiviral agents for the treatment of HFRS, the search for optimal supportive therapy continues. The clinical course of HFRS is characterized by the sequential development of phases of fever, hypotension, oliguria, polyuria and convalescence; each of these phases is characterized by certain pathophysiological mechanisms, knowledge of which is necessary for the correct management of patients with HFRS. This narrative review provides the pathophysilogic rationale and practical experience of using treatment methods for HFRS, such as anti-inflammatory therapy, correction of fluid, electrolyte, hemodynamic and hemocoagulation disorders, as well as, renal replacement therapy and symptomatic therapy.

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