russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2025-6688QJZANSrussjcardiol-6688Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL CASESСистемный тромболизис у пациента с тромбоэмболией легочной артерии промежуточно-высокого риска. Клинический случайSystemic thrombolysis in a patient with intermediate-high risk pulmonary embolism: a case reporthttps://orcid.org/0000-0001-7007-584XКононовС. К.KononovS. K.

Кононов С. К. — к.м.н., зав. отделением неотложной кардиологии, доцент кафедры факультетской терапии

ул. Ивана Попова, д. 41, Киров, 610014; 

ул. Владимирская, д. 112, Киров, 610027

Ivana Popova str., 41, Kirov, 610014; 

Vladimirskaya str., 112, Kirov, 610027

skkononov@yandex.ruhttps://orcid.org/0000-0002-2590-9283СоловьёвО. В.SolovievO. V.

д.м.н., профессор, зам. главного врача; зав. кафедрой факультетской терапии 

ул. Ивана Попова, д. 41, Киров, 610014; 

ул. Владимирская, д. 112, Киров, 610027

Ivana Popova str., 41, Kirov, 610014; 

Vladimirskaya str., 112, Kirov, 610027

НазаровД. Е.NazarovD. E.

к.м.н., зав. отделением реанимации и интенсивной терапии, доцент кафедры госпитальной хирургии 

ул. Ивана Попова, д. 41, Киров, 610014; 

ул. Владимирская, д. 112, Киров, 610027

Ivana Popova str., 41, Kirov, 610014; 

Vladimirskaya str., 112, Kirov, 610027

https://orcid.org/0000-0003-2712-8162МетелевИ. С.MetelevI. S.

к.м.н., врач кардиолог, врач функциональной диагностики, доцент кафедры факультетской терапии 

ул. Ивана Попова, д. 41, Киров, 610014; 

ул. Владимирская, д. 112, Киров, 610027

Ivana Popova str., 41, Kirov, 610014; 

Vladimirskaya str., 112, Kirov, 610027

https://orcid.org/0009-0005-2074-401XГребеневаЕ. В.GrebenevaE. V.

ассистент кафедры факультетской терапии 

ул. Ивана Попова, д. 41, Киров, 610014; 

ул. Владимирская, д. 112, Киров, 610027

Ivana Popova str., 41, Kirov, 610014; 

Vladimirskaya str., 112, Kirov, 610027

https://orcid.org/0000-0003-3127-1797КарпунинаН. С.KarpuninaN. S.

д.м.н., доцент, профессор кафедры госпитальной терапии и кардиологии 

ул. Петропавловская, д. 26, Пермь, 614990

Petropavlovskaya str., 26, Perm, 614990

ХомяковД. А.KhomyakovD. A.

врач кардиолог, врач функциональной диагностики

ул. Ивана Попова, д. 41, Киров, 610014

Ivana Popova str., 41, Kirov, 610014

ОвсянниковаТ. П.OvsyannikovaT. P.

врач радиолог, рентгенолог, зав. отделением радионуклидной диагностики

пр-т Строителей, д. 23, Киров, 610045

Stroiteley prospekt, 23, Kirov, 610045

КОГКБУЗ Центр кардиологии и неврологии; ФГБОУ ВО Кировский государственный медицинский университет Минздрава РоссииРоссияCenter for Cardiology and Neurology; Kirov State Medical UniversityRussian FederationФГБОУ ВО Пермский государственный медицинский университет им. акад. Е. А. ВагнераRussian FederationE. A. Wagner Perm State Medical UniversityRussian FederationКОГКБУЗ Центр кардиологии и неврологииRussian FederationCenter for Cardiology and NeurologyRussian FederationКОГКБУЗ Центр онкологии и медицинской радиологииRussian FederationCenter for Oncology and Medical RadiologyRussian Federation202518012026301266886688Copyright © Кононов С.К., Соловьёв О.В., Назаров Д.Е., Метелев И.С., Гребенева Е.В., Карпунина Н.С., Хомяков Д.А., Овсянникова Т.П., 20262026Кононов С.К., Соловьёв О.В., Назаров Д.Е., Метелев И.С., Гребенева Е.В., Карпунина Н.С., Хомяков Д.А., Овсянникова Т.П.Kononov S.K., Soloviev O.V., Nazarov D.E., Metelev I.S., Grebeneva E.V., Karpunina N.S., Khomyakov D.A., Ovsyannikova T.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/6688

Представлен клинический случай системной тромболитической терапии у пациента с тромбоэмболией легочной артерии промежуточно-высокого риска осложнений и смерти. В настоящее время в мире проводятся несколько рандомизированных клинических исследований тромболитической терапии у данной категории больных, при этом доказательная база данного подхода по-прежнему недостаточна. Демонстрируется эффективность и безопасность тромболитической терапии. Подчеркивается сложность, отсутствие однозначных критериев для принятия решения о проведении тромболизиса в реальной клинической практике. Указывается на важность индивидуальной оценки клинической ситуации.

This article presents a case of systemic thrombolytic therapy in a patient with intermediate-high risk pulmonary embolism (PE). Several randomized clinical trials of thrombolytic therapy in this patient population are currently underway worldwide, but the related evidence base remains insufficient. The efficacy and safety of thrombolytic therapy are demonstrated. The complexity and lack of definitive criteria for deciding on thrombolysis in real-world clinical practice are emphasized. We noted the importance of an individualized assessment of the clinical situation.

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