RUDN Journal of MedicineRUDN Journal of MedicineВестник Российского университета дружбы народов. Серия: Медицина2313-02452313-0261Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)2380910.22363/2313-0245-2020-24-2-135-144THERAPEUTIC DISEASEВНУТРЕННИЕ БОЛЕЗНИReview ArticlePolypathy: searching for etiopathogenetic risks factorsПолипатии: в поиске факторов этиопатогенетических рисковFusA. V.ФусА. В.fusalla@mail.ruPodolinnyG. I.ПодолинныйГ. И.fusalla@mail.ruTiraspol Clinical Center for Outpatient Care № 1Тираспольский клинический центр амбулаторно-поликлинической помощи № 1Taras Shevchenko Transnistria State UniversityПриднестровский государственный университет им. Т.Г. Шевченко15122020242VOL 24, NO2 (2020)ТОМ 24, №2 (2020)13514427052020Copyright ©; 2020, Fus A.V., Podolinny G.I.Copyright ©; 2020, Фус А.В., Подолинный Г.И.2020Fus A.V., Podolinny G.I.Фус А.В., Подолинный Г.И.http://creativecommons.org/licenses/by/4.0https://journals.rudn.ru/medicine/article/view/23809

The article provides an overview of the literature on the actual problem of diseases - polypathy. The review focuses problematic aspects of comorbid states, the scatter of their definitions, the incidence in different countries according to the international scientific community, the frequency of use of comorbid indices, the influence of racial and ethnicity in polypathies, risk factors for the development of combined diseases both at the level of an individual’s genes and aspects of a person’s lifestyle and the environment, options for their pathogenetic development with examples of nodal chains and their effects (nodules), examples of countries with modified risk factors to reduce mortality according to the approved action plan World Health Organization for the Prevention of Chronic Noncommunicable Diseases. The review focuses on factors contributing to the development of polypathy, in particular connective tissue dysplasia. The problems of diagnosing the external signs of connective tissue dysplasia in comorbid patients according to accepted diagnostic criteria and the frequency of their occurrence abroad and in Russia. An analogy is drawn between the concept of cardiovascular continuum and the development of polypathy in the patient’s body with connective tissue dysplasia of varying severity. There is analyzed the experience of treating patients with comorbid pathology of both the international scientific society of comorbidity (2010) and the Russian recommendations on comorbidity (2016). There is raised the development of COVID-19 in different patients with polypathy in China and other countries.

В статье представлен обзор литературных данных по актуальной проблеме внутренних болезней - полипатиям. Рассмотрены проблемные аспекты коморбидных состояний, разброс их дефиниций, встречаемость в разных странах по данным международного научного сообщества, частота использования коморбидных индексов, влияние расово-этнической принадлежности при полипатиях, факторы риска развития сочетанных заболеваний как на уровне генов индивидуума, так и аспектов образа жизни человека и окружающей среды, варианты их патогенетического развития с примерами узловых цепей и воздействия на них (узлы), примеры стран с модификацией факторов риска для снижения смертности согласно утвержденному плану действий Всемирной организации здравоохранения по профилактике хронических неинфекционных заболеваний. В обзоре сделан акцент на факторы, способствующие развитию полипатий, в частности соединительнотканной дисплазии. Рассмотрены вопросы диагностики внешних признаков дисплазии соединительной ткани у коморбидных больных согласно принятым диагностическим критериям и частота их встречаемости за рубежом и в России. Проведена аналогия между концепцией сердечнососудистого континуума и развитием полипатий в организме пациента с дисплазией соединительной ткани различной степени выраженности. Проанализирован опыт лечения пациентов с коморбидной патологией как международного научного общества коморбидности (2010), так и российские рекомендации по коморбидности (2016). Затронут вопрос развития COVID-19 у пациентов с полипатиями в Китае и других странах.

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