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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vmireaviz</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник медицинского института «РЕАВИЗ». Реабилитация, Врач и Здоровье</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2226-762X</issn><issn pub-type="epub">2782-1579</issn><publisher><publisher-name>РЕАВИЗ</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20340/vmi-rvz.2023.5.CASE.6</article-id><article-id custom-type="elpub" pub-id-type="custom">vmireaviz-810</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Клинический случай</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Clinical case</subject></subj-group></article-categories><title-group><article-title>Оролингвальный ангионевротический отек как осложнение системной тромболитической терапии при помощи рекомбинантного тканевого активатора плазминогена</article-title><trans-title-group xml:lang="en"><trans-title>Orolingual angioedema as a complication of systemic thrombolytic therapy with recombinant tissue plasminogen activator</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8490-1417</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ковалева</surname><given-names>Э. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovaleva</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ковалева Элла Александровна - канд. мед. наук, старший научный сотрудник научного отделения неотложной неврологии и восстановительного лечения, старший преподаватель учебного отдела, врач-невролог  неврологического отделения для больных с острыми нарушениями мозгового кровообращения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Ella A. Kovaleva - Cand. Sci. (Med.), Senior Researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, senior lecturer of the educational Department, neurologist of the neurological department for patients with acute disorders of cerebral circulation,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">kovalevaea@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9788-592X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коригова</surname><given-names>Х. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Korigova</surname><given-names>Kh. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Коригова Хеди Валерьевна - младший научный сотрудник научного отделения неотложной неврологии и восстановительного лечения, врач-невролог неврологического отделения для больных с острыми нарушениями мозгового кровообращения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Khedi V. Korigova - Junior Researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, neurologist of the Neurological Department for patients with acute disorders of cerebral circulation,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">korigovahv@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7444-3117</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Вышлова</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Vyshlova</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Вышлова Анна Ильинична - врач-невролог неврологического отделения для больных с острыми нарушениями мозгового кровообращения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Anna I. Vyshlova - Neurologist of the neurological department for patients with acute disorders of cerebral circulation,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">klychnikova.anna@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9750-3509</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шевченко</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shevchenko</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шевченко Евгений Владимирович - канд. мед. наук, заведующий неврологическим отделением для больных с острыми нарушениями мозгового кровообращения, младший научный сотрудник научного отделения неотложнойневрологии и восстановительного лечения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Evgeniy V. Shevchenko - Cand. Sci. (Med.), Head of the Neurological Department for patients with acute disorders of cerebral circulation, junior researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">shevchenkoev@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8096-5029</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ахматханова</surname><given-names>Л. Х.-Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Akhmatkhanova</surname><given-names>L. Kh.-B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ахматханова Лиана Хаваж-Баудиновна - младший научный сотрудник научного отделения неотложнойневрологии и восстановительного лечения, врач-невролог неврологического отделения для больных с острыми нарушениями мозгового кровообращения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Liana Kh.-B. Akhmatkhanova - Junior Researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, neurologist of the Neurological Department for patients with acute disorders of cerebral circulation,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">akhmatkhanovalb@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6824-4114</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рамазанов</surname><given-names>Г. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Ramazanov</surname><given-names>G. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рамазанов Ганипа Рамазанович - канд. мед. наук, заведующий научным отделением неотложной неврологии и восстановительного лечения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Ganipa R. Ramazanov - Cand. Sci. (Med.), Head of the Scientific Department of Emergency Neurology and Rehabilitation Treatment,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">ramazanovgr@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-7417-1845</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алиев</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Aliev</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Алиев Илгар Садыхович - канд. мед. наук, ведущий научный сотрудник научного отделения неотложной неврологии и восстановительного лечения, заведующий отделением реанимации и интенсивной терапии для больных с острыми нарушениями мозгового кровообращения,</p><p>Большая Сухаревская пл., д. 3, Москва, 129090</p></bio><bio xml:lang="en"><p>Ilgar S. Aliev - Cand. Sci. (Med.), leading researcher of the Scientific Department of Emergency Neurology and Rehabilitation Treatment, head of the Intensive Care Unit and Intensive Care unit for patients with acute disorders of cerebral circulation,</p><p>3 Bolshaya Sukharevskaya Square, Moscow, 129090</p></bio><email xlink:type="simple">alievis@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sklifosovsky Research Institute for Emergency Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>20</day><month>07</month><year>2023</year></pub-date><volume>13</volume><issue>5</issue><fpage>116</fpage><lpage>120</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ковалева Э.А., Коригова Х.В., Вышлова А.И., Шевченко Е.В., Ахматханова Л.Х., Рамазанов Г.Р., Алиев И.С., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Ковалева Э.А., Коригова Х.В., Вышлова А.И., Шевченко Е.В., Ахматханова Л.Х., Рамазанов Г.Р., Алиев И.С.</copyright-holder><copyright-holder xml:lang="en">Kovaleva E.A., Korigova K.V., Vyshlova A.I., Shevchenko E.V., Akhmatkhanova L.K., Ramazanov G.R., Aliev I.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://vestnik.reaviz.ru/jour/article/view/810">https://vestnik.reaviz.ru/jour/article/view/810</self-uri><abstract><p>Оролингвальный ангионевротический отёк – редкое, но крайне опасное осложнение системной тромболитической терапии при помощи рекомбинантного тканевого активатора плазминогена, частота развития которого достигает 2,2–5,1 %. Оролингвальный ангионевротический отёк является жизнеугрожающим состоянием, так как может привести к нарушению проходимости дыхательных путей и асфиксии. Представлен анализ клинического случая оролингвального ангионевротического отёка как осложнения системной тромболитической терапии при помощи рекомбинантного тканевого активатора плазминогена, представлены факторы риска его развития и методы лечения. Необходима оценка выраженности отёка каждые 30–60 минут после системной тромболитической терапии для того, чтобы не пропустить момент эскалации процесса. Для лечения оролингвального ангионевротического отёка применяют антигистаминные препараты, глюкокортикостероиды и адреналин, в случае прогрессирующего отёка и нарушения проходимости дыхательных путей выполняют экстренную интубацию трахеи с последующей искусственной вентиляцией лёгких.</p></abstract><trans-abstract xml:lang="en"><p>Orolingual angioedema is a rare, but extremely dangerous complication of systemic thrombolytic therapy with recombinant tissue plasminogen activator, the incidence of which reaches 2.2-5.1 %. Orolingual angioedema is a life-threatening condition, as it can lead to airway obstruction and asphyxia. An analysis of a clinical case of orolingual angioedema as a complication of systemic thrombolytic therapy using a recombinant tissue plasminogen activator is presented, risk factors for its development and treatment methods are presented. Orolingual angioedema is a rare life-threatening complication of systemic thrombolytic therapy with recombinant tissue plasminogen activator. It is necessary to assess the severity of edema every 30-60 minutes after systemic thrombolytic therapy in order not to miss the moment of escalation of the process. For the treatment of orolingual angioedema, antihistamines, glucocorticosteroids and adrenaline are used, in case of progressive edema and impaired airway patency, emergency tracheal intubation is performed, followed by artificial ventilation of the lungs.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>острое нарушение мозгового кровообращения</kwd><kwd>реперфузионная терапия</kwd><kwd>рекомбинантный тканевой активатор плазминогена</kwd><kwd>оролингвальный ангионевротический отек</kwd></kwd-group><kwd-group xml:lang="en"><kwd>acute cerebrovascular accident</kwd><kwd>reperfusion therapy</kwd><kwd>recombinant tissue plasminogen activator</kwd><kwd>orolingual angioedema</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. 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