{"id":20539,"date":"2015-03-26T07:59:06","date_gmt":"2015-03-26T06:59:06","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=20539"},"modified":"2015-03-26T07:59:13","modified_gmt":"2015-03-26T06:59:13","slug":"pozor-na-neuroboreliozu-klistata-se-probouzeji","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=20539","title":{"rendered":"Pozor na neuroboreli\u00f3zu, kl\u00ed\u0161\u0165ata se probouzej\u00ed"},"content":{"rendered":"<p><strong>MUDr. Martin Jan Str\u00e1nsk\u00fd (na sn\u00edmku): \u201eRozpoznat neuroboreli\u00f3zu nen\u00ed v\u016fbec jednoduch\u00e9, nelze se spolehnout ani na krevn\u00ed testy.\u201c<\/strong><!--more--><\/p>\n<p><!--more--><br \/>\nNad \u010dervenou skvrnou ve tvaru p\u00edsmene O s b\u00edl\u00fdm st\u0159edem na k\u016f\u017ei po p\u0159is\u00e1t\u00ed kl\u00ed\u0161t\u011bte by nikdo nem\u011bl m\u00e1vnout rukou. P\u0159\u00edznaky, jako jsou hore\u010dka, \u00fanava a mal\u00e1tnost by pak rozhodn\u011b m\u011bly ka\u017ed\u00e9ho v\u00e9st k praktick\u00e9mu l\u00e9ka\u0159i. V souvislosti s kousnut\u00edm kl\u00ed\u0161t\u011bte jsou to toti\u017e symptomy typick\u00e9 pro Lymeskou boreli\u00f3zu.<\/p>\n<p>Podle MUDr. Martina Jana Str\u00e1nsk\u00e9ho, neurologa z Polikliniky na N\u00e1rodn\u00ed v Praze, prob\u011bhne boreli\u00f3za u nemal\u00e9ho po\u010dtu lid\u00ed  t\u00e9m\u011b\u0159 bezp\u0159\u00edznakov\u011b. Pr\u016fvodn\u00edmi znaky je nap\u0159\u00edklad pouze men\u0161\u00ed \u00fanava \u010di p\u0159\u00edznaky podobn\u00e9 ch\u0159ipce. A podle toho s nimi tak\u00e9 zach\u00e1z\u00edme \u2013 n\u00e1v\u0161t\u011bvu l\u00e9ka\u0159e nepova\u017eujeme za podstatnou a pot\u00ed\u017ee \u0159e\u0161\u00edme samol\u00e9\u010dbou. Pokud ale nen\u00ed boreli\u00f3za v\u010das a dob\u0159e l\u00e9\u010dena, m\u016f\u017ee se b\u011bhem n\u011bkolika t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f vyvinout do chronick\u00e9 formy. Ta m\u016f\u017ee zas\u00e1hnout srdce, klouby, ale tak\u00e9 nervov\u00fd syst\u00e9m. <\/p>\n<p>\u201eP\u0159i neuroboreli\u00f3ze m\u016f\u017ee b\u00fdt posti\u017een nejen pohybov\u00fd \u010di senzorick\u00fd apar\u00e1t, ale dokonce i mozek. Krom\u011b jasn\u00fdch poruch mozku se mohou objevit i v\u00e1\u017en\u00e9 psychiatrick\u00e9 projevy, mezi nimi t\u0159eba deprese,\u201c \u0159\u00edk\u00e1 MUDr. Martin Jan Str\u00e1nsk\u00fd. Spr\u00e1vn\u00e1 diagnostika boreli\u00f3zy je tedy d\u016fle\u017eit\u00e1, bohu\u017eel v\u0161ak v\u016fbec nen\u00ed jednoduch\u00e1 a nelze se stoprocentn\u00ed jistotou spolehnout ani na krevn\u00ed testy.<\/p>\n<p> \u201eProtil\u00e1tky, kter\u00e9 informuj\u00ed o onemocn\u011bn\u00ed boreli\u00f3zou, se v t\u011ble mohou vyv\u00edjet t\u00fddny nebo klidn\u011b i t\u0159i m\u011bs\u00edce po kontaktu s kl\u00ed\u0161t\u011btem. Nav\u00edc v ur\u010dit\u00fdch regionech m\u00e1 a\u017e 25 procent populace pozitivn\u00ed protil\u00e1tky, proto\u017ee pro\u0161lo ji\u017e d\u0159\u00edve onemocn\u011bn\u00edm boreli\u00f3zou a ani o tom nev\u011bd\u011blo. Proto by ka\u017ed\u00e9 pozitivn\u00ed vy\u0161et\u0159en\u00ed m\u011blo b\u00fdt potvrzeno nap\u0159\u00edklad testem ELISA. Ten m\u011b\u0159\u00ed enzymatick\u00e9 l\u00e1tky, kter\u00e9 jsou k aktivn\u00edm protil\u00e1tk\u00e1m v\u016f\u010di boreli\u00f3ze mnohem citliv\u011bj\u0161\u00ed.,\u201c \u0159\u00edk\u00e1 l\u00e9ka\u0159, kter\u00fd krom\u011b \u010cesk\u00e9 republiky p\u016fsob\u00ed i jako prim\u00e1\u0159 neurologie v americk\u00e9 Yale New Haven Medical Center a p\u0159id\u011blen\u00e9 nemocnice. Zdej\u0161\u00ed l\u00e9ka\u0159i pat\u0159\u00ed v l\u00e9\u010db\u011b boreli\u00f3zy ji\u017e tradi\u010dn\u011b k nejzku\u0161en\u011bj\u0161\u00edm na sv\u011bt\u011b. New Haven se toti\u017e nach\u00e1z\u00ed jen p\u00e1r kilometr\u016f od m\u011bste\u010dka Old Lyme ve st\u00e1t\u011b Connecticut, kde bylo v roce 1975 pops\u00e1no prvn\u00edch n\u011bkolik p\u0159\u00edpad\u016f boreli\u00f3zy.<\/p>\n<p>V prvn\u00ed f\u00e1zi onemocn\u011bn\u00ed boreli\u00f3zou jsou prvn\u00ed volbou l\u00e9\u010dby \u0161irokospektr\u00e1ln\u00ed antibiotika. Absolutn\u00ed v\u011bt\u0161ina  nemocn\u00fdch se po jejich nasazen\u00ed vyl\u00e9\u010d\u00ed bez n\u00e1sledk\u016f. Jestli\u017ee v\u0161ak nemoc postoup\u00ed do sekund\u00e1rn\u00ed a terci\u00e1ln\u00ed f\u00e1ze, z\u00e1vis\u00ed l\u00e9\u010dba na konkr\u00e9tn\u00edch projevech. \u201eP\u0159i tzv. pokro\u010dil\u00e9 \u010di terci\u00e1ln\u00ed neuroboreli\u00f3ze s nespecifick\u00fdmi p\u0159\u00edznaky je v\u011bdecky prok\u00e1z\u00e1no, \u017ee antibiotika nemaj\u00ed \u017e\u00e1dn\u00fd smysl,\u201c konstatuje neurolog, a dod\u00e1v\u00e1: \u201e\u0158ada v\u011bdc\u016f dokonce tyto nespecifick\u00e9 p\u0159\u00edznaky, mezi n\u011b\u017e pat\u0159\u00ed nap\u0159\u00edklad bolesti hlavy \u010di svalstva, ob\u010dasn\u00e9 bolesti kloub\u016f a dokonce nap\u0159\u00edklad deprese, neuzn\u00e1v\u00e1 jako p\u0159\u00edm\u00fd d\u016fsledek boreli\u00f3zy.<\/p>\n<p> Boreli\u00f3za tedy fungovala jen jako spou\u0161t\u011b\u010d r\u016fzn\u00fdch protich\u016fdn\u00fdch imunologick\u00fdch nebo psychick\u00fdch akc\u00ed v organismu. Sn\u00ed\u017een\u00ed protil\u00e1tek, nebo zm\u011bna jejich profilu prost\u0159ednictv\u00edm antibiotik, nesouvis\u00ed s klinick\u00fdm stavem. Nejen, \u017ee je v t\u011bchto p\u0159\u00edpadech jejich m\u011b\u0159en\u00ed velice diskutabilni, ale je prokazateln\u011b dolo\u017eeno, \u017ee l\u00e9\u010dba antibiotiky tzv. chronick\u00e9 boreli\u00f3zy  nen\u00ed v\u016fbec efektivn\u00ed, a proto se nedoporu\u010duje.\u201c L\u00e9\u010dba neuroboreli\u00f3zy s nespecifick\u00fdmi p\u0159\u00edznaky je proto pouze symptomatick\u00e1. Podle charakter\u016f probl\u00e9m\u016f jsou pod\u00e1v\u00e1ny nap\u0159\u00edklad protiz\u00e1n\u011btliv\u00e9 l\u00e9ky, antidepresiva \u010di pacient doch\u00e1z\u00ed na fyzioterapii. <\/p>\n<p>Boreli\u00f3zou onemocn\u00ed ka\u017ed\u00fdm rokem v \u010cesk\u00e9 republice  zhruba 4 000 lid\u00ed (3743 v roce 2014 \u2013 program EPIDAT SZ\u00da). To je zhruba dvakr\u00e1t v\u00edce ne\u017e p\u0159ed p\u011btadvaceti lety. Proti boreli\u00f3ze dosud neexistuje \u017e\u00e1dn\u00e9 o\u010dkov\u00e1n\u00ed, av\u0161ak je-li nemoc odhalena a l\u00e9\u010dena v\u010das, odezn\u00ed zpravidla bez dal\u0161\u00edch komplikac\u00ed. Nicm\u00e9n\u011b, kl\u00ed\u0161\u0165ata p\u0159en\u00e1\u0161\u00ed podobnou a nebezpe\u010dn\u011bj\u0161\u00ed nemoc \u2013 kl\u00ed\u0161\u0165ovou encefalitidu, tedy infekci mozku, kter\u00e1 se vyv\u00edj\u00ed podobn\u011b jako boreli\u00f3za. Proti kl\u00ed\u0161\u0165ov\u00e9 encefalitid\u011b v\u0161ak existuje efektivn\u00ed o\u010dkov\u00e1n\u00ed. To je doporu\u010dov\u00e1na p\u0159edev\u0161\u00edm lidem, kte\u0159\u00ed tr\u00e1v\u00ed hodn\u011b \u010dasu v p\u0159\u00edrod\u011b.<\/p>\n<p>Kate\u0159ina Havelkov\u00e1<br \/>\nTiskov\u00e1 zpr\u00e1va<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>MUDr. Martin Jan Str\u00e1nsk\u00fd (na sn\u00edmku): \u201eRozpoznat neuroboreli\u00f3zu nen\u00ed v\u016fbec jednoduch\u00e9, nelze se spolehnout ani na krevn\u00ed testy.\u201c<\/p>\n<\/div>","protected":false},"author":1,"featured_media":20573,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-20539","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/20539","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20539"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/20539\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/20573"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20539"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20539"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}