Bolest v z\u00e1dech nen\u00ed ni\u010d\u00edm zar\u00e1\u017eej\u00edc\u00edm a mnoz\u00ed ji berou jako da\u0148 za pohodln\u00fd, sedav\u00fd \u017eivot modern\u00ed doby. V\u011bt\u0161ina z n\u00e1s ji \u0159e\u0161\u00ed n\u00e1razov\u00fdm u\u017e\u00edv\u00e1n\u00edm voln\u011b prodejn\u00fdch l\u00e9k\u016f proti bolesti, p\u0159\u00edpadn\u011b ob\u010dasn\u00fdmi rehabilitacemi. <\/p>\n
Pokud v\u0161ak za bolest m\u016f\u017ee z\u00e1n\u011btliv\u00e9 revmatick\u00e9 onemocn\u011bn\u00ed zn\u00e1m\u00e9 jako Becht\u011brevova choroba, b\u011b\u017en\u00e9 pr\u00e1\u0161ky ani ob\u010dasn\u00e9 cvi\u010den\u00ed nic nezmohou. <\/p>\n
Becht\u011brevova nemoc, nov\u011bji ozna\u010dovan\u00e1 jako ankylozuj\u00edc\u00ed spondylitida, pat\u0159\u00ed do velk\u00e9 skupiny syst\u00e9mov\u00fdch onemocn\u011bn\u00ed naz\u00fdvan\u00e9 spondyloartritidy. Postihuje struktury p\u00e1te\u0159e, perifern\u00ed klouby a svalov\u00e9 \u00fapony, nap\u0159\u00edklad Achillovu \u0161lachu. Z\u00e1n\u011bt m\u016f\u017ee zas\u00e1hnout i o\u010di v podob\u011b z\u00e1n\u011btu duhovky, k\u016f\u017ei, kdy se projevuje jako lup\u00e9nka, \u010di sliznici st\u0159eva jako Crohnova nemoc,“ \u0159\u00edk\u00e1 na \u00favod \u0159editel Revmatologick\u00e9ho \u00fastavu v Praze <\/p>\n
prof. MUDr. Karel Pavelka, DrSc. <\/p>\n
Jak „Becht\u011brev“ vypad\u00e1 <\/p>\n
Becht\u011brevova nemoc m\u00e1 pomal\u00fd, pl\u00ed\u017eiv\u00fd za\u010d\u00e1tek. Mnoho lid\u00ed jej\u00edmu n\u00e1stupu zpo\u010d\u00e1tku nev\u011bnuje ani pozornost. „V prvn\u00ed f\u00e1zi se objevuje bolest v doln\u00ed \u010d\u00e1sti zad, kter\u00e1 nastupuje v druh\u00e9 polovin\u011b noci. Typick\u00e9 pro tuto z\u00e1n\u011btlivou bolest v k\u0159\u00ed\u017eov\u00e9 \u010d\u00e1sti p\u00e1te\u0159e je, \u017ee se zlep\u0161uje rozcvi\u010den\u00edm a pohybem, naopak se zhor\u0161uje, pokud je nemocn\u00fd v klidu. P\u0159\u00ed\u010dinou t\u00e9to bolesti je z\u00e1n\u011bt meziobratlov\u00fdch kloub\u016f p\u00e1te\u0159e, kter\u00fd vede ke kostnat\u011bn\u00ed vaz\u016f a sr\u016fst\u016fm mezi jednotliv\u00fdmi obratli,“ popisuje profesor Pavelka.
\n„V po\u010d\u00e1tc\u00edch onemocn\u011bn\u00ed si pacient nedos\u00e1hne rukama na kolena, pozd\u011bji se nem\u016f\u017ee v\u016fbec p\u0159edklonit a v pozdn\u00edm stadiu p\u00e1te\u0159 nab\u00fdv\u00e1 charakteru zak\u0159iven\u00e9 tuh\u00e9 ty\u010de. Nemocn\u00fd se nem\u016f\u017ee narovnat ani oto\u010dit. Posti\u017een\u00ed p\u00e1te\u0159e m\u016f\u017ee b\u00fdt i takov\u00e9, \u017ee pacient v d\u016fsledku zak\u0159iven\u00ed p\u00e1te\u0159e ani nevid\u00ed p\u0159ed sebe.
\nM\u016f\u017ee se objevit bolest hrudn\u00edku a chronick\u00e1 t\u011b\u017ek\u00e1 \u00fanava, ve v\u00e1\u017en\u00fdch p\u0159\u00edpadech se objevuj\u00ed i probl\u00e9my s d\u00fdch\u00e1n\u00edm.
\nNel\u00e9\u010den\u00e1 nemoc vede k t\u011b\u017ek\u00fdm po\u0161kozen\u00edm p\u00e1te\u0159e a kloub\u016f, a\u017e k invalidizaci,“ popisuje l\u00e9ka\u0159.
\nNemoc je v sou\u010dasn\u00e9 dob\u011b je\u0161t\u011b st\u00e1le nevyl\u00e9\u010diteln\u00e1. Spr\u00e1vn\u00e1 terapie v\u0161ak m\u016f\u017ee udr\u017eovat ur\u010ditou kvalitu \u017eivota pacienta. Jak ov\u0161em vyplynulo z v\u00fdsledk\u016f jedn\u00e9 studie, probl\u00e9m spo\u010d\u00edv\u00e1 v tom, \u017ee doba od vypuknut\u00ed prvn\u00edch p\u0159\u00edznak\u016f do defi nitivn\u00ed diagnostiky trv\u00e1 a\u017e 9 let! „Za t\u011bchto dev\u011bt let z\u010d\u00e1sti mohou sami pacienti, kte\u0159\u00ed v po\u010d\u00e1tc\u00edch p\u0159\u00edznaky a bolesti v doln\u00ed \u010d\u00e1sti zad podce\u0148uj\u00ed a p\u0159ipisuj\u00ed je \u0161patn\u00e9 matraci \u010di p\u0159et\u00ed\u017een\u00ed. Z\u010d\u00e1sti je ale probl\u00e9m i na stran\u011b l\u00e9ka\u0159\u016f, kte\u0159\u00ed nepom\u00fd\u0161lej\u00ed na ankylozuj\u00edc\u00ed spondylitidu u pacient\u016f s bolestmi zad. Z\u00e1rove\u0148 za pozdn\u00ed diagnostiku mohl i diagnostick\u00fd postup a diagnostick\u00e1 krit\u00e9ria, je\u017e byla dlouhou dobu zalo\u017eena zejm\u00e9na na rentgenov\u00fdch n\u00e1lezech,“ vysv\u011btluje odborn\u00edk.
\nSou\u010dasn\u00e1 medic\u00edna v\u0161ak v tomto sm\u011bru postoupila kup\u0159edu a diagnostick\u00e9 postupy a krit\u00e9ria umo\u017e\u0148uj\u00ed zji\u0161t\u011bn\u00ed Becht\u011brevovy nemoci ji\u017e v obdob\u00ed p\u0159ed t\u00edm, ne\u017e dojde k viditeln\u00fdm zm\u011bn\u00e1m na p\u00e1te\u0159i na rtg sn\u00edmc\u00edch. „Mezi diagnostick\u00e1 krit\u00e9ria Becht\u011brevovy nemoci pat\u0159\u00ed chronick\u00e1, d\u00e9le ne\u017e t\u0159i m\u011bs\u00edce trvaj\u00edc\u00ed z\u00e1n\u011btliv\u00e1 bolest v z\u00e1dech, n\u00e1lez z\u00e1n\u011btu v oblasti sakroiliak\u00e1ln\u00edch kloub\u016f p\u00e1te\u0159e na magnetick\u00e9 rezonanci, kter\u00fd pom\u016f\u017ee nemoc odhalit d\u0159\u00edve ne\u017e zmi\u0148ovan\u00fd rentgen, laboratorn\u011b potvrzen\u00e1 p\u0159\u00edtomnost antigenu HLA-B27 v krvi a dal\u0161\u00ed klinick\u00e9 p\u0159\u00edznaky, nap\u0159\u00edklad ji\u017e zmi\u0148ovan\u00fd z\u00e1n\u011bt duhovky, lup\u00e9nka \u010di Crohnova nemoc,“ popisuje l\u00e9ka\u0159. <\/p>\n
L\u00e9ky proti z\u00e1n\u011btu a bolesti, i operace <\/p>\n
Pokud dojde k potvrzen\u00ed diagn\u00f3zy Becht\u011brevovy nemoci, zah\u00e1j\u00ed se l\u00e9\u010dba. Jej\u00edm smyslem je sn\u00ed\u017een\u00ed bolest\u00ed a zabr\u00e1n\u011bn\u00ed postupu z\u00e1n\u011btu, ztuhlosti kloub\u016f i sr\u016fst\u016f p\u00e1te\u0159e. „Prvn\u00edm krokem je pod\u00e1v\u00e1n\u00ed nesteroidn\u00edch antirevmatik. Dal\u0161\u00ed mo\u017enost\u00ed je lok\u00e1ln\u00ed terapie glukokortikoidy. U pacient\u016f s vysokou aktivitou onemocn\u011bn\u00ed nebo u t\u011bch, u nich\u017e v\u0161echny ostatn\u00ed terapeutick\u00e9 mo\u017enosti selhaly, lze p\u0159istoupit k biologick\u00e9 l\u00e9\u010db\u011b. Tu v sou\u010dasn\u00e9 dob\u011b v \u010cesk\u00e9 republice dost\u00e1v\u00e1 2207 pacient\u016f,“ \u0159\u00edk\u00e1 profesor Pavelka.
\nSou\u010d\u00e1st\u00ed l\u00e9\u010dby je tak\u00e9 cvi\u010den\u00ed a rehabilitace.
\n„U n\u00e1s na klinice je nap\u0159\u00edklad jednou t\u00fddn\u011b rehabilita\u010dn\u00ed cvi\u010den\u00ed c\u00edlen\u00e9 na pacienty s touto chorobou. Rehabilitace by v\u0161ak m\u011bla b\u00fdt pravideln\u00e1 a ka\u017edodenn\u00ed,“ upozor\u0148uje revmatolog. V n\u011bkter\u00fdch p\u0159\u00edpadech je ov\u0161em t\u0159eba i operace. „U \u010d\u00e1sti pacient\u016f je doporu\u010dena chirurgick\u00e1 l\u00e9\u010dba, jej\u00edm\u017e smyslem je narovn\u00e1n\u00ed p\u00e1te\u0159e. V p\u0159\u00edpad\u011b posti\u017een\u00ed ky\u010deln\u00edho, kolenn\u00edho \u010di ramenn\u00edho kloubu je samoz\u0159ejm\u011b mo\u017en\u00e1 jeho n\u00e1hrada,“ up\u0159es\u0148uje odborn\u00edk. Terapii je mo\u017en\u00e9 podpo\u0159it l\u00e1ze\u0148sk\u00fdm pobytem. „Dobr\u00e9 zku\u0161enosti m\u00e1me s l\u00e1zn\u011bmi J\u00e1chymov, kter\u00e9 jsou zam\u011b\u0159en\u00e9 na pohybov\u00fd apar\u00e1t a kde nemocn\u00ed podstupuj\u00ed \u0159adu procedur v\u010detn\u011b koupel\u00ed a cvi\u010den\u00ed v radonov\u00e9 vod\u011b,“ dod\u00e1v\u00e1 profesor Pavelka. <\/p>\n
— <\/p>\n
s postupem \u010dasu se projevy zhor\u0161uj\u00ed a p\u00e1te\u0159 se v d\u016fsledku meziobratlov\u00fdch sr\u016fst\u016f st\u00e1v\u00e1 st\u00e1le m\u00e9n\u011b ohebnou. <\/p>\n
Becht\u011brevova nemoc se vyskytuje \u010dast\u011bji u mu\u017e\u016f ne\u017e u \u017een, obvykl\u00fdm obdob\u00edm, kdy doch\u00e1z\u00ed k n\u00e1stupu prvn\u00edch p\u0159\u00edznak\u016f, je v\u011bk mezi 20 a 30 lety. „V populaci trp\u00ed t\u00edmto onemocn\u011bn\u00edm 0,5 a\u017e 0,8 procenta lid\u00ed, to znamen\u00e1, \u017ee mezi n\u00e1mi \u017eije asi 80 a\u017e 100 tis\u00edc nemocn\u00fdch touto chorobou,“ vypo\u010d\u00edt\u00e1v\u00e1 profesor Pavelka. <\/p>\n
Varovn\u00e9 sign\u00e1ly <\/p>\n
N\u00e1v\u0161t\u011bvu l\u00e9ka\u0159e a upozorn\u011bn\u00ed na p\u0159\u00edpadn\u00e9 obavy z Becht\u011brevovy nemoci by nem\u011bli odkl\u00e1dat lid\u00e9, kte\u0159\u00ed: <\/p>\n
* maj\u00ed d\u00e9le ne\u017e 3 m\u011bs\u00edce trvaj\u00edc\u00ed bolest zad v doln\u00ed \u010d\u00e1sti p\u00e1te\u0159e <\/p>\n
– trp\u00ed bolest\u00ed zad, je\u017e nastupuje zejm\u00e9na v druh\u00e9 polovin\u011b noci <\/p>\n
– maj\u00ed bolest, je\u017e se zhor\u0161uje klidem a naopak se zlep\u0161uje pohybem <\/p>\n
* v\u011bd\u00ed o v\u00fdskytu Becht\u011brevovy nemoci v rodin\u011b (toto onemocn\u011bn\u00ed je d\u011bdi\u010dn\u00e9) <\/p>\n
* maj\u00ed diagnostikovanou lup\u00e9nku \u010di Crohnovu nemoc <\/p>\n
– spadaj\u00ed do v\u011bkov\u00e9 skupiny 20-45 let (v tomto obdob\u00ed doch\u00e1z\u00ed nej\u010dast\u011bji k n\u00e1stupu prvn\u00edch p\u0159\u00edznak\u016f Becht\u011brevovy nemoci) <\/p>\n
O autorovi: Barbora Neubergerov\u00e1, odborn\u00e1 spolupr\u00e1ce: prof. MUDr. Karel Pavelka, DrSc., Revmatologick\u00fd \u00fastav v Praze<\/p>\n
Moje zdrav\u00ed<\/p>\n","protected":false},"excerpt":{"rendered":"
Bolest v z\u00e1dech nen\u00ed ni\u010d\u00edm zar\u00e1\u017eej\u00edc\u00edm a mnoz\u00ed ji berou jako da\u0148 za pohodln\u00fd, sedav\u00fd \u017eivot modern\u00ed doby. V\u011bt\u0161ina z n\u00e1s ji \u0159e\u0161\u00ed n\u00e1razov\u00fdm u\u017e\u00edv\u00e1n\u00edm […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":15661,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-26520","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26520","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=26520"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26520\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/15661"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26520"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26520"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26520"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}