{"id":42096,"date":"2023-09-12T13:29:17","date_gmt":"2023-09-12T11:29:17","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=42096"},"modified":"2023-09-12T13:29:17","modified_gmt":"2023-09-12T11:29:17","slug":"jizveni-plic-je-treba-lecit-vcas-varuji-pneumologove","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=42096","title":{"rendered":"Jizven\u00ed plic je t\u0159eba l\u00e9\u010dit v\u010das, varuj\u00ed pneumologov\u00e9"},"content":{"rendered":"\n

Stovk\u00e1m lid\u00ed v\u00a0\u010cesku se jizv\u00ed pl\u00edce. K\u00a0tomu doch\u00e1z\u00ed z\u00a0nejr\u016fzn\u011bj\u0161\u00edch d\u016fvod\u016f, d\u016fle\u017eit\u00e9 ale je zachytit jizven\u00ed v\u010das a nasadit tzv. antifibrotickou l\u00e9\u010dbu. Ta zpomaluje proces, kdy v\u00a0plic\u00edch miz\u00ed plocha k\u00a0d\u00fdch\u00e1n\u00ed. Des\u00edtky pacient\u016f se z\u00e1va\u017en\u00fdmi nemocemi, kter\u00e9 mohou plicn\u00ed fibr\u00f3zu prov\u00e1zet, v\u0161ak nechod\u00ed na pravideln\u00e9 kontroly plic, kter\u00e9 by mohly l\u00e9ka\u0159e na po\u010d\u00ednaj\u00edc\u00ed jizven\u00ed v\u010das upozornit. Lid\u00e9 p\u0159ich\u00e1zej\u00ed a\u017e ve chv\u00edli, kdy maj\u00ed pot\u00ed\u017ee. To u\u017e b\u00fdv\u00e1 \u010dasto pozd\u011b, jizven\u00ed m\u016f\u017ee b\u00fdt pokro\u010dil\u00e9 a odborn\u00edci pro pacienty nemohou moc ud\u011blat. <\/strong><\/p>\n\n\n\n

Na tento probl\u00e9m upozor\u0148uj\u00ed plicn\u00ed l\u00e9ka\u0159i p\u0159i T\u00fddnu idiopatick\u00e9 plicn\u00ed fibr\u00f3zy (IPF), kter\u00fd startuje 18.\u00a0z\u00e1\u0159\u00ed.<\/strong><\/p>\n\n\n\n

\u201eTo se t\u00fdk\u00e1 \u010dasto i mlad\u00fdch lid\u00ed ve v\u011bku mezi 30\u201340 lety, kte\u0159\u00ed trp\u00ed n\u011bkterou z nemoc\u00ed, je\u017e mohou tzv.\u00a0fibrotizuj\u00edc\u00ed zm\u011bny na plic\u00edch zp\u016fsobovat, tedy nap\u0159\u00edklad autoimunitn\u00edmi nemocemi, jako je revmatoidn\u00ed artritida, syst\u00e9mov\u00e1 sklerodermie \u010di myozitida. Pacienty sice sleduje l\u00e9ka\u0159 kv\u016fli jejich prim\u00e1rn\u00ed nemoci, ale proto\u017ee obvykle zpo\u010d\u00e1tku p\u0159\u00edmo na pl\u00edce \u017e\u00e1dn\u00e9 l\u00e9ky neberou, maj\u00ed pocit, \u017ee je v\u0161e v\u00a0po\u0159\u00e1dku a \u017ee kontrol u pneumologa nen\u00ed t\u0159eba. P\u0159itom u\u017e se kv\u016fli jejich nemoci m\u016f\u017ee za\u010d\u00edt jemn\u00e1 tk\u00e1\u0148 plicn\u00edch skl\u00edpk\u016f m\u011bnit v\u00a0hust\u00e9 vazivo. Kdy\u017e za\u010dne proces rychle postupovat, za\u010dnou poci\u0165ovat klasick\u00e9 p\u0159\u00edznaky fibr\u00f3zy, jako je ka\u0161el \u010di nemo\u017enost se po\u0159\u00e1dn\u011b nadechnout, a to i v\u00a0klidu. \u010casto se s\u00a0nimi potk\u00e1v\u00e1me v\u00a0ordinaci a\u017e ve chv\u00edli, kdy je na nasazen\u00ed \u00fa\u010dinn\u00e9 l\u00e9\u010dby pozd\u011b,\u201c<\/em> popisuje doc.\u00a0MUDr.\u00a0Martina \u0160terclov\u00e1, p\u0159edsedkyn\u011b Sekce pro interstici\u00e1ln\u00ed plicn\u00ed procesy (SIPP) \u010cesk\u00e9 pneumologick\u00e9 a ftizeologick\u00e9 spole\u010dnosti (\u010cPFS). P\u0159ipom\u00edn\u00e1, \u017ee v\u00a0\u010cesku existuje pln\u011b hrazen\u00e1 antifibrotick\u00e1 l\u00e9\u010dba, kter\u00e1 pom\u00e1h\u00e1 lidem s\u00a0plicn\u00ed fibr\u00f3zou \u017e\u00edt d\u00e9le a kvalitn\u011bji. Pacienti najdou pomoc v\u00a0celkem 16 centrech pro diagnostiku a l\u00e9\u010dbu interstici\u00e1ln\u00edch plicn\u00edch proces\u016f, jen mus\u00ed p\u0159ij\u00edt v\u010das.<\/p>\n\n\n\n

V\u00a0zachycen\u00ed nemoci pom\u00e1h\u00e1 i Program \u010dasn\u00e9ho z\u00e1chytu rakoviny plic, kter\u00fd v\u00a0\u010cesku funguje p\u0159es rok. Z\u00a0t\u00e9m\u011b\u0159 2 500 rizikov\u00fdch jedinc\u016f, kte\u0159\u00ed v\u00a0r\u00e1mci programu podstoupili vy\u0161et\u0159en\u00ed plic n\u00edzkod\u00e1vkov\u00fdm CT, dosud na\u0161li odborn\u00edci plicn\u00ed fibr\u00f3zu u osmi z\u00a0nich. <\/p>\n\n\n\n

\u201eJe zn\u00e1mo, \u017ee plicn\u00ed fibr\u00f3za rakovinu plic nez\u0159\u00eddka doprov\u00e1z\u00ed, spou\u0161t\u011b\u010dem b\u00fdv\u00e1 kou\u0159en\u00ed, kter\u00e9 je spole\u010dn\u00fdm jmenovatelem pro ob\u011b nemoci, ale samotn\u00e1 fibr\u00f3za m\u016f\u017ee b\u00fdt stimulem pro rakovinn\u00e9 bujen\u00ed,\u201c <\/em>vysv\u011btluje prof. MUDr. Martina Koziar Va\u0161\u00e1kov\u00e1, Ph.D., p\u0159edsedkyn\u011b \u010desk\u00fdch pneumolog\u016f. Spole\u010dn\u011b s\u00a0kolegy usiluje o to, aby v\u00a0\u010cR vznikl nov\u00fd registr, kter\u00fd by sledoval v\u0161echny pacienty s\u00a0plicn\u00edmi fibr\u00f3zami \u2013 pr\u016fb\u011bh jejich nemoci, p\u0159\u00ed\u010diny vzniku a efekt nasazen\u00e9 l\u00e9\u010dby. <\/p>\n\n\n\n

\u201eTato data n\u00e1m mimo jin\u00e9 velmi pomohou p\u0159i mapov\u00e1n\u00ed, jak jsou l\u00e9ky v\u00a0jednotliv\u00fdch p\u0159\u00edpadech \u00fa\u010dinn\u00e9,\u201c<\/em> \u0159\u00edk\u00e1 prof. Koziar Va\u0161\u00e1kov\u00e1, p\u0159edsedkyn\u011b \u010cPFS. Pokud registr vznikne, zahrne nejenom pacienty s idiopatickou plicn\u00ed fibr\u00f3zou, ale tak\u00e9 ty, u nich\u017e doch\u00e1z\u00ed ke zm\u011bn\u00e1m na plic\u00edch vinou jin\u00fdch chorob, nap\u0159\u00edklad autoimunitn\u00edch. V registru by mohli b\u00fdt tak\u00e9 pacienti s\u00a0tzv.\u00a0\u201eholub\u00e1\u0159sk\u00fdmi \u010di farm\u00e1\u0159sk\u00fdmi pl\u00edcemi\u201c, u nich\u017e doch\u00e1z\u00ed ke zm\u011bn\u00e1m v d\u016fsledku kontaktu s\u00a0pta\u010d\u00edm pe\u0159\u00edm \u010di prachem.<\/em><\/p>\n\n\n\n

\u201eAktu\u00e1ln\u011b jedn\u00e1me o mo\u017enosti nasadit <\/em>l\u00e9\u010dbu i lidem s m\u00e9n\u011b pokro\u010dilou plicn\u00ed fibr\u00f3zou, tedy t\u011bm, kte\u0159\u00ed maj\u00ed zat\u00edm dobrou vit\u00e1ln\u00ed kapacitu plic (FVC) \u2013 kolem 90 %, ale u\u017e u nich doch\u00e1z\u00ed k jizevnat\u00fdm zm\u011bn\u00e1m. V\u010dasn\u00e9 nasazen\u00ed l\u00e9ku by pomohlo d\u00e9le zachovat dobr\u00e9 plicn\u00ed funkce. A naopak bychom r\u00e1di dos\u00e1hli toho, aby l\u00e9ky mohli dost\u00e1vat ti, kte\u0159\u00ed jsou na tom s plicn\u00edmi funkcemi \u0161patn\u011b \u2013 maj\u00ed nap\u0159\u00edklad FVC pod 50 %,\u201c <\/em>uv\u00e1d\u00ed prof. Koziar Va\u0161\u00e1kov\u00e1.<\/p>\n\n\n\n

Du\u0161nost a ka\u0161el je spole\u010dn\u00fdm jmenovatelem p\u0159\u00edznak\u016f plicn\u00edch fibr\u00f3z, u tzv. idiopatick\u00e9 plicn\u00ed fibr\u00f3zy (nezn\u00e1m\u00e1 p\u0159\u00ed\u010dina vzniku) jsou dal\u0161\u00edm typick\u00fdm p\u0159\u00edznakem pali\u010dkovit\u00e9 prsty a nehty ve tvaru hodinov\u00fdch skl\u00ed\u010dek. P\u0159i poslechu pacientova dechu sly\u0161\u00ed l\u00e9ka\u0159 zvuk p\u0159ipom\u00ednaj\u00edc\u00ed ch\u016fzi po zmrzl\u00e9m sn\u011bhu nebo rozep\u00edn\u00e1n\u00ed such\u00e9ho zipu. V \u010cR nyn\u00ed \u017eij\u00ed odhadem tis\u00edce lid\u00ed s n\u011bjakou formou plicn\u00ed fibr\u00f3zy a v\u00edce ne\u017e 1 300 z nich m\u00e1 IPF. Ro\u010dn\u011b p\u0159ibude asi 150 nov\u011b diagnostikovan\u00fdch pacient\u016f. Antifibrotickou l\u00e9\u010dbu u\u017e\u00edv\u00e1 p\u0159ibli\u017en\u011b 800 jedinc\u016f. Bez pat\u0159i\u010dn\u00e9 terapie se doba p\u0159e\u017eit\u00ed pohybuje kolem 2 a\u017e 3 let.<\/p>\n\n\n\n

O idiopatick\u00e9 plicn\u00ed fibr\u00f3ze<\/strong><\/p>\n\n\n\n

Idiopatick\u00e1 plicn\u00ed fibr\u00f3za po\u0161kozuje plicn\u00ed skl\u00edpky, jizv\u00ed je \u2013 bere plochu k d\u00fdch\u00e1n\u00ed, pl\u00edce tuhnou a \u010dlov\u011bk se nem\u016f\u017ee nadechnout. Postup nemoci zpomaluje l\u00e9\u010dba, kter\u00e1 je v tuzemsku hrazena. Pacienti se k n\u00ed v\u0161ak \u010dasto nedostanou, proto\u017ee je nemoc odhalena pozd\u011b. Projevy idiopatick\u00e9 plicn\u00ed fibr\u00f3zy l\u00e9ka\u0159i \u010dasto zam\u011b\u0148uj\u00ed za chronickou obstruk\u010dn\u00ed plicn\u00ed nemoc \u010di srde\u010dn\u00ed selh\u00e1n\u00ed. Nemoc se ohla\u0161uje zprvu nen\u00e1padn\u011b, \u010dlov\u011bk se za\u010dne zad\u00fdch\u00e1vat do schod\u016f, pozd\u011bji i p\u0159i ch\u016fzi \u010di hovoru, v pokro\u010dil\u00e9m stadiu m\u00e1 pocit nedostatku vzduchu p\u0159i b\u011b\u017en\u00fdch denn\u00edch \u010dinnostech a v z\u00e1v\u011bru v\u011bnuje ve\u0161kerou energii tomu, aby se nadechl. Bez spr\u00e1vn\u00e9 l\u00e9\u010dby idiopatick\u00e1 plicn\u00ed fibr\u00f3za v\u00fdrazn\u011b zkracuje \u017eivot pacienta, p\u0159itom s l\u00e9\u010dbou se pr\u016fm\u011brn\u00e9 p\u0159e\u017eit\u00ed nemocn\u00fdch m\u016f\u017ee prodlou\u017eit na dvojn\u00e1sobek. V\u00edce informac\u00ed o nemoci, v\u010detn\u011b Seri\u00e1lu o plicn\u00ed fibr\u00f3ze obsahuj\u00edc\u00edho 12 eduka\u010dn\u00edch vide\u00ed s odborn\u00edkem, lze nal\u00e9zt na: zivotsplicnifibrozou.cz<\/a>.  <\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Stovk\u00e1m lid\u00ed v\u00a0\u010cesku se jizv\u00ed pl\u00edce. K\u00a0tomu doch\u00e1z\u00ed z\u00a0nejr\u016fzn\u011bj\u0161\u00edch d\u016fvod\u016f, d\u016fle\u017eit\u00e9 ale je zachytit jizven\u00ed v\u010das a nasadit tzv. antifibrotickou l\u00e9\u010dbu. Ta zpomaluje proces, kdy […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":27563,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-42096","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\/42096","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=42096"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/42096\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/27563"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42096"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=42096"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=42096"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}