\u010cRo<\/p>\n\n\n\n
Pacient\u016fm s plicn\u00edmi fibr\u00f3zami pom\u016f\u017ee v \u010cesku nov\u00fd l\u00e9k. V \u010cesku se l\u00e9\u010d\u00ed prvn\u00ed pacienti s plicn\u00ed fibr\u00f3zou, nov\u00fdm l\u00e9kem, jeho \u00fa\u010dinnou l\u00e1tkou, je nerandomilast pln\u011b dostupn\u00fd a hrazen\u00fd zdravotn\u00edmi poji\u0161\u0165ovnami, by m\u011bl b\u00fdt od p\u0159\u00ed\u0161t\u00edho roku podle klinick\u00fdch studi\u00ed dok\u00e1\u017ee sn\u00ed\u017eit \u00famrtnost na plicn\u00ed fibr\u00f3zy o 43 % oproti dosavadn\u00edm l\u00e9k\u016fm. Pom\u016f\u017ee tak nap\u0159\u00edklad pacient\u016fm s idiopatickou plicn\u00ed fibr\u00f3zou, kterou popisuje pneumolo\u017eka Martina \u0160terclov\u00e1.<\/p>\n\n\n\n
pneumolo\u017eka Martina \u0160terclov\u00e1<\/p>\n\n\n\n
Doch\u00e1z\u00ed k postupn\u00e9mu prostupov\u00e1n\u00ed plic jizvami, laicky si to nech\u00e1 p\u0159edstavit, jako kdyby pl\u00edce se m\u011bnily v\u00fdzvy, jako kdyby tuhly, tak\u017ee kysl\u00edk z vnit\u0159ku plicn\u00edho skl\u00edpku p\u0159estupuje do krve m\u00e9n\u011b ochotn\u011b ne\u017e u pacient\u016f, kte\u0159\u00ed maj\u00ed pl\u00edce v po\u0159\u00e1dku.<\/p>\n\n\n\n
\u010cT24<\/p>\n\n\n\n
Ch\u016fze po zmrzl\u00e9m sn\u011bhu nebo rozep\u00edn\u00e1n\u00ed Such\u00e9ho zipu, to jsou zvuky nebo podobn\u00e9 zvuky sly\u0161\u00ed l\u00e9ka\u0159, kter\u00fd poslechem vy\u0161et\u0159uje pl\u00edce pacienta s idiopatickou plicn\u00ed fibr\u00f3zou. A pr\u00e1v\u011b z\u00e1\u0159\u00ed je m\u011bs\u00edc, kter\u00fd je v\u011bnovan\u00fd plicn\u00edm fibr\u00f3z\u00e1m a c\u00edlem je zv\u00fd\u0161it pov\u011bdom\u00ed o nich. Pro \u00fasp\u011b\u0161nou l\u00e9\u010dbu je toti\u017e d\u016fle\u017eit\u00e9 v\u010dasn\u00e9 odhalen\u00ed a prevence. Potvrd\u00ed to ur\u010dit\u011b i m\u016fj dal\u0161\u00ed host, kter\u00fdm je Martina Koziar Va\u0161\u00e1kov\u00e1, p\u0159ednostka pneumologick\u00e9 kliniky prvn\u00ed l\u00e9ka\u0159sk\u00e9 fakulty Univerzity Karlovy a Fakultn\u00ed nemocnice Fakultn\u00ed Thomayerovy nemocnice, dobr\u00e9 r\u00e1no. Pan\u00ed profesorko. Tak my se potk\u00e1v\u00e1me pravideln\u011b v z\u00e1\u0159\u00ed pr\u00e1v\u011b u p\u0159\u00edle\u017eitosti t\u00e9 akce, kterou jsem zm\u00ednil a roz\u0161i\u0159ujeme to pov\u011bdom\u00ed o t\u011bch nemocech. Je to n\u011bjak zn\u00e1t. Chod\u00ed lid\u00e9 \u010dast\u011bji, na prevenci ub\u00fdv\u00e1 t\u0159eba pacient\u016f, kte\u0159\u00ed p\u0159ijdou pozd\u011b.<\/p>\n\n\n\n
mluv\u010d\u00ed 13<\/p>\n\n\n\n
No, mus\u00edm \u0159\u00edct, \u017ee o plicn\u00ed fibr\u00f3ze se v\u00ed st\u00e1le v\u00edce, nicm\u00e9n\u011b prevence plicn\u00ed, ona jedinou vlastn\u011b plicn\u00ed prevenci, kterou tady m\u00e1me, program, kter\u00fd by byl n\u00e1rodn\u00ed, je \u010dasn\u00e1 detekce nebo screening rakoviny plic pr\u00e1v\u011b v r\u00e1mci kter\u00e9ho nach\u00e1z\u00edme \u0159adu \u010dasn\u00fdch f\u00e1z\u00ed plicn\u00edch fibr\u00f3z, \u010dili tak jako t\u0159eba u jin\u00fdch plicn\u00edch diagn\u00f3z, proto\u017ee pl\u00edce nejsou vid\u011bt, pl\u00edce se ozvou, a\u017e kdy\u017e prost\u011b \u010dlov\u011bku berou dech, nebo kdy\u017e za\u010dne t\u0159eba ten proces pror\u016fstat v p\u0159\u00edpad\u011b n\u00e1doru mimo pl\u00edce, tak vlastn\u011b ta diagnostika bu\u010f na z\u00e1klad\u011b symptom\u016f, to je m\u00e9n\u011b v\u00fdhodn\u00e1, proto\u017ee jde o pokro\u010dilou nemoc a na z\u00e1klad\u011b n\u00e1hodn\u00e9ho zji\u0161t\u011bn\u00ed, co\u017e je ur\u010dit\u011b v\u00fdhodn\u011bj\u0161\u00ed, tak\u017ee jak \u0159\u00edk\u00e1te, chodit na prevenci, znamen\u00e1 v podstat\u011b v p\u0159\u00edpad\u011b n\u011bkter\u00fdch c\u00edlov\u00fdch skupin, co\u017e jsou t\u0159eba ku\u0159\u00e1ci 55\u201374 let, tak doj\u00edt na screening rakoviny plic, v r\u00e1mci kter\u00e9ho m\u016f\u017eeme \u010dasn\u011b zachytit pr\u00e1v\u011b i fibr\u00f3zu a v p\u0159\u00edpad\u011b fibr\u00f3z, tak ur\u010dit\u011b je to pro apel pro v\u0161echny, nejen potenci\u00e1ln\u00ed pacienty, ale i l\u00e9ka\u0159e, \u017ee zad\u00fdch\u00e1v\u00e1n\u00ed se m\u016f\u017ee znamenat tak\u00e9 plicn\u00ed fibr\u00f3zu, kter\u00e1 je velmi z\u00e1va\u017enou nemoc\u00ed a m\u016f\u017ee vlastn\u011b zp\u016fsobit pacientovi p\u0159ed\u010dasn\u00fd odchod z tohoto sv\u011bta, p\u0159ed\u010dasnou smrt, pokud nen\u00ed l\u00e9\u010dena.<\/p>\n\n\n\n
mluv\u010d\u00ed 9<\/p>\n\n\n\n
Co se t\u00fd\u010de t\u00e9 prevence nebo toho v\u010dasn\u00e9ho z\u00e1chytu, zvl\u00e1dne to i praktick\u00fd l\u00e9ka\u0159 nebo je pot\u0159eba v\u017edy j\u00edt ke specialistovi?<\/p>\n\n\n\n
mluv\u010d\u00ed 13<\/p>\n\n\n\n
V\u00edte, my m\u00e1me vlastn\u011b t\u011bsnou spolupr\u00e1ci s praktick\u00fdmi l\u00e9ka\u0159i k diagnostice vlastn\u011b v\u0161ech z\u00e1va\u017en\u00fdch plicn\u00edch nemoc\u00ed, ten praktick\u00fd l\u00e9ka\u0159 pije pr\u00e1v\u011b ten, kter\u00fd mus\u00ed pomyslet na to, \u017ee kdy\u017e se pacient zad\u00fdch\u00e1v\u00e1 nebo st\u011b\u017euje si, \u017ee u\u017e nevyjde do toho \u010dtvrt\u00e9ho patra, jak vy\u0161el, tak \u017ee to prost\u011b nelze bagatelizovat a \u017ee je pot\u0159eba to vy\u0161et\u0159it a \u017ee mimo t\u0159eba srde\u010dn\u00edho onemocn\u011bn\u00ed to m\u016f\u017ee b\u00fdt pr\u00e1v\u011b plicn\u00ed onemocn\u011bn\u00ed a t\u0159eba zrovna plicn\u00ed fibr\u00f3za. A jak jste na za\u010d\u00e1tku \u0159ekl, ta ch\u016fze po zmrzl\u00e9m sn\u011bhu nebo crepitus je jedna ze zn\u00e1mek, kterou, kdy\u017e jednodu\u0161e ho endoskopem pacienta poslechnete, tak usly\u0161\u00edte a u\u017e je tam podez\u0159en\u00ed velmi nal\u00e9hav\u00e9, \u017ee to pr\u00e1v\u011b plicn\u00ed fibr\u00f3za m\u016f\u017ee b\u00fdt.<\/p>\n\n\n\n
mluv\u010d\u00ed 9<\/p>\n\n\n\n
Jak\u00e9 dal\u0161\u00ed p\u0159\u00edznaky mohou b\u00fdt vlastn\u011b n\u00e1vodn\u00e9, \u017ee by to nemusela b\u00fdt, \u0159ekn\u011bme, nap\u0159\u00edklad nemoc chronick\u00e9, obstruk\u010dn\u00ed, plicn\u00ed nemoc, kter\u00e1 se velmi \u010dasto zam\u011b\u0148uje.<\/p>\n\n\n\n
mluv\u010d\u00ed 13<\/p>\n\n\n\n
No, ano, spr\u00e1vn\u011b. Pr\u00e1v\u011b krom toho, t\u00e9 ch\u016fze po zmrzl\u00e9m sn\u011bhu k rapitu jsou to t\u0159eba tzv. pali\u010dkovit\u00e9 prsty, to je v podstat\u011b takov\u00fd p\u0159\u00edznak, \u017ee zbyt\u0148uj\u00ed se posledn\u00ed \u010dl\u00e1nky prst\u016f a je to velice specifick\u00fd p\u0159\u00edznak, on nen\u00ed prost\u011b, nevyskytuje se jenom u plicn\u00ed fibr\u00f3za, ale t\u0159eba u n\u011bkter\u00fdch srde\u010dn\u00edch vad nebo u n\u011bkter\u00fdch jin\u00fdch nemocnic, nicm\u00e9n\u011b pro tu plicn\u00ed fibr\u00f3zu je zcela typick\u00fd za m\u011b, ale pokud prost\u011b ten praktick\u00fd l\u00e9ka\u0159 na diagn\u00f3zu mimo jin\u00e9 t\u00e9 idiopatick\u00e9 plicn\u00ed, fibr\u00f3zy mysl\u00ed, tak j\u00ed prost\u011b nem\u016f\u017ee minout to podez\u0159en\u00ed, ta diagn\u00f3za samotn\u00e1 potom spad\u00e1 do rukou plicn\u00edch l\u00e9ka\u0159\u016f, odborn\u00edk\u016f a l\u00e9\u010dba spad\u00e1 do center interstici\u00e1ln\u00edch plicn\u00edch proces\u016f, kter\u00e9 m\u00e1me v dostate\u010dn\u00e9m po\u010dtu po cel\u00e9 republice, ale jak \u0159\u00edk\u00e1m, to podez\u0159en\u00ed mus\u00ed vzej\u00edt u toho l\u00e9ka\u0159e, ke kter\u00e9mu poprv\u00e9 ten pacient jde.<\/p>\n\n\n\n
mluv\u010d\u00ed 9<\/p>\n\n\n\n
Jak potom prob\u00edh\u00e1 ta samotn\u00e1 l\u00e9\u010dba t\u00e9to nemoci? Je to n\u011bco, co se d\u00e1 \u00fapln\u011b vyl\u00e9\u010dit, anebo se jenom vlastn\u011b potla\u010duj\u00ed p\u0159\u00edznaky a projevy.<\/p>\n\n\n\n
mluv\u010d\u00ed 13<\/p>\n\n\n\n
No, ono je to nejenom potla\u010den\u00ed p\u0159\u00edznak\u016f a projev\u016f, ale to zpomalen\u00ed pr\u016fb\u011bhu t\u00e9 nemoci, kdy\u017e si vezmete samotnou idiopatickou plicn\u00ed fibr\u00f3zu z cel\u00e9 t\u00e9 \u0161k\u00e1ly plicn\u00edch fibr\u00f3z, tak vlastn\u011b d\u00e9lka takov\u00e9 st\u0159edn\u00ed p\u0159e\u017eit\u00ed je 2,5\u20133 roky nebo 3,5 roku bez l\u00e9\u010dby, to znamen\u00e1, \u017ee je to v\u00e1\u017en\u00e1 nemoc, v\u00e1\u017en\u00e1, stejn\u011b jako n\u011bkter\u00e9 n\u00e1dory. A v\u010dasn\u00fdm nasazen\u00edm t\u00e9 l\u00e9\u010dby, kter\u00e1 potla\u010duje jizevnat\u011bn\u00ed, fibrotizaci t\u011bch plic, m\u016f\u017eeme dos\u00e1hnout toho, \u017ee se v\u00fdznamn\u011b nejen zm\u00edrn\u00ed obt\u00ed\u017ee pacienta, ale prodlou\u017e\u00ed se i jeho p\u0159e\u017eit\u00ed, \u010dili nelze o\u010dek\u00e1vat, \u017ee pacient se zlep\u0161\u00ed a vylep\u0161\u00ed. My ty jizvy z t\u011bch plic neum\u00edme odstranit, ale \u017ee vlastn\u011b ten proces toho jizevnat\u011bn\u00ed se v\u00fdznamn\u011b zpomal\u00ed a ty l\u00e9ky, kter\u00e9 m\u00e1me k dispozici, jsou st\u00e1le \u00fa\u010dinn\u011bj\u0161\u00ed pr\u00e1v\u011b v tom, aby se progrese t\u00e9 nemoci zm\u00edrnila a velk\u00e1 \u0161ance je na je\u0161t\u011b dal\u0161\u00ed prodlou\u017een\u00ed \u017eivota. Pr\u00e1v\u011b ten v\u010dast\u00fd z\u00e1chyt, kdy my vid\u00edme t\u0159eba p\u0159i screeningu rakoviny plic, tam je 3 % cirka pozitivn\u00edch n\u00e1lez\u016f, kter\u00e9 se \u0159e\u0161\u00ed jako uzl\u00edky, potenci\u00e1ln\u00ed n\u00e1dory, ale z\u00e1rove\u0148 je tam 3 % vlastn\u011b pozitivn\u00edch n\u00e1lez\u016f, kter\u00e9 odpov\u00eddaj\u00ed po\u010d\u00ednaj\u00edc\u00edm stadi\u00edm t\u00e9 fibr\u00f3zy.<\/p>\n\n\n\n
mluv\u010d\u00ed 9<\/p>\n\n\n\n
A zp\u00e1tky k tomu kou\u0159en\u00ed, o kter\u00e9m byla \u0159e\u010d na za\u010d\u00e1tku, je to ten hlavn\u00ed d\u016fvod, pro\u010d se u pacient\u016f tahle nemoc objevuje, anebo zkr\u00e1tka m\u016f\u017ee postihnout velkou \u010d\u00e1st i neku\u0159\u00e1k\u016f?<\/p>\n\n\n\n
mluv\u010d\u00ed 13<\/p>\n\n\n\n
No, kou\u0159en\u00ed hraje roli u idiopatick\u00e9 plicn\u00ed fibr\u00f3zy, m\u00e9n\u011b u t\u011bch ostatn\u00edch fibr\u00f3z, ale d\u00e1 se \u0159\u00edci, \u017ee to je tzv. multifaktori\u00e1ln\u00ed onemocn\u011bn\u00ed, \u010dili m\u00e1te n\u011bjakou genetickou z\u00e1t\u011b\u017e, kter\u00e1 v\u00e1s p\u0159edur\u010duje k tomu, \u017ee t\u0159eba po b\u011b\u017en\u00e9 ch\u0159ipce nebo pot\u00e9, co se nad\u00fdch\u00e1te n\u011bjak\u00e9ho prachu a m\u00e1te poran\u011bn\u00ed plicn\u00edch skl\u00edpk\u016f, \u017ee m\u00edsto toho, abyste je norm\u00e1ln\u011b zahojila, znovu obnovil ten plicn\u00ed skl\u00edp, tak se za\u010dnou tam tvo\u0159it jizvi\u010dky, tak\u017ee genetika ur\u010dit\u011b hraje roli a pak jsou prost\u011b dal\u0161\u00ed p\u0159isp\u00edvaj\u00edc\u00ed faktory pr\u00e1v\u011b jako vdechov\u00e1n\u00ed n\u011bkter\u00fdch typ\u016f prach\u016f, p\u0159\u00edpadn\u011b p\u016fsoben\u00ed n\u011bkter\u00fdch l\u00e9k\u016f, anebo to kou\u0159en\u00ed, tak\u017ee kou\u0159en\u00ed samoz\u0159ejm\u011b neprosp\u00edv\u00e1 v\u016fbec nikomu. Je to jedna z nej\u0161kodliv\u011bj\u0161\u00edch v\u011bc\u00ed, co \u010dlov\u011bk m\u016f\u017ee pro sv\u00e9 zdrav\u00ed nebo proti sv\u00e9mu zdrav\u00ed ud\u011blat. Tak\u017ee kauz\u00e1ln\u00ed souvislost tam jist\u011b je, ale ne jedin\u00e1 u plicn\u00ed fibr\u00f3zy.<\/p>\n\n\n\n
mluv\u010d\u00ed 9<\/p>\n\n\n\n
Z\u00e1\u0159\u00ed je nemoc\u00ed nebo je m\u011bs\u00edcem, kter\u00fd upozor\u0148uje na rizika plicn\u00edch fibr\u00f3z a my jsme o tom te\u010f mluvili s Martinou Kozar Va\u0161\u00e1kovou. Pan\u00ed p\u0159ednostko, d\u011bkujeme, hezk\u00fd den.<\/p>\n","protected":false},"excerpt":{"rendered":"
\u010cRo Pacient\u016fm s plicn\u00edmi fibr\u00f3zami pom\u016f\u017ee v \u010cesku nov\u00fd l\u00e9k. V \u010cesku se l\u00e9\u010d\u00ed prvn\u00ed pacienti s plicn\u00ed fibr\u00f3zou, nov\u00fdm l\u00e9kem, jeho \u00fa\u010dinnou l\u00e1tkou, je […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14127,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-64975","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\/64975","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=64975"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/64975\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14127"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=64975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=64975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=64975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}