Follow Us:Respiratio 2017; 7 (1-2): 108-113
DISFUNKCIJA SKELETNIH MIŠIĆA KOD OBOLELIH OD HRONIČNE
OPSTRUKTIVNE BOLESTI PLUĆA
DYSFUNCTION OF SKELETAL MUSCLE IN PATIENTS WITH CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
Zorica Ćirić¹, Milan Radović¹, Nemanja Ćirić¹, Ivana Stanković², Tatjana Pejčić², Lidija Ristić², Milan Rančić²
¹Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Republic of Serbia; Clinic for Lung Diseases, Clinical Centre of Nis, Nis, Serbia
²Klinika za plućne bolesti 'Knez Selo', Klinički centar Niš, Srbija
Original Research
Naučni članak
SAŽETAK:
Uvod: Gubitak telesne i mišićne mase sa posledičnom disfunkcijom skeletnih mišića su
komorbiditeti koji se često sreću kod pacijenata sa hroničnom opstruktivnom bolešću pluća (HOBP).Disfunkcija skeletnih mišića povećava dispneju i smanjuje toleranciju napora obolelih od HOBP
Cilj: utvrđivanje prisustva gubitka telesne i mišićne mase, disfunkcije skeletnih mišića obolelih od HOBP I analiza u odnosu na stepen težine HOBP. Metode: ispitivano je 85 pacijenata sa stabilnom HOBP. Određivan je indeks telesne mase (BMI) i debljina kožnog nabora (TSF) za procenu uhranjenosti, a obim sredine nadlaktice (MUAC) za procenu mišićne mase. Za procenu disfunkcije skeletnih mišića korišćen je 6-minutni test hodanja (6MWT) i Borg skala i modifikovana MRC (mMRC) skala dispneje.
Rezultati: vrednosti BMI, TSF i MUAC sa porastom težine HOBP su opadale bez statističke značajnosti. Sa porastom težine HOBP značajno su opadale vrednosti 6MWT (p=0,000), a rasle vrednosti Borg skale pre i posle 6MWT (p=0,000), kao i vrednosti mMRC (p=0,000). Težina bolesti u celoj grupi bolesnika imala je začajnu negativnu korelaciju sa 6MWT (p=0,000) i obimom sredine nadlaktice (p=0,033).
Zaključak: sa povećanjem težine bolesti pacijenti sa HOBP imaju veći gubitak telesne i mišićne mase, značajno lošije tolerišu fizički napor i imaju veći stepen dispneje.
Ključne reči: hronična opstruktivna bolest pluća, indeks telesne mase, dispneja,skeletni mišići.
LITERATURA
|
1. Global Initiative For Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. (2017 Report) http//www.goldcopd.org. Accessed November 29, 2016. |
|
|
|
|
|
2. Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol 2016:138(1);16-27. |
|
|
|
|
|
3. Wagner PD. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J 2008;31:492-501. |
|
|
|
|
|
4. Gosker HR, van Mameren H, van Dijk PJ, et al. Skeletal muscle fiber-type shifting and metabolic profile in patients with chronic obstructive pulmonary disease, Eur Respir J 2002; 19:617-625. |
|
|
|
|
|
5. Engelen MP, Schols AM, Does JD, Wouters EF. Skeletal muscle weakness is associated with wasting of extremity fat-free mass but not with airflow obstruction in patients with chronic obstructive pulmonary disease. Am J Nutr 2000; 71: 733-738. |
|
|
|
|
|
6. Van,t Hul A, Harlaar J, Gosselnik R, Hollander P, Postmus P, Kwakkel G. Quadriceps muscle endurance in patients with chronic obstructive pulmonary disease. Muscle Nerve 2004; 29:267-274. |
|
|
|
|
|
7. Jeffery Mador MJ, Kufel TJ, Pineda L. Quadriceps fatigue after cycle exercise in patients with chronic obstructive disease. Am J respir Crit Care Med 2000;161:447-453. |
|
|
|
|
|
8. Jones NL, Killian KJ. Mechanisms of disease: Exercise limitation in health and disease. N Engl J Med 2000; 343: 632-641. |
|
|
|
|
|
9. Marquis K, et al. Midthigh muscle cross-sectional area is better predictor of mortality than body mass index in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002; 166:809-813. |
|
|
|
|
|
10. Pellegrino R, Viegi G, Brusasco V, Crapo R.O., Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-968. |
|
|
|
|
|
11. Standardisation of spirometry. Eur Respir J 2005;26:319-338. |
|
|
|
|
|
12. Stanković, Pejčić T. Patofiziologija hronične opstruktivne bolesti pluća. U: Bošnjak-Petrović V,ed. Hronična opstruktivna bolest pluća. Beograd:Klinički Centar Srbije, Beograd, 2004:29-35. |
|
|
|
|
|
13. Milenković B. Inflamacija u hroničnoj opstruktivnoj bolesti pluća. U: Stanković I, ed. Savremena saznanja o hroničnoj opstruktivnoj bolesti pluća. Niš: Medicinski fakultet Univerziteta u Nišu,2012:24-29. |
|
|
|
|
|
14. PintoPlata VM, Mullerova H, Toso JF, Feudjo-Tepie M, Soriano JB,Celli BR. C-reactive protein in patients with COPD, control smokers and non smokers.Thorax 2006;61(1):23-28. |
|
|
|
|
|
15. Wagner PD. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J 2008;31:492-501. |
|
|
|
|
|
16. Nikolić M. Održavanje telesne mase. U Nikolić M, urednik. Dijetetika. Niš: Medicinski fakultet Univerziteta u Nišu&WUS Austria; 2008. s.115-131.(srpski) |
|
|
|
|
|
17. Zvezdin B. Hronična opstruktivna bolest pluća i komorbiditet. U: Stanković I, ed. Savremena saznanja o hroničnoj opstruktivnoj bolesti pluća. Niš: Medicinski fakultet Univerziteta u Nišu, 2012:82-86. |
|
|
|
|
|
18. Liu X, Ji Y, Chen J, Li S, Luo F. Circulating visfatin in chronic obstructive pulmonary disease. Nutrition 2009; 25(4):373-378. |
|
|
|
|
|
19. Powell-Tuck J, Hennessy E.M. A comparison of mid upper arm circumference, body mass index and weight loss as indices of undernutrition in acutely hospitalized patients. Clinical Nutrition 2003; 22(3):1-6. |
|
|
|
|
|
20. Gosker HR, van Mameren H, van Dijk PJ, et al. Skeletal muscle fiber-type shifting and metabolic profile in patients with chronic obstructive pulmonary disease, Eur Respir J 2002; 19:617-625. |
|
|
|
|
|
21. Gosker HR, van Mameren H, van Dijk PJ, et al. Skeletal muscle fiber-type shifting and metabolic profile in patients with chronic obstructive pulmonary disease, Eur Respir J 2002; 19:617-625. |
|
|
|
|
|
22. Debigare R, Maltais F. The major limitation to exercise performance in COPD is lower limb muscle dysfunction. J Appl Physiol 2008; 105:751-753. |
|
|
|
|
|
23. Criner G. 6-minute walk testing in COPD: is it reproducible? Eur Respir J 2011;38:244-245. |
|
|
|
|
|
24. Hernandes NA, Wouters EFM, Meijer K, Annegarn J, Pitta F, Spruit MA: Reproducibility of 6-minute walking test in patients with COPD. Eur Respir J2011; 38: 261-267. |
|
|
|
|
|
25. ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care 2002;166: 111–117. |
|
Submitted: April 10th, 2017
Accepted: May 10th, 2017
Zorica Ćirić
18 000 Niš, Srbija. Uroša Predića 4/25
Tel: +381631703489
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.