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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 Ćirić
¹, 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

doi: 10.26601/rsp.aprs.17.16

 

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.

 

Full Article (PDF) 

 

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.
[CrossRef]
PMid:27373322

 

 

3. Wagner PD. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J 2008;31:492-501.
[CrossRef]
PMid:18310396

 

 

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.
[CrossRef]
PMid:11998989

 

 

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.
[CrossRef]
PMid:14755493

 

 

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.
[CrossRef]
[CrossRef]

 

 

8. Jones NL, Killian KJ. Mechanisms of disease: Exercise limitation in health and disease. N Engl J Med 2000; 343: 632-641.
[CrossRef]
PMid:10965011

 

 

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.
[CrossRef]
PMid:12231489

 

 

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.
[CrossRef]
PMid:16264058

 

 

11. Standardisation of spirometry. Eur Respir J 2005;26:319-338.
[CrossRef]
PMid:16055882

 

 

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.
[CrossRef]
PMid:16143583 PMCid:PMC2080714

 

 

15. Wagner PD. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J 2008;31:492-501.
[CrossRef]
PMid:18310396

 

 

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.
[CrossRef]
PMid:19056239

 

 

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.
[CrossRef]

 

 

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.
[CrossRef]
PMid:11998989

 

 

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.
[CrossRef]
PMid:11998989

 

 

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.
[CrossRef]
[CrossRef]

 

 

23. Criner G. 6-minute walk testing in COPD: is it reproducible? Eur Respir J 2011;38:244-245.
[CrossRef]  
PMid:21804159

 

 

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.
[CrossRef]
PMid:21177838

 

 

25. ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care 2002;166: 111–117.
[CrossRef]
PMid:12091180

 

 

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.

 

 

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