Vol 3, No 2 (2017)
Review paper
Published online: 2017-06-20
Kacheksja reumatoidalna
Forum Reumatol 2017;3(2):65-71.
Abstract
Wyniszczenie jest wynikiem długotrwałego złożonego procesu patologicznego, w którym dochodzi do utraty tkanki mięśniowej, tłuszczowej i kostnej. Konsekwencją ubytku masy mięśniowej jest osłabienie siły mięśniowej i sprawności fizycznej, prowadząc do wzrostu ryzyka upadków co przy ubytku tkanki kostnej prowadzi do wzrostu ryzyka złamań i ich powikłań. Obecnie nie jest znany mechanizm prowadzący do wyniszczenia, ale zwraca się dodatkowo uwagę na wzrost spoczynkowego wydatku energetycznego, wzmożony katabolizm białkowy oraz nadprodukcję cytokin prozapalnych. Kacheksja w reumatoidalnym zapaleniu stawów uważana jest za czynnik pogarszający rokowanie zarówno co do przebiegu choroby, jak i przeżycia. Nie ma dotychczas opracowanych standardów postępowania leczniczego w kacheksji reumatoidalnej. Ćwiczenia wytrzymałościowe i siłowe, dostosowane do aktualnego stanu chorych, wydają się najbardziej skuteczną metodą zapobiegania utracie masy mięśniowej, natomiast wyniszczenie w przebiegu reumatologicznego zapalenia stawów wydaje się być oporne na terapię żywieniową i rozwija się nawet wobec prawidłowo zbilansowanej diety.
Keywords: reumatoidalne zapalenie stawówkacheksja
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