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Vojnosanitetski pregled
2018, vol. 75, br. 3, str. 273-280
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 31/05/2018
doi: 10.2298/VSP160617212R
Creative Commons License 4.0
Efekti pulsnog elektromagnetnog polja ekstremno niske frekvencije na gustinu kosti i incidenciju preloma kod bolesnika sa terminalnom bubrežnom slabošću na dijalizi - trogodišnja studija praćenja
aKliničko-bolnički centar Zvezdara, Beograd
bVojnomedicinska akademija, Klinika za fizikalnu medicinu i rehabilitaciju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
cKlinički centar Srbije, Centar za medicinsku biohemiju, Beograd
dUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za reumatologiju, Beograd

e-adresa: milanpetronijevic@yahoo.com

Sažetak

Uvod/Cilj. Različite metode fizikalne terapije koriste se u lečenju mišićno-skeletnih oboljenja uključujući i ona koja se karakterišu sniženom mineralnom koštanom gustinom (BMD). Pulsno elektromagnetno polje ekstremno niske frekvencije (ELF-PEMF) stimuliše formiranje koštanog tkiva. Zbog poremećaja koštanog tkiva multifaktorijalne patogeneze bolesnici sa terminalnom bubrežnom slabošću (TBS) imaju visoku učestalost preloma. Vitamin D, suplementi kalcijuma, antiresorptivni i anabolički lekovi kod ovih bolesnika, zbog izmenjene farmakodinamike i farmakokinetike imaju minimalne ili ograničene efekte. Cilj ovog rada bio je da se ispitaju efekti dugotrajne primene ELF-PEMF u kombinaciji sa kineziterapijom na BMD, učestalost novih preloma kostiju i koncentraciju parathormona kod bolesnika sa TBS na programu hemodijalize. Metode. U 3-godišnjoj prospektivnoj kliničkoj studiji bolesnici, njih 151, sa TBS na programu hemodijalize na dobrovoljnoj bazi, svrstani su u dve grupe: studijska grupa (ELF-PEMF, 18 Hz, 2 mT, primenjivana tokom 40 min posle 10 uzastopnih procedura hemodijalize, četiri puta tokom jedne godine, ukupno 120 tretmana tokom tri godine uz kineziterapiju) i kontrolna grupa (samo kineziterapija). Rezultati. Ukupno 124 bolesnika je završilo ispitivanje. U studijskoj grupi (n = 54), nezavisno od pola, posle tri godine primene ELF-PEMF postignuto je značajno poboljšanje BMD, T-skora i Z-skora na lumbalnoj kičmi i vratu butne kosti. U kontrolnoj grupi (n = 70), primećeno je značajno smanjenje BMD, T-skora i Z-skora uz veću incidencu novih preloma kostiju. Zaključak. Tehnika ELF-PEMF mogla bi predstavljati korisnu i bezbednu nefarmakološku metodu u programu prevencije preloma kod bolesnika sa TBS.

Ključne reči

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