{"id":3484,"date":"2024-09-13T23:25:17","date_gmt":"2024-09-13T16:25:17","guid":{"rendered":"https:\/\/ykhoataynguyen.com\/site\/?p=3484"},"modified":"2024-09-13T23:26:30","modified_gmt":"2024-09-13T16:26:30","slug":"tai-sao-ucmc-lai-chong-chi-dinh-tren-bn-hep-2-dong-mach-than-2","status":"publish","type":"post","link":"https:\/\/ykhoataynguyen.com\/site\/tai-sao-ucmc-lai-chong-chi-dinh-tren-bn-hep-2-dong-mach-than-2\/","title":{"rendered":"T\u1ea0I SAO UCMC L\u1ea0I CH\u1ed0NG CH\u1ec8 \u0110\u1ecaNH TR\u00caN BN H\u1eb8P 2 \u0110\u1ed8NG M\u1ea0CH TH\u1eacN"},"content":{"rendered":"
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T\u1ea0I SAO UCMC L\u1ea0I CH\u1ed0NG CH\u1ec8 \u0110\u1ecaNH TR\u00caN BN H\u1eb8P 2 \u0110\u1ed8NG M\u1ea0CH TH\u1eacN<\/strong><\/em>
\nL\u01b0u l\u01b0\u1ee3ng m\u00e1u th\u1eadn \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh nghi\u00eam ng\u1eb7t b\u1edfi \u0111\u01b0\u1eddng k\u00ednh l\u00f2ng m\u1ea1ch c\u1ee7a \u0111\u1ed9ng m\u1ea1ch th\u1eadn. Trong th\u1ef1c t\u1ebf, c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 quan tr\u1ecdng kh\u00e1c c\u0169ng \u1ea3nh h\u01b0\u1edfng t\u1edbi l\u01b0\u1ee3ng m\u00e1u ch\u1ea3y t\u1edbi mao m\u1ea1ch c\u1ea7u th\u1eadn. Nh\u01b0 \u1edf b\u1ea5t k\u1ef3 v\u1ecb tr\u00ed n\u00e0o, c\u00e1c \u0111\u1ed9ng m\u1ea1ch x\u00e1c \u0111\u1ecbnh t\u00ednh tr\u1edf kh\u00e1ng v\u00e0 t\u1ed1c \u0111\u1ed9 d\u00f2ng ch\u1ea3y
\nKh\u00f4ng gi\u1ed1ng nh\u01b0 c\u00e1c vi tu\u1ea7n ho\u00e0n kh\u00e1c, th\u1eadn c\u00f3 m\u1ed9t c\u00f4ng vi\u1ec7c \u0111\u1eb7c bi\u1ec7t \u0111\u1ec3 l\u00e0m, t\u1ee9c l\u00e0 l\u1ecdc nh\u1eefng ph\u00e2n t\u1eed \u0111\u1ed9c h\u1ea1i. Do \u0111\u00f3, \u0111\u1ed1i v\u1edbi m\u00e1u \u0111i v\u00e0o th\u1eadn, ch\u1ee9c n\u0103ng nu\u00f4i d\u01b0\u1ee1ng th\u1eadn d\u01b0\u1eddng nh\u01b0 \u00edt quan tr\u1ecdng h\u01a1n! C\u00e1c nephrons c\u1ee7a th\u1eadn c\u00f3 l\u1ebd l\u00e0 nh\u1eefng t\u1ebf b\u00e0o “c\u00f4ng ngh\u1ec7 cao” nh\u1ea5t trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi (t\u1ea5t nhi\u00ean, ch\u1ec9 b\u00ean c\u1ea1nh c\u00e1c t\u1ebf b\u00e0o n\u00e3o) . M\u00e1u \u0111i v\u00e0o qua \u0111\u1ed9ng m\u1ea1ch h\u01b0\u1edbng t\u00e2m, qua mao m\u1ea1ch c\u1ea7u th\u1eadn l\u1ecdc v\u00e0 1 ph\u1ea7n v\u1ec1 theo \u0111\u1ed9ng m\u1ea1ch li t\u00e2m.
\nD\u00f2ng m\u00e1u v\u00e0o mao m\u1ea1ch c\u1ea7u th\u1eadn \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh b\u1edfi c\u1ea3 \u0111\u1ed9ng m\u1ea1ch h\u01b0\u1edbng t\u00e2m v\u00e0 li t\u00e2m th\u00f4ng qua ki\u1ec3m so\u00e1t c\u1ee7a t\u00edn hi\u1ec7u th\u1ea7n kinh. S\u1ef1 l\u01b0u th\u00f4ng n\u00e0y \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh b\u1edfi b\u1ed9 m\u00e1y c\u1eadn c\u1ea7u th\u1eadn. N\u00f3 \u0111i\u1ec1u ch\u1ec9nh l\u01b0u l\u01b0\u1ee3ng m\u00e1u c\u1ea7u th\u1eadn b\u1eb1ng c\u00e1ch ti\u1ebft ra renin, ho\u1ea1t \u0111\u1ed9ng th\u00f4ng qua angiotensin 2 tr\u00ean \u0111\u1ed9ng m\u1ea1ch li t\u00e2m
\nTr\u01b0\u01a1ng l\u1ef1c c\u1ee7a \u0111\u1ed9ng m\u1ea1ch li t\u00e2m \u0111\u01b0\u1ee3c cho l\u00e0 y\u1ebfu t\u1ed1 quan tr\u1ecdng duy nh\u1ea5t trong c\u01a1 ch\u1ebf \u0111i\u1ec1u khi\u1ec3n d\u00f2ng m\u00e1u t\u1edbi mao m\u1ea1ch c\u1ea7u th\u1eadn
\n\u0110i\u1ec1u g\u00ec x\u1ea3y ra \u1edf h\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn?
\nKhi c\u00f3 h\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn 2 b\u00ean, l\u01b0u l\u01b0\u1ee3ng m\u00e1u th\u1eadn t\u1edbi mao m\u1ea1ch c\u1ea7u th\u1eadn gi\u1ea3m kh\u00f4ng \u0111\u00e1ng k\u1ec3 nh\u01b0ng ph\u1ea3i t\u0103ng co l\u1ea1i \u0111\u1ed9ng m\u1ea1ch li t\u00e2m. N\u00f3 gi\u1ed1ng nh\u01b0 m\u1ed9t van ki\u1ec3m tra \u0111i\u1ec3m x\u1ea3 l\u0169 c\u1ee7a 1 con \u0111\u00ea, \u0111\u00f3ng 1 ph\u1ea7n \u0111\u1ec3 duy tr\u00ec \u0111\u1ee7 \u00e1p l\u1ef1c (\u1edf \u0111\u00e2y l\u00e0 \u00e1p l\u1ef1c \u0111\u1ec3 l\u1ecdc m\u00e1u \u1edf mao m\u1ea1ch c\u1ea7u th\u1eadn)<\/span><\/div>\n
\u0110i\u1ec1u g\u00ec x\u1ea3y ra khi d\u00f9ng ACEI?<\/strong>
\nM\u1ed9t khi ch\u1ea5t \u1ee9c ch\u1ebf ACE \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, \u0111\u1ed9ng m\u1ea1ch li t\u00e2m m\u1ea5t kh\u1ea3 n\u0103ng co, \u00e1p l\u1ef1c trong mao m\u1ea1ch c\u1ea7u th\u1eadn gi\u1ea3m, \u00e1p l\u1ef1c l\u1ecdc gi\u1ea3m
\nL\u01b0u \u00fd: ACEI kh\u00f4ng l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u th\u1eadn tr\u1ef1c ti\u1ebfp nh\u01b0ng \u00e1p l\u1ef1c t\u01b0\u1edbi m\u00e1u c\u1ea7u th\u1eadn gi\u1ea3m n\u00ean l\u00e0m gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn c\u1ea5p.<\/strong><\/em>
\n\u00dd ki\u1ebfn c\u1ee7a b\u1ea1n v\u1ec1 hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 th\u1eadn c\u1ee7a ACEI l\u00e0 g\u00ec?<\/em>
\nC\u00e1c nh\u00e0 tim m\u1ea1ch v\u00e0 chuy\u00ean gia v\u1ec1 th\u1eadn \u0111\u00e3 lu\u00f4n tin r\u1eb1ng ACEI kh\u00f4ng th\u00e2n thi\u1ec7n v\u1edbi th\u1eadn. Nh\u01b0ng, b\u00e2y gi\u1edd ch\u00fang ta c\u00f3 b\u1eb1ng ch\u1ee9ng, ACEI kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t ph\u00e2n t\u1eed kh\u00f4ng th\u1ec3 d\u00f9ng trong r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1eadn.<\/em>
\n\u0110i\u1ec1u n\u00e0y d\u1ef1a tr\u00ean c\u00e1c quan s\u00e1t \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n, trong nh\u1eefng n\u0103m m\u00e0 Angiotensin 2 ph\u1ea3i ch\u1ecbu tr\u00e1ch nhi\u1ec7m cu\u1ed1i c\u00f9ng cho th\u1eadn!<\/em>
\nAT 2 g\u00e2y t\u0103ng huy\u1ebft \u00e1p n\u1ed9i m\u1ea1ch v\u00e0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf ACEI l\u00e0m gi\u1ea3m n\u00f3. \u0110i\u1ec1u n\u00e0y li\u00ean quan t\u1edbi ch\u1ebf \u0111\u1ed9 l\u1ecdc c\u1ee7a nephron v\u00e0 s\u1ef1 t\u1ed5n th\u01b0\u01a1ng c\u1ea7u th\u1eadn. V\u00ec v\u1eady, ng\u01b0\u1eddi ta ngh\u0129 ACEi c\u00f3 vai tr\u00f2 r\u00f5 r\u00e0ng trong vi\u1ec7c g\u00e2y ti\u1ebfn tri\u1ec3n t\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o th\u1eadn<\/em>
\n\u0110i\u1ec1u n\u00e0y t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e2u chuy\u1ec7n ch\u1eb9n beta trong CHF ban \u0111\u1ea7u \u0111\u01b0\u1ee3c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf CHF sau \u0111\u00f3 tr\u1edf th\u00e0nh ch\u1ec9 \u0111\u1ecbnh r\u00f5 r\u00e0ng<\/em>
\nACEI c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u ho\u1eb7c ti\u1ebfp t\u1ee5c \u1edf b\u1ea5t k\u1ef3 m\u1ee9c \u0111\u1ed9 creatinine n\u00e0o trong CKD \u1ed5n \u0111\u1ecbnh c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 l\u1ecdc m\u00e1u<\/em>
\nTuy nhi\u00ean, ACEIs c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c d\u1eebng l\u1ea1i trong t\u1ea5t c\u1ea3 c\u00e1c \u0111i\u1ec1u sau \u0111\u00e2y<\/em>
\nSuy th\u1eadn c\u1ea5p
\n\u0110\u1ee3t c\u1ea5p c\u1ee7a suy th\u1eadn m\u1ea1n
\ncreatinine t\u0103ng nhanh (nh\u01b0 h\u1eb9p \u0111\u1ed9ng m\u1ea1ch th\u1eadn hai b\u00ean)\"C\u00f3<\/a>
\nNgu\u1ed3n b\u00e0i vi\u1ebft v\u00e0 \u1ea3nh: Ph\u1ea1m H\u1eefu H\u00f9ng<\/strong><\/em><\/span><\/div>\n<\/div>\n<\/div>\n
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T\u1ea0I SAO UCMC L\u1ea0I CH\u1ed0NG CH\u1ec8 \u0110\u1ecaNH TR\u00caN BN H\u1eb8P 2 \u0110\u1ed8NG M\u1ea0CH TH\u1eacN L\u01b0u l\u01b0\u1ee3ng m\u00e1u th\u1eadn \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh nghi\u00eam ng\u1eb7t b\u1edfi \u0111\u01b0\u1eddng k\u00ednh l\u00f2ng m\u1ea1ch c\u1ee7a \u0111\u1ed9ng m\u1ea1ch th\u1eadn. Trong th\u1ef1c t\u1ebf, c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 quan tr\u1ecdng kh\u00e1c c\u0169ng \u1ea3nh h\u01b0\u1edfng t\u1edbi l\u01b0\u1ee3ng m\u00e1u ch\u1ea3y t\u1edbi mao m\u1ea1ch c\u1ea7u th\u1eadn. Nh\u01b0 …<\/p>\n","protected":false},"author":32,"featured_media":3485,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[138],"tags":[],"class_list":["post-3484","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-tin-tuc"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/3484","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/users\/32"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=3484"}],"version-history":[{"count":3,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/3484\/revisions"}],"predecessor-version":[{"id":4410,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/3484\/revisions\/4410"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/3485"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=3484"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=3484"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=3484"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}