Y HOC VIET NAM T H A N G 10 - SO DAC BIET/2011
KET QUA DIEU TRj VA YEU TO LIEN QUAN DEN THOI GIAN SONG THEM SAU MO UNG THir DA DAY TIEN TRIEN TAI BENH VIEN DA KHOA
TINH THAI BINH TUT 1/2006 DEN 4/2009
Do Tr9ng Quyet*, Do Diic Van**, Trjnh Hong Son***
TOM T A T
Nghien ciiu thir nghiem lam sang co ddi chirng doi vdi 105 benh nhan ung thd da day dirdc phau thuat D2 tai Benh vien da khoa tinh Thai Binh va Benh vien Dai hoc y Thai Binh tir
1/2006 - 4/2009, cho ket qua sau:
• Khong co tCr vong sau mo. Cac ddc tfnh cua hoa chat tren huyet hoc va chiirc nang gan chii yeu d do 1. Tat ca cac tru'dng hdp deu kiem soat du'dc.
• Thdi gian sdng toan bd cua 101 benh nhan (4 benh nhan mat tin): 28,64±1,2 thang.
Th6i gian sdng them trung binh ciia 101 benh nhan sau 36 thang: 62,6 thang. Say 3 nam td vong 30/101 benh nhan (29,7%) vi tai phat do benh.
• Ket qua thdi gian sdng them lien quan vdi: Giai doan benh, kich thu'dc va do xam lan khdi u, mire do di can hach va do biet hoa te bao.
Nhirng khong thay siT khac biet giu'a nhom benh nhan tren va du'dl 60 tudi.
SUMMARY
The clinical trial with the case-control study design on 105 gastric cancer patients who experienced the D2 gastrectomy in Thalblnh General Hospital and Thalblnh Medical University Hospital from 1/2006-4/2009. Results are follows:
• There were no post-operational deaths.
Toxicity of the chemicals In the blood and liver mainly found at the level 1. All of these cases were controlled.
• The life expectancy of all the 101 patients:
28.64±1.2 months. Average life time of 101 patients in 36 months: 62,6%. After 3 years, the death rate due to the diseases relapsed was 30/101 (29,7%).
* B^ihoc Y Thii Binh; ** Trw&ng Dai hoc Y Hi Noi
***B$nl) vi§n Vi§t Dire Ha N0i
* Life time of patient was found related to the disease phase, size and invasion of tumor, lymphoma metastasis and cell specialization; no differences between patients above and below 60 years of age.
I.
OAT V A N OEUng thu da day (UTDD) la benh thudng gap tren The gidi cung nhu d Viet Nam, dimg hang dau trong so cac ung thu dudng tieu hoa.
Ve dieu tn UTDD cho den nay chii yeu la phau thuat triet can. Tuy nhien, da so benh nhan bi UTDD khi dugc phat hien da d giai doan mudn vi the khoang 60% sd benh nhan da mo se bi tai phat trong vdng 2 - 3 nam. Vi the, de cai thien tien lugng cua cac UTDD tien trien, sau md can dieu tri bd trg bang hoa chat, mien djch va xa tn [6].
Thdi gian song sau md la thudc do ket qua dieu tri UTDD, ma ket qua nay phu thuoc rat nhieu yeu td. Tai Thai Binh chua cd nghien cuu ve cac yeu td lien quan den thdi gian song them sau md cua benh nhan UTDD. Tren ca sd dd, chung tdi tien hanh de tai nghien cuu nay vdi muc tieu sau: Ddnh gid kit qud dieu tri vd mgt so yeu td lien quan den thai gian song them sau md ung thu dg ddy tien trien tgi Thdi Binh
II. 061 Tl/(?NG VA PHaONG P H A P NGHIEN CCfU 2.1. D o i ttfong nghien cihi
Doi tugng nghien cuu gom 105 benh nhan (BN) dugc xac dinh la UTDD co chki
HOI NGH! KHOA HOC BENH VIEN HLfU NGHj VI^T TIER H A I PHONG LAN T H C / 3 7
doan 1110 b^nh hgc la Adcnocarcinomc, viio dieu tri vii mo tai Khoa Ngoai tdng hgp B^nh vien Da khoa tinh Thiii Binh vii Khoa Ngoai Benh XICMI Dai hoc y Thiii Binh tir thiing 1/2006 den thang 4/2009.
2.2. Phuong phap nghien ciiu
Nghien ciru thir nghiem liuii .simg c6 ddi chirng, chia nhom ngiui nliicMi, mil dan, 1 nhom chung chi phau thuat dan thuan (nhom
1), 1 nhom nghien ciru dugc dieu tri bo trg sau md bang hoa chat (nhdm 2), 1 nhdm dugc dieu trj bd trg sau md being hoa chat ket hgp mien dich Asleiii (nhom 3).
* Phau thuat ciit da day rong + nao \cl hach DT
* Dieu tri boa chat theo phac dd EM' (Etoposide + Leucovorin + 5-Fu)
Chu ky 21 ngay: Diing 6 dgt, mdi dgt 3 ngay.
* Mien dich: Sir dimg Aslem, each dimg: 7 ngay sau md, tiem lien tuc trong 30 ngay, tiem bap mdi ngay 2 ong. Sau do tiep tuc tiem b5p 3 ngay/lan, lien tuc trong 6 thang.
* Benh nhan dugc tai kham dinh ky 1 thang, 3 thang, cho den khi tir vong. Nghien cihi mdt sd yeu td anh hudng den thdi gian sdng them sau phau thuat: dieu tri hoa chat, mien dich tri lieu, muc do xam lan, mire do di cSn hach, do biet hoa te bao, giai doan benh.
* Danh gia ket qua dieu tri, ty lc song them ciia 105 BN sau 36 thang
* Cac sd li?u dugc xir ly tren ph^n m^ni SPSS 13.0
* U'dc lugng ty lc song them tinh theo phuang phap Kaplan-Meier.
III. KET QuA NGHIEN COU
Tudi mac b?nh trung binh ciia 3 nhdm:
58,2 ±9,2, tuoi thSp nhk: 34, tudi cao nhat 75.
Nam gidi chiem 71,4%, nir gidi chilm 28,6%, ty le nam/nir: 2,5.
Tuoi mhc benh ciia timg nhdm nghien cuu:
+ Nhdm 1: 57,7±8,6; nhdm 2: 58,4±9,2;
nhom 3: 58,7±10. Tudi \a ty le nam/nu ciia 3 nhdm khac nhau khdng cd y nghTa thong ke vdi p > 0.05
3.1. Ket qua gan.
Khdng CO tir vong sdm sau md, chi co 5,1% nhiem trimg vet md.
3.2. D9C tinh cua hoa chat.
Cac ddc tinh ciia thuoc doi vdi huyet hoc va chirc nang gan than chii >cu d do 1, vdi ty lc nhu sau: Giam huyet sac td do 1: 197 trudng hgp (56,3%), giam bach cau dp 1: 77 trudng hgp (22%), giam tieu cau do 1: 48 trucrng hgp (13.7%)). Tang Bilirubin mau do 0 va do 1: 343 trudng hgp (98%)), tang men gan do 1: 110 trudng hgp (31.4" 0), tang Creatinin do 1: 16 trirdng hgp (4.6%). Chi cd 2 trucrng hgp (0,6%)) giam bach cau do 3 va 1 trudng hgp (0,3%o) tang Bilirubin mau do 3.
3.3. Ket qua xa.
* KC't qud theo ddi benh nhdn sau md:
Dhn ngay 30 42009, tdng sd 101 benh nhan cd tin da tir \ ong 30 benh nhan (29,7%).
Trong dd nhdm 1 co 16 benh nhan (15,8%), nhdm 2 tir vong 8 benh nhan (7,9%)), nhom 3 la6b?nh nhan (5,9%).
* i'cxc luang thai gian song them cua 101 hC'nh nhdn
Thdi gian sdng them cua 101 benh nhan:
28,64±1.2 thang, do tin cay 95%.
Thdi gian sdng them trung binh ciia 101 benh nhan sau 36 thang: 62,6%).
Y HOC VIET NAM T H A N G 10 SO DAC BIET/2011
Survival Function
"T Censored
Bieu do 3.1 Thdi gian song them ciia 101 benh nhan
* Ifdc lugng thai gian sdng them sau md cua cdc nhdm.
Nhom 1 la 23,61±2.3 thang; Nhdm 2 la 29,37±2,0 thang Nhom 3 la 29,49±1.2 thang ; test Log Rank \a\ p = 0,006
T y l *
% Nh6m nghifin ciiu
J l NUinUI Nliilill II P Nhlliiil
• """'""censored
Bieu do 3.2 Thai gian song them ciia cac nhom.
* So sdnh thai gian song them cua cdc nhom cho kit qud nhu sau:
Nhdm 1 va nhdm 2: Su khac biet cd y nghia th6ng ke, test Log Rank, p = 0,047
Nhom 1 va nhdm 3: Sir khac biet co y nghia thdng ke, test Log Rank, p = 0,003
- Nhom 2 va nhdm 3: Sir khac biet khdng co y nghia thdng ke, test Log Rank, p = 0,44
Nhom 1 va nhdm 2 + 3: Su khac biet cd y nghia thdng ke, test Log Rank, p = 0,002.
* Ddnh gid hieu qud dieu tri giira cdc nhom:
De khao sat hieu qua di^u tri bd trg sau m6, chung tdi phan tich nguy ca tu vong
cua cac nhdm 2 va 3 so vdi nhom khong dieu tri bo trg (nhdm 1). Sir dung md hinh "Fit cox proportional hazards model" cho thay:
Nhom 2 CO ty xuat tir vong giam 2,3 lan so vdi nhdm 1, sir khac biet cd y nghia thong ke vdi p = 0,04.
Nhom 3 CO ty xuat tir vong giam 2,2 lan so vdi nhdm 1, vdi p = 0,001.
Ty xuat tir vong giiia nhdm 2 va nhdm 3 khong co sir khac biet, p = 0,17.
- Nhdm 2 + nhdm 3 co ty xuat tir vong giam 3,1 lan so vdi nhdm 1, p = 0,002.
* Khdo sdt thai gian sdng them vd cdc yeu to lien quan.
Hpl NGH! KHOA HQC BgNH VIEN HUTU NGHj VIET TIEP H A I PHONG LAN THLf 37
Thdi gian song them vdi tudi bfnh nhan.
lyi*
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J" - 60 t• " - 6 0 ,
* 1 censored
• J censored
Biiu dd 3.3 Thiri gian sc^ng them ciia nhdm BN £ 60 va > 60 tudi.
+ Nhdm BN < 60 tu6i: I'hiri gian siing them Irung binh la 28,3±1,5 thang + Nhdm BN > 60 tu6i: Thai gian scing Ihcni trung binh la 28,5±2,0 thang Tets Log-Rank, .sir khac bigt khdng co y nghTa thdng ke, \ (Vi p = 0,8
Thoi gian song them vdi kich thuoc khoi u.
Tyi«
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n • icin J l .Son
• ^
* censofed
Bieu do 3.4 Thai gian sdng them \ cVi kich thudc khdi u.
-I- Kich thudc khdi u < 5 cm: Thdi gian sdng them trung binh la 32±1,3 thang -I- Kich thudc khdi u > 5 cm: Thdi gian song them trung binh lit 22±1.8 thang Sir khac bi?t cd y nghTa thdng ke, Tets Log-Rank \a\ p = 0,001.
- Thdi gian song them vdi d9 xam lan khoi u.
Tyi#
%
J l ' + '
• i « « • • • • .
10 -r-
20 - I —
30 40
Biiu do 3.5 Thai gian sdng them vdi do xam lan khdi u.
Y HOC VIET NAM T H A N G 10 • SO DAC BIET/2011
+ Khdi u (T2): Thdi gian s6ng them trung binh la 34±1,6 thang + Kh6i u (T3): Thdi gian sdng them trung binh la 34,1±1,4 thang.
+ Khoi u (T4): Thdi gian sdng them trung binh la 21,6±1,6 thang.
Sir khac biet cd y nghTa thdng ke, Tets Log-Rank vdi p = 0,001.
Thdi gian song them vdi di can hach.
T y i «
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0 ?
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20 1
30 40
Dl c6n hgch, J l pNO J l ONJ
• pNO.cwnuHMd + pNI.oan»orm1
Bieu do 3.6 Thai gian song them vdi di c an hach.
+ Khong di can hach: Thdi gian sdng them trung binh la 32,6±1,6 thang + Di can hach pNi: Thdi gian sdng them trung binh la 28,6±1,8 thang + Di can hach pNi: Thdi gian sdng them trung binh la 23,0±2,2 thang SIT khac biet cd y nghTa thdng ke, Tets Log-Rank vdi p = 0,01.
Thdi gian song them vdi giai doan benh (theo TNM).
%
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J l 200 300 J\AOO + 2 00^«nBor«J
3 00-c«nMr«l + 4 00-c«n»orBd
10 20 -r-
30
40
Biiu dd 3.7 Thdi gian sdng them vdi giai doan benh.
+ Giai doan II: Thdi gian sdng them trung binh la 33±1,9 thang + Giai doan III: Thdi gian sdng them trung binh la 30,5±1,3 thang + Giai doan IV: Thdi gian sdng them trung binh la 14,7±1,6 thang Sir khac biet cd y nghTa thdng ke, Tets Log-Rank vdi p = 0,01.
Hpl NGH! KHOA HOC BENH VIEN HUTU NGHI VI^T TIER H A I PHONG LAN THLf 37
IV. BAN LUAN
4.1. lVl9t .so (lac diem ciia nh(>m nghien cuu Tudi mac hcnh trong nhdm nghien ciru nam a khoiuig 34 dC'ii 7^ tudi iniic bpnh trung binh la 58,2 i*),2. Kcl qua nay phii Imp
\di nhicu nghien ciru trong nude nhir:
NguNcn Xuan Vinh |71 luoi iniic hcnh trung binh la 57.3; Trinh IlOng San [5]: 54,6.
Trong 3 nhdm nghien ciru, chiing toi thay tuiti mac benh tirang tir nhau, p = 0,05.
UTDD ha\ gap a nam gicVi, i\ lc nam/iirr trong nghien ciru la 2,5. Nhu ket qua ciia Nguyen Lam Hoa la 2,5 [2|, Nguyen Xuan
Vinh la 2,1 [7].
4.2. Ket qua gan
Benh nhan trong nhdm nghien ciru cua chiing toi khong cd tir vong va ciic hihn chimg CO the gap trong cat doan da day.
Chung tdi chi gap 6 trucrng hgp (5,7%)) nhiem triing vet md. Theo nghien cim ciia cac tac gia trong va ngoai nude, dii phau thuat cat doan da day va nao vet hach D2 cQng khong lam tang ty le bien chung sau md [5].
4.3. Dgc tinh cua hoa chat.
Dilu tri UTDD bang phau thuat triet can + Dieu tri hda chat bd trg ELF la phac do it gay ra nhimg thay ddi cac thanh phSn ca ban ciia mau ngoai vi va it dgc vdi gan than [ 1 ], [6].
4.4. Ket qua xa
4.4.1. Kit qud chung cua 105 b^nh nhdn vd ciia moi nhdm.
* Kel qud chung ciia 3 nhdm.
Thdi gian sdng toan bd ciia 101 benh nhan: 28,64±1,2 thang. Then gian song trung binh sau 36 thang ciia 101 BN la: 62,6 thang, do tin cay 95% (bieu dd 3.1)
Theo ddi sau 3 nam cd 30/101 BN tir vong vi tai phat do benh chilm 29,7%.
So vdi kht qua cua Nguyen Van Hidu nghien curu tai B?nli vien K Ha Ndi [1] cho kht qua s6ng trung binh sau 3 nam la 63,36%.
* Ket qud rieng cua cdc nhdm:
Nhimi 1 la 23,61 ±2,3 thang Nhom 2 lii 29,37±2,0 thang Nhdm 3 la 29,49± 1,2 thang test Log Rank vcVi p = 0,006
Ket quii tren cho thay, dieu tri bd trg sau md bang hoa chat va khi ket hgp vdi mien dich cho ket qua kha quan hem.
* Ddnh gid hieu qud dieu tri giira cdc nhom.
Chimg toi khao siii hieu qua dieu tri cua hoii chat vii mien djch, bang each phan tich nguy ca tu \ong cua cac nhdm 11 \a 111 so vdi nhom I, su dung md hinh "Fit Cox proportional hazards model" (phan mem Stata 10.0). Ket qua cho thiiy: Nhdm II co ty xuat tir vong giam 2,3 lan so \ di nhom I (p = 0,04), nhdm III giam 2,2 lAn (p = 0,001) va nhdm 111 giam 3,1 l4n (p = 0,002). Nhung gitra nhom II va nhdm 111 khdng cd su khac biet vdi p = 0,17. Ket qua kiem dinh tren cho thay: Hoa tri sau md cd tac dung keo dai thcri gian sdng sau md. Dieu tri Aslem cho thdy sir khac bi?t khdng cd >' nghTa thdng ke.
4.4.2. Ket qua xa va cdc yeu tS lien quan,
* Thdi gian song them vdi tuoi b^nh nhan Ket qua ciia chung tdi chi cd 1% benh nhiin dudi 60 tudi, phan tich mdi lien quan
\ di thdi gian sdng them cho thdy khdng co sir khac biet giira 2 nhdm.
* Thoi gian song them vdi kich thu'dc khoi u:
Ket qua nghien cihi cua chiing toi cho thay, thdi gian sdng toan bd phu thuoc vit nhieu vao kich thudc khdi u:
Kich thudc u dudi 5 cm: Thdi gian sdng trung binh la 32,1 ± 1,3 thang
- Kich thudc u tren 5 cm: Thdi gian s6ng trung binh la 22,0 ± 1,8 thang
Test Log-Rank, sir khac biet cd y nghia thdng ke vdi p = 0,001
Y HOC VIET NAM T H A N G 10 SO D A C BIET/2011
* Thoi gian song them vdi do xam lan khoi u:
Khdi u xam idn T2: Thdi gian sdng tnmg binh la 34,3 ± 1,6 thang
Khdi u xam idn T^: Thai gian song tmng binh la 34,1 ± 1,4 thang.
Khdi u xam lan T4: Thdi gian song trung binh la 21,6 ± 1,6 thang.
Test Log-Rank vdi p = 0,001.
* Thoi gian song them vdi miic do di can hach:
Thdi gian sdng them ciia benli nhan klidng di can hach pNO la 32,6±1,6 thang.
Thdi gian sdng them ciia benh nhan di can hach pN 1 la 28,6± 1,8 thang.
Thdi gian sdng them ciia benh nhan di can hach pN2 la 23,0±2,2 thang.
* Test Log-Rank, p = 0,01.
Nguyen Xuan Kien theo ddi 144 benh
nhan UTDD dugc phau thuat cho ket qua thcri i^^j ny^ ^i|u t^i.
i - r i n v « n A v . . r > n n . . C X "* I ' l l * * J ' - - - '
Do biet hoa kem: Thdi gian song trung binh la 15,5± 1,8 thang.
Test Log-Rank cho bilt sir khac biet co y ngliTa thdng kc vdi p = 0,001
V. KET LUAN
5.1. Ket qua dieu trj.
5.1.1. Ket qud gdn.
Khdng CO tii' vong sau md.
Ciic doc tinh ciia boa chdt tren huylt hoc va chirc nang gan chii yeu d do 1. Tdt ca cac trudng hgp deu kiem soat dugc.
5.1.2. Ket qud xa.
Thai gian sdng them ciia 101 benh nhan: 28,64 ± 1,2 thang. Thdi gian sdng trung binh ciia 101 benh nhan sau 36 thang:
62,6%). Sau 3 nam tir vong 30/101 benh nhan (29,7%) vi tai phat do benh.
5.2. Mot so yeu to tien luong doi vdi gian sdng sau 5 nam ciia nhdm khdng di can
hach la 72,23%, nhdm pNl la 18,17%, pN2 va pN3 la 0%), sir khac nhau cd y nghTa thong ke vdi p = 0,001. Di can hach la mdt ylu td tien lugng quan trgng ciia UTDD theo kit qua nghien cuu cua nhilu tac gia [2], [3], [5], [6].
* Thdi gian song them vdi giai doan benh:
Ket qua nghien cuu cua chung tdi, theo doi sau 3 nam dieu tri thdi gian sdng them cd lien quan vdi giai doan benh.
Benh nhan thudc giai doan IV se chet trong thcri gian ngan ban so vdi giai doan III va benh nhan d giai doan III se chet trong thcri gian ngan ban giai doan II, kiem dinh bang test Log-Rank sir khac biet cd y nghTa vdi p = 0,001.
* Thdi gian song them vdi do biet hoa te bao:
- Do biet hoa cao: Thdi gian sdng trung binh la 36,0 ±0,9 thang.
- Do biet hoa vira: Thdi gian sdng trung la 28,9 ± 2,3 thang.
Ket qua thdi gian sdng them lien quan vdi:
- Kich thudc khdi u thcri gian sdng them ciia nhom cd kich thudc khdi u < 5 cm dai ban nhdm cd khdi u > 5 cm.
Khdi u xam lan cang nhieu thdi gian sdng sau md cang ngan.
Khdng di can hach thdi gian sdng dai hon cd di can bach.
- Giai doan benh giam dan tir giai doan II, 111, IV-
- Thdi gian sdng giam rd ret tir do bi?t hoa cao din do biet hoa thap.
Trong nhom nghien cuu cua chung tdi:
Nhdm benh nhan tren va dudi 60 tudi khac nhau khdng cd y nghTa thdng ke vdi p > 0,05.
TAI UEU THAM KHAO
/. Nguyen Van Hieu (2005), "Nghien ciru hieu qua hoa chat trong dilu tri ung thu da day", Bdo cdo nghiem thu de tdi nhdnh cua di tdi NCKH cdp nhd nude KC. 10.06, Bg khoa hgc
HOI NGHI KHOA HOC BENH VIEN HUfU NGHI VIET TI^P H A I PHONG LAN THL/ 37
cdng ngh(' vu nidi trudng, Hd Ngi.
2. Nguyen Lam Hoii (2008), "NghiC-ii ciru dilc dicni lam siing, gi.ii pliiui haih, kcl quii dieu trj phiui thiii.il ung llur da (l;i> va hoa tri b(i fro lai hcnh vien Viet I iep I liii Phcing", Ludn dn Tien ,vv v hoc. Hoc r/V// (Judn )'. Hd Ndi- 3. Nguyen Xuan Kien, Nguyin Cirong I hjnii
(2006), " y nghia lien lugng ciia di can hach trong ung thir d^i clay", Ngogi khoa, lap 56, so 3, tr. 2-6, Hd Not.
4. Ha Van Quyet vii cs. (2009), "C'linn doan vii dieu tri ung thu da day .sdm" Ni^oai khoa, lap 59, .s() J, tr. 6-1-l. Hd Ngi.
5. Irinh Hong Son (2001), "NghiC-n ciru nao
vet hach trong dilu trj phau thuat ung thu da day", /.//(/// dn Tien .sy y hgc, Truirng Dgi hgc V Hd Ndi.
6. Do Dire Van, Nguyen Ba Dire (2005),
"Nghien ciru cac bien phap chan doan sdm va xay di,rng phac do dieu trj b?nh ung thu da day", Bdo cdo nghiem thu de tdi nhdnh cua de tdi NCKH cdp nhd nirdc KC. 10.06, Bg khoa hoc cdn^ ngh^ vd mdi trudng, Hd Ngi.
1. Nguyen Xuan Vinh (2001), "Lien quan giira nhiem flelicobacter Pylori va ung thu da day" Ludn dn Tien sy y hgc, Truang Dai hoc V Dirge TP. Hd Chi .Minh
NGHIEN curu PHAT TRIEN KY THUAT MULTIPLEX REVERSE TRANSCRIPTION - POLYMERASE CHAIN REACTION (MRT-PCR)
PHAT HIEN NHANH VIRUS CUM A/H5N1
Nguyen Nam T h i n g ' , Tran Thi Tinh', Pham Ngoc Khai', Dinh Duy Khang', Lurong Xuan Hien
T 6 M TAT
oat van de: Virus ciim gia cam H5N1 khdng chi gay benh tren gia cam va chim hoang da ma con CO kha nang lay nhiem va gay benh cho ngu'di vdi ti le tir vong cao. Phu'dng phap: Ky thuat mRT-PCR dddc xay ddng nham phat hien nhanh virus cum A/H5N1. Ky thuat dddc thdc hien vdi 3 cap mdl cho phep phat hien dong thdi cac trinh t y dac bleu tren gen H5 (371 bp), gen N l (292 bp) va gen M (154 bp) ciia virus cum A/H5N1. Phan Lrtig dddc tdi du hoa va danh gia do nhay, dp dac bleu, dong thdi thCr nghiem tren 14 mau benh pham thu thap tCr gia cam va ngu'di. Ket qua: Ky thuat mRT-PCR cho phep phat hien dac bleu virus
'Dgi hoc Y Thdi Binh, ^Vi^n Cong ngh4 Sinh hgc
cum A/H5N1 tren ca ngu'di va gia cam. Ky thuat CO kha nSng phat hien khi trong mau benh pham cd tir 10 ban sao virus trd len. Ket luan: Ky thuat mRT-PCR phat hien virus cum A/H5N1 noi bat vdi cac uli diem la: nhanh, kinh te, dp dac hieu va dp nhay cao. Do dd ky thuat nay cd the iTng dung trong chan doan va sang Ipc d cdng ddng khi dich cum A/H5N1 xay ra.
Viet tat: RT-PCR: Reverse Transcription Polymerase Chain Reaction; mRT-PCR; multiplex RT-PCR; DNA: deoxyribonucleic acid; RNA:
ribonucleic acid.
riykhoa: Virus cum gia cam, H5N1, RT-PCR, multiplex RT-PCR, cum A.
