Tap chl Tai MOi Hgng Vi#t Nam - Volume (58-16). N°4 - June, 2013
NGHIEN c i r u DAC DIEM LAM SANG VA TY LE MAC VIEM MUI DI UTVG DO DI NGUYEN LONG Vtj (J NHCTVG NGU^CH
CHAN NUOI GIA CAM TAI THAI BINH
Ngo Thanh Binh*, Vd Minh Thuc**, TangXuan Hdi***
TOM TAT
Nghien cuu md td cdi ngang gdm 524 nguai chdn nuoi gia cdm lai 2 xd thugc linh Thai Binh cho thdy: Ti lemdc viem mUi di img dg di nguyen Idng vu Id 26.15%. Sd nguai mdc benh ca thai gian liip xuc tren 16 ndm chiim ly le Idn (45.25 %). Thai gian liip xtic cdng keg ddi thi khd ndng mdc benh cdng tdng. Ba s6 cdc benh nhdn diu cd liin sir di img cd nhdn khd rg (60,58 %). Cdc trieu chiing hit hai vd chdy mdi gap a lit cd cdc benh nhdn, trgng do chu yeu Id a mirc dg ndng. Nggt mUi vd ngiia miii gap > 80% trudng hgp viem mm di img ( VMDU), chii yiu la a miic do trung binh. Niem mac mm phii ni a 100%
so benh nhdn, chu yiu a mdc do phii ni it vd nha mdu. Chi co 45% sd benh nhdn cd cudn mm dudi qud phdt vd chit yeu Id qud phdt nhe.
Titkhda:chdn nudi gia cdm,viem mQi di ling SUMMARY
CLINICAL CHARACTERISTICS AND THE RATE OF ALLERGIC RHINITIS CAUSED BY FEATHER ON POULTRY RAISERS IN THAIBINH PROVINCE
This is a cross-study carrying out on 524 poultry raisers in 2 communes ofThaibinh province. The study showed that: The rate of allergic rhinilis due lo feather is 26,15%. The number of patient who contact with poultry over 16 years is highl (count for 45.25 Vo). The more time patients contact with poultry, the more risk for these patients lo have allergic rhinilis. Almgst gfpatients have allergic prehistory (60.58 %). The symptom of sneeze and mucous from nose appears in all patients, mainly in severe level. The symlom of stuffy and nose itch appears in over 80% patients, mainly in moderate level. Nasal mucosal edema appears in 100% patients. Only 45% patients have hypermyotrophy inferior turbinates and distribution are mainly slight level.
Key wortls: poultry raisers, allergic rhinilis.
1. DAT VAN D E '-'^ i ^ S ^ cac nuac tren the gioi. Benh co Ngay nay di iing chiim mot vi tri quan <^'^J^" ' ^ " ^ g S'^ ' ^ ? ^' ""*'^ ' • \ ° • * ' « "
trong trong y hoc hien dai, tren t h i gioi 15- ™ ' ' " ^ 8 J^l ™'.' ^^' " " ^"^ T^
20% dan s6 bi di tag, trong do viem mui di "^i >'.'" ™ * • * • " ^ ^ ' 1 ' ' , " ^^?.?'Z^^^^
ling (VMDU) Id benh rdt ph6 biln trong P * ! " ' . ' " » cong "ghiep hoa va hien dai hoa.
chuyen khoa Tai Mui Hong vd chuyen khoa ^J '* J?!"* " ™ ?>"'^> f « " Uy 2W^,
— i -. — Hong Cong 4 3 % ; An Dp 26%; Autralia 41 -
•TnrtagDaihocyTUiBtah 47%; Nhat Bdn 13-20%; Phap 20-25%;
" Benh vien Tai Mai Hong Trang uong Anh-Diic 21-24%. Ci Viet Nam uac tinh CO
*** Benh vian HOu nghi Da khoa Ngha An Nhan bSi 25/4. Duyet in 5/5/2015
Tgp chi Tai MQi Hgng Vi$t Nam - Volume (58-16). N°4 - June, 2013
12,3% bi di ung miii xoang. Ti 1? viem mui di ung trong cpng dong dan cu H^ Npi la 29,05-32%.
M3c du CO s\r da dang ve c^n nguyen gay dj ung, nhung di nguyen long vu la nguyen nhan pho bien gay VMDU' dung sau di nguyen byi nha. Theo cac tac gia Tay Au thi 30-40% benh nhan bi di ung ducmg ho hap tren co man cam v6i di nguyen long vu, con a Viet Nam con so tren la khoang 31-35%. VMDU" trong cac cong ty chan nuoi gia cam, xi nghipp che bien long vu, bong, len, vai sai la de tai dang dupe chu y 6 the gioi va Viet Nam.
Vi vay chung toi tien hanh de tai nay nham cac muc tieu sau:
1. Dieu tra ty le mac viem miii dj iing do di nguyen long vu a nhung nguai chan nuoi gia cam tai Thai Binh.
2. Nghien cuu dac diem lam sang va can lam sang cua benh viem mui di ung do di nguyen long vu.
2. DOI TlTONG VA PHlTOfNG PHAP NGHIEN c u t !
2.1. Doi tvffng nghien cihi.
2.1.1. Dia diim nghien cuu
Tai 2 xa Binh Minh va Thuang Hi§n, huyen Kien Xuong, tinh Thai Binh.
2.1.2. Thdi gian nghien cuu
Tir thang 12 nam 2008 d^n thang 05 nam 2009.
2.1.3. Doi tuprng nghien ciru.
- Nhung ngucri chan nuoi gia cdm tai cac ca so chan nuoi gia cdm thupc dia ban nghien cuu se duac chpn vao nghien cuu neu thoa man 3 dieu kien sau:
+ Co dp tuoi tu 16 den 55.
+ Dang lam viec trong cac co sa va xi nghiep dupe chpn tai thai digm diiu tra.
+ Co thai gian lam viec t6i thi6u tai cac ca sa nay tu 12 thang tra len tinh thii
thai diem dieu tra.
Loai ra khoi nghien cuu nhiing tru6Tig hpp sau:
+ Dang hoSc d\r kien mang thai trong dpt dieu tra.
+ Mac cdc benh tim mach, gan than, ho hap d giai doan mat bu trir.
+ Dang CO con tam than.
+ Mdc mdc benh tu mien.
+ Dang bj benh ly nhiem khuan cap a mui xoang.
2.2. PhiroDg ph^p nghien cuu.
2.2.1. Thiet ke nghien cuu: La nghien cihi dich te hpc mo td voi cupc dieu tra ngang nhdm xac dinh ty le mac benh va nghien cihi ddc diem 1dm sang cua VMDU" do DNLV.
2.2.2. Phuong phdp chpn mdu vd cdmau nghiin ciru.
Co mdu duac dp dung theo cong thiic sau:
„ _ , 2 P(l - P ) Trong do: a: La do tin cay lay a nguong95% (Z(l-a/2) =1,96)
p: Id ty le mac viem mQi di ling ucrc tinh qua mgt dieu tra truoc. Tir mot so nghien cihi truoc ddy tai dong bdng Bac Bo, ty le ndy uac tinh Id 31,9%.
d: Id do sai lech uac muon, Idy d bang 0,05.
Co mau nghien cihi theo tinh toan la 333 ngiroi.
De tang tinh chinh xdc trong viec xac dinh ty 1$ VMDLT chiing toi liy tang oa mau len 1,5 Idn, thi ca mdu cdn di^u tra trong nghien eta nay se la 500 nguoi.
Tong so doi tuong nghien eta Id: n = 524 nguai.
Tap chf Tai MOi Hpng Vi$t Nam - Volume (58-16). N 4 - June, 2013
*. Phuongphdp chpn mdu Chpn cdc ca sa, trang trai chdn nuoi gia cdm theo phuong phdp chpn mau co muc dich, chi chpn vao nghien cuu nhiing ca sa, trang trai da di vao chdn nuoi tren 12 thang. Tiin hanh nghien cuu toan bp cong nhdn vien cua cac co so, trang trai da chpn sao cho vira du voi c a mau da tinh toan.
2.2.3. Cac ky thuat 4p d u n g trong nghien cihi
2.2.3.1. Khai thdc tiin su di img Dua vao Mau 25^ cua WHO v l hoi tiin su di ung va Mdu cdu hoi chi tiet co tinh diem ciia ISAAC (International study of allergy and asthma childhood 1994), chung toi xay dung dupe bdng tinh diem cho tiin su di ung dupe torn tat duai ddy.
Tiin sir di ung gia dinh:
B6 N I U CO 2 diem Me N I U CO 2 diem Anh chi em nipt Neu co 2 diim Ho ben B6 N I U C6 1 diim Ho ben Me N I U C6 1 diem Tiin sir di img bdn thdn, cd cdc benh tdi diin:
Cham di ung, eczema Neu c6 2 diem Viem miii di ung Neu c6 2 diem Hen phi qudn Neu co 2 diem May day sin ngiia Neu co 1 diem Di ling thu6c N I U C6 1 diem Di ling thiic an Neu co 1 diem Phil Quink(phu mat, moi) N I U CO Idilm 2.2.3.2. Khdm Idm sdng: chung t6i dua theo mau:
+ Bang cau hoi danh gid trieu chirng miii cua benh n g h i nghiep duong ho hap (phdn mui) duac coppy tir bo cau hoi ciia Institude of occupatinonal medicine trong British Journal of Industrial Medicine
1988.
-^ Thang cho diem danh gia cdc trieu chiing mui ciia Bent Weeke va Niels Mygind, Dan Mach 1985.
+ Mpt s6 cau hoi chi tiet ve lam sang dupe xem xet va bo sung.
Co ndng. Co cac bieu hien thucmg gap - Ngiia mGi thuong xuyen Neu co 2 diem
- Hdt hoi thuang xuyen Neu c62 diem
- Chdy mui trong N I U C62 diem - Ngat mui timg dot Neu c61 diem - Ho, ngiia hpng thudng xuyen
Neu col diem - Do, ngiia mdt timg dot N I U CO 1 diem - Phan ling miii a noi lam viec
(bilu hien ro han khi nghi lam.) Neu c64 diem Thuc the:
- Niem mac miii nhat nhat 2 diem - Phil n l cdc cu6n va niem mac miii
2 diem - Polype miii 1 ^i^m - Dpng nhilu dich nhay miii 1 diem - Cu6n duai qua phat 1 diem - Viem hpng, viem amidan man tinh
1 diem Til viec khai thdc tiin sir, kham lam sang CO tinh diim, nhung benh nhdn VMDU* dupe lira chpn la nhimg benh nhan CO t6ng s6 diem dat 16 tra len.
2.2.3.3 Test Idy da (Prick lest): Dupe tiin hanh theo ky thuat cua T.J SuUivan (1981):
Ldm sach mat da vung truac cang tay bdng c6n 70°, d l kho, rSi Idn luot nho len mat da a cac vi tri each nhau 3-4 cm, moi cho mpt gipt cdc dung dich chimg va thir;
73
Tap chi Tai Mui Hgng Vi^t Nam - Volume (58-16) N°4 - June, 2013
- NaCl 0,9%.
-Histamin 0,1%.
- Dung dich di nguyen long vu nong dp lOOOPNU/ml.
DCmg kim xuyen qua gipt dimg dich cam nhe vao mdt da qua lop thupng bi (khong chay mau) tao mpt goc 45° roi lay nhe len (moi gipt diing mpt kim Idy da rieng), dpi 3-5 phiit sau diinp bong tham 6 ria gipt dung dich cho kho het. Dpc ket qud sau 15-20 phut. Miic dp phan iing dupe ddnh gia theo 2 miic dp: am tinh va duong tinh.
2.2 3.4 Chdn dodn xdc dinh.
Tir viec khai thdc tien sii, kham ldm sdng CO tinh diem va xet nghiem, nhung benh nhan dupe chdn doan xac dinh la VMDU do DNLV phai thoa man 3 diiu kien:
- Tong so diem dat 16 tra len.
- Dupe chdn doan lam sang la VMDU".
- Duong tinh vai DNLV khi lam test lay da.
2.4. Xu ly so lieu: So lieu thu dupe trong qua trinh nghien ciiu dupe xii ly bdng chuong trinh SPSS 15.0.
3. KET QUA NGHIEN ClTU 3.1. Ty le mac benh va tiin sir di irng.
Bang 1 Tneu chung ISm sang VMDLf va test lay da
~^\rest lay da
C6 trieu chi>ng Khong c6 trigu
chiing Tong s6
(+)
%
n 137 67,8266 32,16
202 38,55
(-)
%
n 49 15,22273 84,78
322 61,45
Tong
%
n 186 35.50338 64,50
524 100
Han 1/3 so tnrong hgp (+) v6i DNLV khi lam test liy da (38,55 %)
Co 67,82 % (+) voi DNLV co diu hi?u lam sdng cua VMDLT.
- Ty 1? VMDir do DNLV la 137/524 chiem 26,15%.
Bdng 2. Ty 1$ VMOLT theo th&i gian tiip xijc "
v*i DNLV Thdri gian
ti6p xuc 1-5 nSm 6-10 ndm 11-15 nam 2 16 nam
T6ng
S6 b$nh nhdn (n=137)
15 22 38 62 137
Ty 1$ % 10,95 16,06 27,74 46,25 100 Nhdn xet: So benh nhdn co thai gian tiep xiic vai DNLV > 16 ndm la cao nhdt (45,25%)
Bang 3. Tien si> dj Cfng cd nhdn Ten b#nh di
ung May day Chdm di ling
HPQ Di u-ng thu-c dn
Di trng thu6c Vi6m l<et mgc Khdng dj i>ng
So b^nh nhdn (n=137)
58 17 19 13 15 32 54
Ty 1$ % 42,34 23,29 26,03 9,49 10,95 23,36 39,42
Nhan xet:
Nhan xet:
So benh nlran co tiin su di ling ca nhan (60,58 %) cao hem s6 benh nhSn khong CO tiSn su dj ilng ca nhan (39,42 %) voi p<0,05
Cac b?nh mdy day vd viem ket m?c Id hay gap nhit.
Tgp chi Tai MQi Hong Vi$t Nam - Volume (58-16) N°4 - June, 2013
Bang 4. Ti^n su dj ting gia dinh M6i quan h$
B6 hodc me 86 vd me Anh chj em ru6t
6ng, bd
S6 b$nh nhdn (n=137)
9 10
Tyl«
%
36,77 7,30 12 1 8,76
8 1 5,84 Nhan xet:
- So b$nh nhan VMDU" co bo hoac me bj benh di iing vd cd hai bo me deu mdc benh di iing chiem ty 1? cao nhat, tong so t6i 43,07%
3.2. D^c diem lam sang.
3,2.1. Cdc tri$tt chung co nang.
-4^
Ngiia rtiQiHat hoi Chay mONgat mui
•Khong DTningbinli BNang
Bieu do 1. Tn^u chCrng ca nang a cac miic do Nhan xet:
- Tdt ca cdc trucmg hop VMDU" deu CO bilu hien hdt hoi va chdy mui, trong do chu yiu la a miic dp ndng (> 55%).
- Ngiia miii va ngat miii chii yeu a miic dp trung bmh (> 60%)
3.2.2. Cdc trieu chirng thuc thi.
Bang 5. Tinh trgng niem mac mui
Nhdn xet:
Tat ca cdc benh nhan deu co niem mac miii khong binh thuang, trong do chii yeu la phii ne it va nhpt mau (67,88%).
Bang 6. Tinh trang cuon mQi dudi
Niem mac mQi PhO ne nhi^u,
xuSt tiet Phii riFit, nhd
mdu Binh thuong
So benh nhdn (n=137)
44 93 0
Tyl#
%
32,12 67,88 0
Cu6n mui duO-i Qud phdt ndng Qud phdt nhe Kh6ng qud phdt
S6 bSnh nhdn (n=137)
24 38 75
Ty le % 17,52 27,74 54,74 Nhan xet:
- Chi CO 62/137 s6 benh nhan co cuon ducri qua phat, chiem 45,26%.
4. BAN L U ^
4.1. Ty le viem mui di irng do di nguyen long vu.
Theo cac tdc gia ngoai nuoc thi VMDlT la mpt loai viem mui ph6 bien nhit dugc ngucri ta phan ra tir hang so loai viem miii khong di ung qua su tham kham ky luong vS tiin sir thuc thS va ngoai ra viem mui di ling co the la viem mui theo miia, quanh nam hoac viem miii do nghe nghiep.
VMOlT thucmg phat triSn bat ddu a do tuoi tucmg doi tre.
Trong nghien cuu ciia chiing toi, ty le VMOlf do DNLV khong co su khac biet ro ret v6 Ilia tu6i. KSt qua nay ciia chung toi phii hrpp vcri kk qua ciia tac gia Vu Trung Kien va Nguyin Ngoc Chiic khi nghien cim vh VMDLT a tre em hoc duong nam 2008.
Ni thai gian tiSp xuc vai di nguyen, theo cac kk luan cua cdc tac gia ttong yd ngoai nuoc biSu hien cua VMOlT co chieu huong bdt ddu tir liic moi tiip xiicva sau mot thoi gian tiip xuc dai co the nidn cam voi di nguyen nen cac biiu hien dan giam di. YSu t6 nguy co bao g6m gen vd moi fruong s6ng. Tuy nhien, nghien ciiu ciia
Tap chl Tai MOi Hpng Vi0t Nam - Volume (58-16). N°4 - June, 2013
chiing toi cho thiy ty I? VMDU" do DNLV tdng len theo thai gian tiep xiic. Sy khac biet nay theo chung toi Id do trong nh6m doi tupng nghien cim cua chiing toi chu yeu la nhiing nong ddn chdn nuoi theo m6 hinh kinh te gia dinh, co thdi gian tiep xiic khong thuang xuyen nen khong dii hinh thdnh khdng the, hon nua trang thiet bi bao ho lao dpng khon^ c6 hodc khong ddy dii ciing la mot yeu to anh huong den si^ dieu chinh cua co the nguoi benh.
0 Viet Nam da co nhilu cong trinh nghien ciiu ve VMDU nhung cac nghien ciiu ve DNLV va diiu tri ddc hieu bdng DNLV chua nhieu, truac nghien cuu cua chiing toi chi co hai tdc gid Vu Minh Thuc va Pham Vdn Thiic la co mpt vai cong trinh ve VMDU do DNLV. Trong nghien ciiu cua chiing toi, ti le VMDU la 35,50 %, trong do CO 26,15% la VMDU do DNLV.
Ket qua cua chiing toi phii hpp voi cdc kit qua cua Vii Minh Thuc va Pham Van Thirc (32,5-39 %), va cao hon so voi kit qua ciia Vii Trung Kien va Nguyen Ngpc Chiic (19,3 %). Sa dt CO su khdc biet Ion la trong nghien ciiu cua chiing toi cdc d6i tuong nghien cihi la nhiing nguai lam cong viec chan nuoi gia cam nen VMDU mang tinh chdt nghe nghiep.
Co 9,35 % so doi tupng nghien ciiu tren lam sang co bieu hien VMDU song lai dm tinh khi lam test lay da voi DNLV. theo chiing toi nhihig trucmg hpp nay co mdc VMDU song dj iing vai cdc di nguyen khac. Ngupc lai con 12,40 % s6 truong hop cho kit qua duang tinh voi DNLV khi lam test lay da song khong co ddu hieu lam sang ciia VMDU. Qua khai thac tiin sir va tham kham lam sang toan dien chiing toi nhan thay nhimg truang hpp nay thuang xuyen bi vjem ket mac miia xudn hoac nii me day mdi khi tilp xuc vol gia elm. Mpt
so it truang hop c6 dau hieu ciia hen phi quan nhung 6 miic dp nhp.
4.2. D^c diem lam s^ng.
4.2.1. Tien su di ung.
Ve tien su di ling cd nhan, trong nghien ciiu cua Nguyen Nang An ty 1| nay la 43,24%, cua Doan Thj Thanh Ha la 60%,- ciia Nguyen Nhat Linh la 70,59%. Cac benh thudng gdp nhdt la HPQ, me day va cham di img. Trong nghien cihi ciia chiing toi thi ty le nay la 60,58 % va cdc b^nh hay gdp nhat la me day, viem ket mac dj iing vd HPQ. Ket qua nay phii hpp voi cac tac gia tren.
Ve tien sir di iing gia dinh, nghien cuu cua Vazquez - Nava- F (2000) tren 58 benh nhan VMDU cho thdy 56,8%) s6 benh nhan CO tien sir di iing gia dinh. Theo Wayoff va Moneret - Vautrin, tien sir di ling gia dinh chiem 45%. Nghien cihi ciia Nguyin Ndng An va cpn^ su dieu tra trong nhihig nguoi VMDU thdy 32,7% c6 ong ba npi ngoai, b6 me hodc anh chi em nipt ciing mac benh di irng. Nghien cim cua chiing toi co 35,77 % so benh nhan co bo hoac me mac benh dj ling; 7,30 % co ca bo va me bi benh di iing
; 8,76 % CO anh chi em rupt va 5,84 % co ong bd mdc benh dj iing. Kit qud ciia chiing toi tuong duang vai kit qua cua tac gia Vazquet-Nava. F la do co su chpn Ipc benh nhdn khd dien hinh vd mau nghien cihi.
Theo Dreborg, neu ca bo me deu co co dja di ling thi ty le con se bj di iing la 50% - 75%; neu chi co b6 hoac me thi ty 1? con mdc la 25%)-50%o; khodng 10% diia ti-e mdc benh khi cd b6 va m? khong co tien sii di ung. Nhu vay, khai thac tien sii di irng gia dinh CO the tien dodn duac phan nao kha nang mac benh cua ngudi benh.
4.2.2. Trifu chirng CO nang.
Khdo sat ky luang tien su benh la cdn
Tap chl Tai MQi Hpng Vifet Nam - Volume (58-16). N''4-June, 2013
cii de phdn biet ddy la mpt VMDU th^rc sir hay chi la dpt cdp ciia viem miii do. Theo P.Demoly va J.Bousquet (1997), trieu chiing dien hinh VMDU quanh ndm Id tdc ngat miii. Cdc trieu chiing hat hoi thdnh trang, chay miii va ngiira mui di kem theo nhung khong noi trpi nhu trong VMDU theo miia (do phdn hoa). Ciing theo tieu chuan chdn dodn VMDU cua hai tdc gid tren thi VMDU quanh nam nhdt thiet phdi CO tir 2 trieu chiing tro len (trong so cac trieu chiing hdt hoi, ngiia miii, chdy miii, i^at miii), bieu hien hon mpt gid moi ngay ngoai dpt nhiem virus. Nghien ciiu ciia Vii Cao Thien (1999) tren 57 benh nhan VMDU thi 100%) diu CO tam chiing hdt hai, chdy miii, ngat miii.
Kit qua nghien ciiu cua chiing toi cho thdy CO 100% so benh nhan co ddu hieu hat hoi va chay miii d cac miic dp, trong do chii yiu la d miic dp nang (tren 55 %). Co tren 80% s6 benh nhdn co tir 3 trieu chiing trd len. Day la budc danh gia ddu tien trudc khi kham benh. Kit qud ciia chiing toi phu hpp tieu chuin chdn doan P. Demoly va J.
Bousquet.
Kit qua ciia chiing toi co 92,7%) s6 trudng hop co ngiia miii, dau hieu ddu tien khi tilp xiic vdi di nguyen, trong dd chii yiu la d miic do trung binh (67,88%)). Ket qua cua chiing toi ciing phii hpp vdi cac tdc gid Vu Minh Thuc, Pham Van Thiic vd Vu San khi ngien cihi vl VMDU nghe nghiep d cdc cong nhan cac cong ty, xi nghiep det may (xi nghiep det 8-3), chl biln long vii Hai Phong vd mot s6 trang trai chan nuoi gia elm d Hdi Duang.
Cdc trudng hpp giam ngui deu cd bieu hien ngat miii d mirc dp ndng vd sau dieu tri tinh trang ngat miii cung khong thay doi.
Nhu vdy tinh trang ng^t miii nang va giam ngiii CO 16 lien quan din su thoai hoa niem
m^c miii noi chung va cuon mui dudi noi rieng gdy ra va rat it dap iing vdi diiu tri MDDH dudng dudi ludi.
4.2.3. Trifu chirng thifc the
Chung tdi nghien cihi tren tham kham npi soi tai miii hpng de danh gia 2 tri?u chiing thuc the ca bdn trong viem mui di ling la tinh trang niem mac miii vd tinh trang cuon mui, ddc biet Id cuon duoi.
Tat cd cdc benh nhan deu c6 tinh tr^g niem mac miii phii ne, trong do chii yeu la phii ne it va nhat mau (67,88%). Ddy Id mpt dau hieu rdt quan trpng de chdn doan phdn biet VMDU vdi cac trudng hop viem miii xoang khac vi trong cdc trudng hpp nay niem mac mui thudng phii ne va sung huyet do.
Ve tinh trang cuon miii dudi chiing toi nhan thdy chi c6 45,26% s6 benh nhdn co cuon mui dudi qud phat trong do 27,5% la qud phdt nhe, cuon mui dudi vdn co hoi sau khi dat thudc co mach Naphazolin 0,05%.
Con 17,52%) s6 benh nhdn qua phdt nang khdng CO hdi khi dat thudc co mach, chiing tdi tiin hanh tham do cudn bdng bay ddu tii thay cudn dudi rat ciing va dudi cuon thoai hda nang san siii nhu siip-lo. Ket qua cua chiing toi ciing phii hpp vdi ket qua nghien ciiu cua Imleat va Vu Minh Thuc.
K E T L U ^
1. Ty le VMDU do DNLV.
- Ty le VMDU trong nhdm ddi mpng nghien ciiu cao; 35,50 %.
- Ty le duong tinh vdi DNLV khi lam test lly da la 38,55 %.
- Ty le VMDU do DNLV cao, chiim 26,15%.
- Sd benh nhan cd thdi gian tilp xiic tren 16 ndm chiim ty le Idn (45,25 %).
- Thdi gian tilp xiic cang keo dai thi 77
Tap chl Tai Mui Hpng Viet Nam - Volume {58-16). N°4 - June, 2013
kha nang mac benh cang tang.
2. Dac diem lam sang.
- Da sd cdc benh nhdn deu cd tien sii di ling ca nhan kha r6 (60,58 %), trong do, b?nh may day va viem ket mac miia xudn Id hay gdp nhdt.
- Cac trieu chiing hat hoi va chay mui gap d tat cd cdc benh nhdn, trong dd chii yeu la d miic dp ndng. Ngat miii va ngiia mui gap d hau het cdc trudng hpp VMDU (tren 80%), trong do chii yeu la d miic dp trung binh.
- Niem mac miii phii ne d tdt ca cdc benh nhan, chii yeu d miic dp phii ne it va nhpt mdu, chiem 67,5%. Chi cd 45% sd benh nhdn cd cudn miii dudi qua phat va chu yeu la qud phat nhe.
TAI LIEU THAM KHAO 1. Nguyen Nang An (1995), Mdy vdn di y
hoc CO so trong cdc phdn ung vd benh di img. NXB Y hpc. Ha Npi.
2. Dodn Thi Thanh Ha (2002), Nghien cuu chdn dodn vd diiu tri mien dich viem miii di img do di nguyen bui nhd. Luan dn Tien sy y hoc, Hoc vien qudn y 108.
Ha Ndi.
3. Imleat, Vii Minh Thuc (2006), Ddnh gid hieu qud dieu tri MDDH trong VMDU do di nguyen Dermatophagoides pteronyssinus bdng dudng duoi ludi.
Luan vdn Th^c sy Y hpc, Dai hpc Y Ha Npi.
4. Vu Trung Kien, Nguyen Ngpc Chiic (2009), Thi^c trgng mdc hen phi qudn, viim mdi di ung vd mpt sd yeu td liin quan d tre em 11-14 tudi tgi Thdnh pho Thdi Binh, L u ^ vdn Thac s^ Y hpc, Dai hpc Y Thai Binh.
5. Vu Cao Thien (1999), Nghien cim ldm sdng vd mpt sd test trong chdn dodn viim mUi di img. Luan an Thac sy y hpc.
Trudng DHY Ha Npi.
6. Vu Minh Thyc va CS (2009). Nghien cuu diiu chi, tieu chuan hod di nguyen long vU a nhimg ngudi tiep xuc vdi gia cdm trong ngdnh chdn nuoi thu y. De tai nghien ciiu khoa hpc cdp Thdnh pho Hd Ndi, ma sd: OlC-08/06-2007-2.
7. Demoly. P; Bousquet. J (1997), Rhinites allergiques. Le quotidien du medecin.
No6082. Lundi 9 Juin
8. Dreborg-S. (1989), "Skin test used in typel allergy testing position paper/prep.
By the sub-comm-on skin tests of the Europ", Acad, of Allergo and Clin- immuno-Copenhagen-Munlsgrardy Vol 44,N.I0,pp.59-61.
9. Vazquez Nava- F (2000), ''Immunology and immunotherapy for allergic rhinitis*\
