Y Hpc VI$T NAM THANG 6 • sd 1/2011
combined Phacomuftsication and Victrectomy patients with diabetic vitreous hemonhage, J.Korean ophthalmol 41 (11), pp. 2375-2380.
Michels R.G. (1981), "Vitre.ous surgery", The CV mosby company ST Louis. Toronto.
London, 8-58, 59-97, 135-205, 207.
Ryan S.J., Allen A.W. (1979), "Pars plana vitrectomy in ocular trauma", Am.J.
Ophthalmol.. SB, 483-491.
Shen X., Xu G.Z. (2008), "Vitrectomy in vitreo- retinal complications associated with", Intennediate uveitis. Zhonghua Yan KezaZhi, 44{1): 25-29.
DANH GIA DO DAY LClP SffI T H A N KINH QUANH GAI THj TREN MAT TRE EM CO TAT KHUC XA
Vu Thi Bich T h u y * MTAT
Muc ti@u: d^nh gia (To day Idp sdi than kinh ig mac (RNFL) 6 mSt tre c6 tgt khuc xa (TKX), Doi (ng va phuUng phap: 181 BN la tre em ^ 3 tuoi TKX den kham tai BV M§t TW nam 2008. Nghien I mo la cSt ngang. Do khuc xa, true nhan cau va dp ' RNFL. Kit qua va ban lu^n: do day RNFL giam I theo ttiuf tu" tiJf tren, du'dl, mui va thai du'dng. Bp ' RNFL tmng binh d nhom can thj la 99,65pm, im vien thj 112,59|jm. 06 day RNFL co lien quan an chieu vdi TKX va ngu'dc chieu vdi true nhan cau.
t luan: dp day RNFL tmng binh mat can thi 99,65 va vien thi la 112,59 pm. E>p day RNFL giam <^n 0 thu' t l / tif tren, du'dl, mui va thai du'dng. 06 day
=L CO moi tu'dng quan vdi TKX va true nhan cau.
TuT Idioa: Idp sdi than kinh.
MMARY
To evaluate the thickness of retinal nerve ribres layer in children with refractive error 1 Purpose: to evaluate the thickness of retinal f/e fribres layer (RNFL) in children with refractive pr. Objective and Methods: 181 children ^ 3 Irs old with refractive error had examnined in VNIO
2008. Desaibed cross-section study. Measure Active error, axialength and thickness of RNFL.
^ults: thickness of RNFL decrease from upper, [sr, nasal and temperal. Average thickness of RNFL
myopia group is 99,65Mm and hyperopia is 59pm. RNFL has relationship together with jctive emir and opposite direction with axialength.
'elusion: average thickness of RNFL in myopia ' p is 99,65Mm and hyperopia is 112,59pm.
I*<ness of RNFL decrease from upper, under, nasal temporal. RNFL has relationship with refractive enor l^alength. Keyword: retinal nerve f bres layer.
inh vien i^at Trung udng
>J>r biSn khoa hoc: PGS.TS. Dd Nhu Hdn
I.
OAT V&N OETat khuc xa (TKX) la mot trong nhihig nguyen nhan hang dau gay giam thi It/c d tre em. Tai BV Mat TW, nam 1999 da co 34.i340 lu'dt ngu'di den kham vi tat khuc xa (chiem 30% tong so lu'cJt ngu'di den kham), trong do 70% la tre em va hoc sinh [ T D T l ] . Tinh trang khuc xa ciia mat la do sir phoi hdp cua ba yeu Ixf giai phau dp dai true nhan cau, cong suat hpi tu va chi so khuc xa ciia quang he mat. Ngay nay, ciing vcfi su" phat trien cua khoa hpc ky thuat ngoai chieu dai true nhan cau, dp day giac mac, do sau tien phong chung ta co the xac dinh chinh xac do day Idp sdi than kinh vong mac, kich thu'dc gai thj ...
Theo ket qua nghien cuXi cOa nhieu tac gia tren the gidi, mat co TKX cd su* thay ddi ve chi so sinh hoc nhu" Idp sdi than kinh, true nhan cau. Tuy nhien viec danh gia dp day Idp sdi than kinh (RNFL) d mSt CO TKX dac biet d tre em se ho t r d cho viec chan doan, phan biet va tien lu'dng dieu trj. Vt vay chung toi tien hanh nghien ciTu de tai vdi muc tieu: Khao sat do day RNFL d mat tre em cd TKX va tim hieu mot sd yeu to lien quan.
II. Odl TUilfNG VA PHaONG P M A P NGHIEN COU 2 . 1 . D63 tu'dng nghien cuU: 181 BN la tre em tir 3 den 15 tuoi va 00 TKX den kham tai BV Mat TW til" thang 01 nSm 2008 den thang 09 nam 2008.
Tieu chuih loai trUt: cd benh khac tai mat hoac toan than khong phoi hdp de kham.
Cd mSu nghien ciii/: Ap dung cong thu'c ti'nh c3 mau toi thieu la 323 mat
2.2. Phu'dng phap nghidn cCfu mo ta cat ngang. Do khuc xa khach quan bSng soi bong
Y HQC VlgT NAM THANG 6 • S6 1/2011
dong til sau Het dSu tiet. Do chlBu dai tru'dc sau true nhan cau bSng may IOL Master. Chgp cSt Idp vong mac: phan tich dp day RNFL quanh dia thj vdi du'dng lu'nh vong quel 2,27 x di/dng l<Inh dTa thj. Danh gia do day trung binh vh d cAc gdc tren, du'dl, mui va thii du'dng...
III. KET QuA N G H I E N C O U
3.1. C$c di^m cua nh6m BN nghlSn cihi oac diem BN: nhdm nghign ciru cd 91 BN (50,3%) va 90 BN nam (49,7%), stT khac bi$t nay ithong co y nghla thong k&.
Khi phSn tich theo ba nhdm tuoi <7, tir 11 va S12 tuSi chiing tni thay ty le viin thj giar tuHng img vdi cac nhom tuoi ia 48,2%; 28,0 23,8%, ngu'dc lai ty le can thj tang dan 1!
34,2% vk 50,3%. Nhan xet nay ciia chtJng tni phu h(Jp vdi tac gia Karta Zadnii< va cong ! nghiSn ciru tren 2583 tre tir 6 den 14 tuoi [3].
•flnh hinh TKX; ket qua nghien cijl thSy cd 193 mSt can thj (54%) va 164 mSl thi (46%) trong do nhom cd TKX < 3D chii igcao nhat 79/357 BN (22,1%), nhom c khiic xa tir 3- 6 ia 93 mSt (26,1%) va it nl nhdm cd TKX a 9D la 41 mSt (11,5%).
3.2. Sanh gii I6p s^i thSn kinh
3.2,1. Tinh tr^ng Idp stfl thSn kinh quanh dia th/glic Bang 1. Tinh tranq do day RNFL
Vitri
_ _ _ _ R N F L ( i i m ) Ti^n Dirdi MQi Thdi dt/tfng Trung binh
Trung binh 129,86
126,75 78,16 80,18 103,86
0 $ l^ch chuan 22.0 22,5 19,22 15,89 13.66
ThSp nhat 53 20 26 37 34,22
Caonh3 179 189 156 149 142,51
Qua chup cat Idp vong mac danh gia dp day RNFL chung toi thay do day RNFL theo thif h/
dan tOr phi'a tren, du'dl, mui va thai du'dng, SLT khac biet nay cd y nghTa thong ke (p<0,05). Do chi nghien ciilj nao trong nu'dc ve RNFL nen chung toi so sanh vdi dp day RNFL trong nghien cutJ (U pm) thay khong cd su" khac biet vdi Huynh Sdn khi do d ngudi nu'dc ngoai binh thudng (110 pm Sif phii hdp nay con the hien khi chung toi phan tich dp day RNFL theo gdc phan tu*
Bang 2:^
Tac qia Choi [5]
day RNFL (|jm) theo cac qdc phan
Trung binh6,85±1,32 V.T.B.Thuy 4,82±3,49
Tren 125,7±15,29
123,3±21,3 dl
Du'iSi 117,9±14,1 119,4±19,9
Mui 60,3±12,01
72,1±16,7
T h i i du'On 86,1±17/
74,2±11,
KS qua do day RNFL aja chiing toi dTO thay RNFLd phia tran va duidl cao hdn phia thai duHng va mui. Kg qua nay hoan toan phii hijp vdi Choi va cac tac gia khac khi nghi&i cuti dp day RNFL b^n mSt be em cd TKX va mSt be em binh thuftng [5]. Oieu njy cung phii hdp vdi SI/ phan bo sinh iy giai phau binh thu'dng oJa idp sdi TX quanh gal.
3,ZZ MS lien quan giO^ df diy RNfl vdi mptsoyeuti
Do day RNFL trung binh d nhdm can thj ia 99,65 ± 12,12 (im va nhom vien thj ia 112,59 ± 12,B7|jm, SI/ khac biet nay cd y nghTa thong ke vdi p<0,001. Dp day RNFL trung binh theo cac gdc tren, du'dl, mui, thai du'dng glii^ nhdm mat
can thi va vien thj ciing cd si/ khac biet nhai nghla thong ke (p < 0,001).
Rieng trong nhdm mSt can thj: dp day cd su* khac biet giij^ cac mut dp can thi nhau nhuiig si/ khac bigt chi co y nghTa thoi giiici nhdm < 3D va nhdm >6D (p < 0,01 day RNFL gliici hai nhom vien thj < 6,0
>6,0D khong co si/ khac biet (p>0,05).
Op day RNa oJa mSt ndi chung va d d ptan ta/cd lien quan dai the k»i va mut:dpT1<
r = 0,51). 06 day RNFL cao nhat d nhdm »i nSng va thap d nhdm can thj nSng. KS qua na hdp vdi Choi va Huynh Son , t ^ gia nay nghH tren 1765 be od tuSi trung binh la 6,7.
3.2.3. Lien quan dp ddy RNFL va trgc ddl truVt sau nhSn cSu
Chiing toi cung tim thay mSi tu'dng quan tuyen tinh nguUc chieu ciia dp day RNFU vdi do di
tru'dc sau cua nhan rau. ' "s
Y Hgc VI^T NAM THANG 6 - SO 1/2011
T n f c nil On c&u <nun)
Biiu Oo /Tu'dng quan giiJa dp day RNFL va true nhan a u
Bieu do tren cho thay true nhan c3u cang gan thi dp day RNFL cang tSng va ngu'dc lat.
ol tu'dng quan tuyen tinh ngu'dc chieu nay cd 9 jhTa thong ke vdi p < 0,001 va r = - 0,67.
K i t qua nay cung phu hdp vdi nghl§n ciili ja Huynh son va Bayraktar [ 2 ] , tuy nhien he so Wng quan ciia Bayraktar tim du'dc thap hdn lap hdn (r = -0,21). S y khac biet cd the do doi rdng nghien cuTj khac nhau, phu'dng phap do uc dai tru'dc sau nhan cSu khac nhau, Bayraktar jng sieu am A con chiing toi diing IOL (faster.
^dz te true nhan rau do bang sieu am A cho ket ja ngan hdn so vdi dung lOLr^aster [ 6 ] .
. KET LUAN
Dp day RNFL trung binh d nhom mat can thj 99,65pm va vien thi la 112,59Mm. Dp day '^FL giam dan tir tren, du'dl, mui va thai du'dng.
3 day RNFL cd moi tu'dng quan tuyen tinh uan chieu vdi mu'c dp TKX va ngu'dc chieu vdi jc dai tn/dc sau ciia nhan cau.
l A l UEU T H A M K H A O
1. Nguyen Vdn Lien (1998), "O^nh gii ttnh hinh c?n thi trong hpc sinh d tinh Nam Dinh n3m hoc 1997 -1998", Luan vSn thac sy y hoc - Tru'dng Dai hoc Y Ha Npi.
2 Bayraktar et al. (2001), "Influence of scan radius correction for ocular magnification and relationship between scan radius with retinal nerve fiber layer thickness measured by OCT", J Glaucoma, vol 10, PP 163 -169.
3 Karia Zadnik et al. (2003), "Ocular component data in schooktilMren as a function of age and gender".
Optometry and Vision Sdence, vol 80(3), PP 226 - 236.
4. Son C. Huynh et al. (2006), "Peripapillary retina! nerve fiber layer thickness in a population of 6 year old children". The American Academy of Ophthalmology, vol 113, PP 1583 -1592.
5. Sung-Won Choi et al. (2006), 'Thickness changes in the fovea and peripapillary retinal nerve fiber layer depend on the degree of myopia", Korean Journal of Ophthalmology, vol 20(4), PP 215 - 219.
6. Tung M Quoc ( 2 0 0 3 ) , "Protocol for IOL Master", Sydney Myopia Study.
D A N H GIA KHA N A N G PHAT H I E N TROt TIEP GEN DOC TO
( CUA BACILLUS CEBEUSJmm MOT SO THUD PHAM CO NGUdN GOC TUTGAO BANG KY THUAT MULTIPLEX PCR
I r a n Huy Hoang^/ NguySn Thj Anh Tuyet^, Pham Nguyet M i n h ^ Le Huy H o a n g ^ Nguyen Kien D y ^ Nguyen Thj H a \ T r a n V a n K h a n h ^ va Ta Thanh Van^
'MTAT
Ngd dpc thu'c pham gay tieu chay bdi Bacillus HIS (B. cereus) Ici do tac dpng cua ba lo^i dpc ^
nj$t bao gom d^c to ly giai hong cau (Hbl), khong ly glal hong cau (Nhe) va dpc to rupt (BceT) g3y ra.
Nghien ciili nay nhSm daiih gia kha nang phat hien hyt dep cac gen dgc ^ gay deu chay aia B. txreus trudng Dai hgc Y Ha Noi, ^ Wen V$ mh Dich te Trung udng,
•n Dinh Du'dng Qudc Gia, ^ Trung tarn Y te Huyen Me Llnh, Ha Ngi
h biin khoa hoe: PGS.TS. Nauuen Thi Hd 25
