Y HQC VigT NAM THANG 12 - s 6 1/2012 4 . 7 . V e v a n d e kinh t e : Khi gay te bSng
phffdng phap nhd mat tai eho vdi collyre tetrarain 0,5% dffpc san xuat tnang nffdc se giiip tiet kiem chi phi' cho cudc phau thuat, phu hdp vdi dieu ki$n ciia nffdc ta hien nay ma van bao dam an toan cho ngffdi benh.
V. KET LU&N:
- Phffdng phap nhd thuoc te tai cho vdi collyre tetracain 0,5%, trong phau thuat due the thiiy tinh bSng ky thuat nhu tffdng hda d ngffdi trffdng thanh cd hieu qua tot, benh nhan hoan baan khdng cd cam giac dau khi phau thuat dat la 90,8%, dau nhe: 6,8%. Chi ed 2 , 2 % dau trung binh va 0 , 2 % dau nhieu, khSc phuc dffdc bSng nhd bo sung 1 den 2 lan. Khdng od nhffng phcin utig phu anh hiidng den phau thuat Tranh dffdc tai t»en do nhijtig phuOng phap vd cam khac gay ra.
Trong tten hanh gay te tai cho be mSt nhan rau de thffc hien phau thuat phaco, viec giai thfch, hffdng dan benh nhan ve quy trinh phau thuat, tac dung, Idi leh ciia phffdng phap gay te la rat quan trpng. Nhd thuoc 3 lan, moi fan 2 gipt, each nhau 5 phiit trffdc khi phau thuat. Trong khi phau thuat neu benh nhan cd cam giac dau cd the bo sung 1 den 2 lan.
- Nhd te tai cho la m p t trong nhffng phffdng phap vo cam an toan, cd the lffa chpn cho cac t)enh nhan tnidng thanh, cd kha nang hdp tac. Khong cd chong chi djnh sff dung thuoc
nhff; benh nhan mdi bj nhol mau cd tim, dj iing vdi thudc.
TAI U|U THAM KHAO:
1. Dinsmore S C , e t al, "Approaching a 100%
success rate using topical anesthesia with mild intravenous sedation in phacoemulsification procedures", Ophthalmic Surg Lasers, (1996),27, pp:935-938.
2. Gills JP, e t al., "Unpreserved lidocaine to control discomfort during cataract surgery using topical anesthesia", J Cataract Refract Sugery, (1997), 23, pp: 545-550.
3. Gregorgy L. Skuta, Louis B, Cantor, Jayne S.
Weiss, "Evaluation and management of Cataract in Adults", In: Richard A. Zorab, Hal Straus,Lens and Cataract, (2011), pp 100 -108.
4. Joanne Katz, et al, "Injectable versus topical anesthesia for cataract surgery: patient perceptions of pain and side effects", Academy of ophthalmology. Published by Elsevier Science Inc, (2000),Vol 107, No 11, pp: 2054-2060.
5. Jolliffe DM., et al, ""A comparition Of topical anesthesia and retrobulbar block for cataract surgery", (1997), Eye, 11, pp: 858-862 6. Kershner RM., "Topical anesthesia for small
incision self-sealingcataract surgery. A prospective evaluation of the first 100 patients",J. Cataract Refract Surg, (1993),19, PP 290 - 292.
7. Patel BCK, e t al., "A comparision of topical and retrobulbar cataract sugrery". Ophthalmology, (1996), 103, ppl 196-1203.
MAT DO XIATNG VA NONG DO VITAMIN 0 CUA TRE THAP COI TAI THANH PHO CAN THO
Nguyen Minh Phu'dng*, Nguyen Phu Oat**, Ta Thanh Van**
TOM ikv.
Vitamin D ta mot loai hormon cd chffc nSng quan trong, thieu Vitamin D la mot yeu to nguy cd lam Ioang xiiwng vh gay cham tang ffffdng d tre em. Myc tieu:
Danh gia mat dd xi/dng, nong do Vitamin D d tre thap cdi va moi tu'dng quan giiS^ mat dp xu'dng va nong do Vitamin D Ooi t f f d n g : 356 hoc sinh tff 11-16 tuoi tai
cac tru'dng trung hgc cd sd huyen Thdi Lai, TP. Can Thd. Phffdng phSpnghien cffu: Mo ta. Ket qua: Tre thap coi chiem t / le 19,1%, nam - nO' lan Iffdt chiem ty le la 20%, 18,23%. Mat do xuttng (Bone mineral density =BMD) ciia 68 ffe thap coi du'dc so^sanh vdi 107 tre binh thu'dng, tu'dng ddng ve nhdm tuoi va gidi.
Co 17 tru'dng hdp cd giam BMD chiem ty le: 9,71%,
* Tnidng Bai hgc Y Duvc Can Tha, "Tmdng D^i HQC Y Ha NQI Phin bi#n khoa hgc: GS.TSKH U Nam T r i
Y HPC VigT NAM T H A N B 12 - S 6 1/2012 tre thap coi CO mat dp xi/tfng giam chiem 7,35%.
Nong do Vitamin D trung binh d tre nam 1^: 25,378 ± 8,51, 6 tre nff ia:21,032± 6,38 ng/ml (t=3,8247, p=0,0002), thieu Vitamin D (J nam 38,36% thSp hdnnff la 61,64%, ngilijc lai gl^m Vitamin D d nam cao hon nff (an lutjt la: 51,28%, 48,72%. Ty If tri thSp c6l thieu Vitamin D 1^ 31,51%, glim Vitamin D li 46,15%, K@t lu^n: Nong d$ Vitamin D cd tu'dng quan tuy^n tinh m?nh vdl BMD, Theo phudng trinh h6i quy tuy^n tinh dl/ doan giam m^t dQ xu'dng d tr^ i^: BMD (g/cm=)=0.2933921+ 0.0008893 Vitamin D (ng/mL).
ABSTRACT:
BONE MINERAL DENSITY AND VITAMIN D OF STUNTING CHILDREN IN CANTHO CITY
Vitamin D insuf^dency is adversely associated with health outcome: osteoporosis, diabetes meiiltus, asthma...O/'/ectfi'es.' This study sought to assess vitamin D, Bone mineral density (BMD), and relationship bebween BMD and Vitamin D. Study 356 students aged 11-16 years in secondary schools in rural areas of Cantho city. Methods: A cross-sectional study. The results: The stunting prevelence was 19,1%, boys, girls were 20%;18,237o. Bone mireral density of 68 stunting children was compared with of normal and heaithyl07 children with similarities in gender and age.There were 17 cases having decreased bone density accounting for 9,71%, stunting children had low BMD was 7,35%.Vitamin D deficient levels: boys/girls was 38,36% and 61,64%, but insufficient levels: boys/girls was 51,28%, 48,72%.
Vitamin D deficient levels and insufficient levels in stunting group were 31,51%, t6,15%.COncluslon:The total vitamin D was strongly con'elated with bone mineral density, the linear regression for reduced bone density prediction In children Is BMD (g/cm^)=0.2933921+ 0.0008893 Vitamin D (ng/mL).
I. Dl^l V A N oi:
Tlieo To chij'c Y te the gicli (WHO), tren khSp the gidi hang trieu tre em dang b! anh hu'dng bdi cac van de dinh du^ng va cd cac bieu hien kem phat trien ve the chat, ttnh than do bj suy dinh dudng tij' nhd. Tren the gidi hien con 36 nu'dc cd ty le tre suy dinh duBng thap cdl (SDD-TC) cao.
N3m 2010, Vien Dinh duSng Quoc gia cho biet CLT 3 tre CO 1 tre thap cdi dan den h i qua chieu cao thanh nien Viet Nam thap hdn so vdi cac nu'dc trang khu vi/c toe dp tSng tnrdng liic tru'dng thanh udc dat 1,2 cm/thap ky d nam va Icm/thap ky d nO', trong khi d Thai Lan va Trung Quoc la 2 cm, Dong Au va Nhat Ban dat tdi 3cm.
Hien nay chieu cao cua ngu'di Viet Nam d nam tru'dng thanh khoJng 163,7cm va nif 153 cm [5].
VISt Nam 1^ nu'dc nhi$t ddi, nhlSu inh sing mSt trdi nhu'ng thieu canxi vi vitamin D vin duBc quan tSm vi 80,33% trd cdl xu'dng cd canxi miu gISm [l],[4],thieu Vitamin D lim giam m$t dp xUdng v i l i mot ySu to nguy cd mSc cic benh ly m?n t(nh nhu: tiiu du'dng, tim m?ch, ung thu, nhiem trung, hen suySn, va ting nguy cd tif vong [1],[2). Tuy nhien d Viet Nam chuS c6 nghlin cij^i he thong ve tinh tr?ng thieu Vitamin D d tre d^c biit t r i thSp cdl.
M^c tieu: 1. Xic djnh ty t i t r i thap cxii va gii trj mit do xUdng ciJa hpc sinh tal trUdng pho thdng cd sdhuyen Thdi Lai, TP. CSn Thd; 2. Xac djnh ty l i thieu Vitamin D v i moi tUdng quan gi&a mat d0 xUdng vdi nong dp Vitamin D.
11. Odl VjtfNG VA PHUONG PHAP NGHIEN COU:
2.1. Doi tif^ng: hpc sinh tU 11 den 16 tuoi hpc tai cic trung hpc cd sdtai dja bin Huyen ttvt thupc Thinh Pho Cin Thd.
2.2. Cd mau:
Z'|.„,;xpx(l-p) d'
- Tl l i tre suy dinh dudng the thap colli 8,9
%[4], ->N=n6#_^130tri
Chpn mau ngau nhiin theo phutfng phip cum h i thong (PPS), 68 tre thap cdl dUtte so sanh vdi 107 tre dor chijhg trong 356 mau khao sat. Dy^ theo chieu cao, can ning de dinh gii.
2.3. Phu'dng pliip: Nghiin cUu mo l i , thdi gian nghien CLTU: Tir thing04/2012din thing09/2012.
Nhdm thap cdi; cd chi so CC/T < -2 SD (Z- scores) dUdc so sanh vdi tre ciing gidi, ciing liJS tudi, theo tieu chuan W^HO 2007, dUdc sing Ioc bing phin mem Who Anthro Plus.
Nhdm doi ChiTng l i nhdm be binh thudng, khde manh, tUdng dong tuoi v i gidi vdi nhom Chii diu, CO (XIT > - 2SD (Z-scores) theo Ueu chuan WHO 2007.
Xir ly so lliu bing phin mem Stata 10.0 Tre dUdc do ti trpng khoing chat ciia xudng, tai Vj tri xuHng cSng tay liSng phUdng phip DEXA nhan hieu Osteoview Dexa Scanner CE 0318, Benh vien Bai Hpc Y DU^c, TrUdng OHYD Can Thd. Bdn vj tinh BMD g/cm* dinh gii mat do ioang xUdng theo chi so Z - score.
12
Y H(?C VigT NAM THANS 12 • s6 1)2012 i BMD - m BMD
Trpng do, IBMD la mat do xUdng ciia doi tupng i,^mBMD l i mat dp xUdng trung binh ciia
quSn the cd cimg do tuoi vdi doi tUdng, va SD la - dp lech chuan ciia mat do xutJng trung binh ciia Vitamin D < 20ng/mL: gpi l i thieu, tU 21-30:
quan the cd cimg dp tupi vdi doi tutJng. Neu Z- ng/"il- coi la giam, i 30ng/mL: binh thUdng [6].
scores la < -ISD ket luan doi tUdng cd mat dp XUdng thap, binh thudng >- ISD [3].
Ndng do Vitamin D do tai Trung tam Chan doin Y Khoa, TP. Hd Chi Minh (MEDIC), bing miy Centaur XP Siemens, khi nong dp Total
III. KET O u i NGHIEN CCfU:
3.1. Oac diem chung: Ty le tre thap col trong quin t h i nghiin ciTuchiem ty Ip 19,1%; nam, nff lan lUdt chlem ty Ip la 20%, 18,23%, sU khic blit khdng cd y nghTa thong ke vdi p>0,05.
Bi CC/T
s - 2 SD 2SD Tdng
igliP Tudi n 1
(%)
n2
(%)
n
(%)
ian bo tre tha 11 - 1 1 , 9
10 14,71
13 12.15
23 13,14
p col theo nho 1 2 - 1 2 , 9
27 39,71
32 29,91
59 33.71
m tudi 1 3 - 1 3 , 9
12 17,65
34 31,78
46 26,29
1 4 - 1 4 , 9 10 14,71
23 21,50
33 18,86
1 5 - 1 5 , 9 9 13,24
5 4,67
14 8,0
Tdng 68 38,36
107 61.14
176 100,0
X",P
x' =
9,3750 p= 0,052 Tre thap cdi trong nghien ciTu: 68 chiem ty l i 38,86%, nhieu nhat d iii^a tuoi 12-12.9 tuoi chiem ty l i 39,71%, thap nhat d iil^a tuoi 15-15.9 chlem ty l i 13,24%
3.2. Mat do xi/dng
Mat dp XUdng cua t r i thap cdi dUdc so sanh vdi tre binh thudng, tUdng dong ve gidi va nhdm tudi. Tre giim mat dp xUdng khi Z-scores< -ISD cd 17/175chiemty le 9,71%
Nhin Chung mat dp xutJng trung binh d tie b3i cap hdn so vdi tre gii, v i sU khac biet nay cd y nghTa IJiong ke d nhdm tiioi tir 12-12.9 vdi p=0,043,ntidm tir 11-11.9 mat dp xUdng tre gii cao hdn tre trai.
Trong 17 tre cd mat dp xUdng giam, luS tuoi tff 14-14.9 cd 6 trUdng hdp (35,29%), ke den l i lffa tuSi 12-12,9 cd 5 dirdng hdp chiem ty le 29,41%
Bang 2; Uen quan qiija mat dd xffdng va thap cdi
BMD2-1SD BMD<-1SD Tdng
CC/Ts-2SDn1
^4L (92.65)
5 (7,35)
68 (38,86) CC/T>-
Tdngn
m
95 (88,79)
12 (11,21)
107 (61.14) 158
(90,29)
17 (9,71) Y' = 0.70710=0,400
175 (100,0) Ty l i tie thap cdi cd mat dp xffdng giam l i 7,35%, tre binh thffdng cd mat dp xffdng glim la 11,21% sff khac biit khdng cd y nghTa thong k i
3.3. Nong do Vitamin D
Nong ddVitaniin D trung binh chung la: 23,19 ±7,80 ng/mL, d tre nam la: 25,378 ± 8,51 ng/mL, trenii'la:21,032±6,38ng/mL(t=3,8247p=0,0002)
Thieu vitamin D d nam 38,36% thap hdn nff la 61,64%, nguOc lai giam Vitamin D d nam cao hdn nff vdi ty le lan Iffdt la: 51,28%, 48,72% (x" =12,171p=0,002)
Bina 3: Phan bo nSnq do Vitamin D theo CC/T
~ T i S S ^ V i f a m i n D I Thipc6in1(%) I Trt binh thu-drngn 2(%) Giam
Binh thtfdng
23(31,51%) 36(46,15%) 9 (37,50%)
50 (68.49%) 42 (53.85%) 15(62,50%)
Tdngn(%) 73(41.71%) 78(44,57%) 24(13,71%)
Y H(?C VlfeT NAM THANG 12 - S 6 1)2012 COng
Trung binh X^.P
68 (38.86%) 23,92 ± 8,66
107(61.14%) 22.73 ± 7,22
175(100%) x'=3.4266p=0,180
Trong 175 tre nghiin cffu, cd 41,71% tre thieu Vitamin D, 44,57% t r i cd giam Vitamin D va 13,71 % t r i binh thudng c6 nong do Vitamin D a 30 ng/mL. Ty le thiiu v i glim Vitamin D cpng don la 86,28%.
Ty l i t r i thIiu Vitamin D trong nhdm thap cdl li 31,51%, nhdm trd binh thudng l i 68,49%; sir khac biit giffa phan bo nong dp Vitamin D theo CC/T khdng cd y nghTa thong ki.
Banff J ; Phan bo nonq do Nong dp Vitamin D
Thi4u Giim Binh thudnq
COnq x'.P
Vitamin D va BMD BIVID>-1SD
65(89,04%;
72(92,3»%;
21 (27,30%) 158(90.29%)
BMDS-1SD 8(10,96%)
6 (7,69%) 3 (12,50%) 17(9,71)
Tdng 73(41,71%) 78(44,57%) 24(13,71%) 175(100,0%) x'= 0,70490=0,703
Thiiuvi giim Vitamin D g^p ty le kha cao ddi vdl nhdm cd BMD > - ISD lan ludt vdi ty le la 89,04%, 92,31%, sU khac dipt giuS phan bd nong dp Vitamin D d nhdm BMD binh thudng vi BMD giim khdng cd y nghTa thdng ki. Nong dp Vitamin D tUdng quan tuyen tinh manh vdi BMD, phutAig trinh hoi quy tUdng quan dff doin BMD theo Vitamin D nhff sau;
BMD (g/cm^)=0.2933921-^ 0.0008893 VitD(ng/mL)
IV. BAN LUijiN:
4.1. Ty 1^ thaip cdi va mat dp xu'dng Tre thap cdi chiem ty l i 19,1%, nam va nQ' lan lUdt chiem ty le la 20%, 18,23%. Ty l i niy thap hdn so vdi thdng k i Vien Dinh dudng Quoc gia 31,9%, dung thff 20 tren The gidi, Mexico tre tff 6-14 tuoi la 22,3%, d Bic Ninh ty le cdi cpc d thinh phd la 14,2%, d ndng thdn l i 39%. Cao hdn so vdi TP. l^o Chi Minh nghlin ciJu tff 6-17 tuoi i i 14.5% hpc sinh cap 2 la 16.0%. Nghien cffu cua chung tdi tffdng dffdng vdi nghien cilu ii Tiy Nam Nigeria: ty l i chung 19,6%, nam 20,9%, nCr 17,9%; va Pakistan 19% nhdm 11-12 tuoi [4].Vi nghiin cffu niy mdi chi thu'c hien tai dia bin huyen, TP. Can Thd, nen mau chu^ dai dlin c i thanh pho va tinh trang thap cdi cung thap hdn so vdi tren toan quoc. TP. Ho Chi Minh ty i i thap cdi thap hdn cic tinh khic, do dieu kien kinh te xa hdi phit trien hdn cac tinh khic.
Qua kit qui do BMD d 68 tre thap cdi vi 107 t r i binh thffdng khde manh, chung tdi cd iBt qui 17/17S (9,71%) tie cd giim mat dp xffdng.
Ti Ip nay cao hdn Chlebna- Sokol D [8] trong 74 tre khdng benh ly thay cd: 2/74 (2,7%) toang xffdng, 12/74(16,2%) thieu xUHng, 60/74 binh thudng. Mat dp xUdng trung binh d tre trai cao hdn so vdi tre gii,nhdm tir 11-11,9 m|t d5 XUdng t r i gai cao hdn tre trai. Theo Kaman K Manwaiha [5] BMD ciia tre da tiing cao hdn Ire da den (p<0.001, BMD tie trai > t i i gii (p<0.05), BMD d tre trudng thinh (16 tuoi) cap bang hoSc hdn so vdi phu nff tiin man kinh. NC ciia chiing tdi thap hdn Michelle T. Ban-ack [8] nghiin ciili S 93 nff 13-18 tuoi la 11,8% BMD < - 1 SD. BMD trung binh d timg nhdm tudi, theo gidi trong nghiin cirtj ciia chijng tdi cung tutJng ddng vdi tic gii Kaman K Marwaiha nqhien ciTu d tre khde manh 10-18 tuoi d mien Bac An Dp.
Y HQC VigT NAM THANG 12 - S6 1/2012 Mat dp xirong cua tre thap col trong nghien
cuXi du'dc so sanh vdi tre binh thu'dng, tu'dng dong ve gi6i va nhom tuoi. Tre giam mat do xu'dng Ithi Z-scores< -ISD co 17/175chlemty le 9,71%. Nhin chung mat do xu'dng trung binh d tre trai cao hdn so vdi tre gai, va si/ khac biet nay co y nghTa thong ke d nhom tuoi tu" 12-12.9 vdi p=0,043;nh6m tii 11-11.9 mat dp xu'dng tre gai cao hdn tre trai cd the do tuoi day thi tr6 gai sdm hdn tre trai, va Hia tuoi nay chfnh la lira tuoi day thi cua tre gai. Trong 17 tre co mat do xu'dng giam, lii^ tuoi tij" 14-14,9 co 6 tru'dng hdp (35,29%), ke den la lii^ tuoi 12-12,9 co 5 trudng hdp chiem ty I? 29,41%. Mat dp xudng giam d tre thap coi tutfng duWng tre binh ttiuSng, sy" khac bien khdng co y nghTa thong ke. Vi nhdm tre binh tiiudng chung toi chpn tudng dong ve tuoi, gidi, va dieu kien kinh ts, dja ly gan giong nhau, nen khong OT SU* khac biet giij^ 2 nhom nay.
4.2. Nong tf$ Vitamin D Vci tu'dng quan glQci Vitamin D vh mSt dq xu'dng
Nong dpVitamin D trung binh: 23,19 ± 7,80 ng/mL, Nong ddVitamin D trung binh d tre nam la: 25,378 ± 8,51, d tre nu" la:21,032 ± 6,38 ng/mL. Ket qua cung tu'dng du'dng tac gia Nguyen Thj Thanh Hu'dng [1] nghien CUIJ d 558 doi tu'dng 13-83 tuoi. Vitamin D d nam 28,6 ± 8,9 ng/mL, d nff la:24,l ± 8,9 ng/mLThap hdn cac tac gia tac gia Ho Pham Thuc Lan, Nguyen Van Tuan [2] ngliien cuti tuoi tilr 18-47, nam (36,8 ± 10,2 ng/mL), nff (30,1± 5,9 ng/mL).
Nong do Vitamin D trung binhtrong nghien cffu cua Kaman K Marwaiha nghien cffu d tre khoe manh 10-18 tuoi thap hdn nhieu so vdi ket qua CLia chung toi nhdm nho la: 10,3 ± 0,4 ng/mL, d nhom tre Idn la:13^7 ± 0,4 ng/mL, dieu nay cung CO the ly giai: tre An Dp da sam mau thi hap thu Vitamin D cung giam nhff mpt so nghien cffu da bao cao [5].
Co 41,71% tre thieu hut Vitamin D, 44,57%
tre CO giam Vitamin D va 13,71 % tre binh thudng CO nong dp Vitamin D > 30 ng/mL. Ty le tre thieu Vitamin D trong nhom thap col la 31,51%, nhom tre binh thffdng la 68,49%. Thieu Vitamin D khi nong dp Vitamin D< 20 ng/mL: d nam 38,36% thap hdnnff la 61,64%, ngffdc lai giam Vitamin D khi nong dp tff 21-30 ng/mL d nam cao hdn nuVdi ty le lan Iffdt la: 51,28%, 48,72%. Nong do Vitamin D tffdng quan tuyen dnh manh vdi BMD, phffdng trinh hoi quy tudng quan dff doan BMD theo Vitamin D nhff sau:
BMD (g/cm0=0.2933921+ 0.0008893 VitD (ng/mL).
Ty le nghien cffu cua chung toi cao hdn nghien cffu thieu Vitamin D d ngffdi trffdng thanh nam 20%, nff 46% [2], va tffdng dffdng tac gia Nguyen Thi Thanh Hffdng, Ho Phgm Thuc Lan, Nguyen VSn TuSn nff 77,4%, nam 58,3% [1].
Thieu vitamin D gay ra giam mat dp xffdng cdn gpi la benh coi xffdng,nong dp vitamin D thap lien quan mat dp khoang cua xffdng thap.
Nong dp vitamin D thap la mpt yeu to nguy cd doi vdi benh Iao, benh hen suyen, tieu dffdng, tang nguy cd nhiem HIV. Vitamin D la xet nghiem dinh Iffdng chat chuyen hoa 25- hydroxyvitamin (Vitamin D3). Vitamin D co 2 dang: ergocalciferol (vitamin D2) va choiecalciferol (vitamin D3), tuy nhi§n, D2 ft dffdc cac nha lam sang quan tam nhff D3. Mpt so nghien cffu chi ra rSng ergocalciferol (vitamin D2) thi it CO tac dung va thcfi gian tac dung cung ngSn hdn choiecalciferol. Ergocalciferol (vitamin 02) va choiecalciferol (vitamin D3) khong cd sff tffdng dffdng sinh hpc nen khong the thay the cho nhau trong dieu tri. Dffa tren cac nghien cffu dffdc dpng hpc va bang chffng lam sang, choiecalciferol dffdc sff dung nhieu hdn ergocalciferol. Choiecalciferol ton tai trong huyet tffdng lau hdn ergocalciferol. Cac nghien cffu gan day cho thay D3 giup tang hieu qua gap 3 lan ve viec tang va duy tri ham Iffdng vitamin D trong mau, 25-hydroxyvitamin D3 la dang Iffu hanh chu yeu cua Vitamin D trong cd the va la thong so tot nhat the hien tinh trang vitamin thffc sff cua benh nhan [3].
Mac du nghien cffu cua chting toi tien hanh d vung nong thon, tre tiep xuc vdi anh nang nhieu hdn tre thanh thi nhuHg ty 1$ tre thieu, giam Vitamin D van cao, ty le tre thap coi va tre binh thffdng deu giam nong dp vitamin D khong cd sff khac biet co y nghTa, thffc ra cac tre d nong thon cd mffc song sinh hoat nhff nhau, nhu cau va cung cap vitamin Dtff thffc an cung giong nhau, nen khong tim thay sff khac biet giQs 2 nhdm nay.Co the do mau da cua tre dam tff mffc trung binh den mau den va da cang sam mau, sac to cang ft UV-B tham nhap vao nen dan den giam Vitamin D nhff cac nghien cffu g3n day khuyen cao chi djnh bo sung Vitamin D d nhffng nhom tre nay.
Y HOC VigT NAM T H A N G 12 - S6' 1/2012
V. KET L U A N :
- Ty le tre thap col la: 1 9 , 1 % , khong c6 sff khac biet giffa nam vanff.
- Tre giam mat dp xffdng chiem ty l# 9 , 7 1 % . Ty le tre thap c6l cd mat dp xffdng gi^m la 7,35%, tre binh thffdng c6 mat do xffdng giam \h 11,21%.
- Nong dpVitamin D trung binh: 23,19 ±7,80 ng/mL, nong dpVitamin D trung binh d tre nam cao hdn tre nff.
- Nong dp Vitamin D tffdng quan tuy^n tfnh manh vdi m^t dp xffdng, theo phffdng trinh hol quy tffdng quan dff do^n mat dp xffdng theo Vitamin D la:BMD (g/cm^) =0.2933921+
0.0008893 Vitamin D (ng/mL)
TAI LIEU THAM K H A O :
1. Nguyen Thj Thanh Hu'dng (2010), " Tan so v^
yeu \D nguy cd thieu vitamin D d cac tinh phta BSc", Ioang xuifng, gay xu'dng vS Wtamin D, Hpi Loang xuWng TP. HCM, tr 7-8
2. Ho Ph^m Thuc Lan (2010), " Thieu vitamin D trong cpng dong: thi/c trang va yeu to nguy cd", Loang xWdng, gay xu'dng va Vitamin D, Hoi Loang xu'dng TP. HCM, tr 5-7
Nguyl&n Vdn TuSin, Nguy2n Dinh NguySn (2007), LoSng xudng: nguyin nhSn, chin doin, diSu trf v^ phdng ngda. H^i lo3ng xu'dng TP. H5 Chf Minh. Nh^ xuSft bin Y Hpc
B$ Y T£, Vi$n Dinh du^ng (2012), The prevalence of stunting, overweight and (Aesity, and metabolic disease risk in rural South African children", "Chien li/dc Qu6c Gia v3 dinh du3ng 2011-2020 v^ tSm nhin 2030"
Rashmt Aggarwal, Raman K Marwaha (2005),
"Vitamin D and BMD status of health schooldiidtai In northern India". Am J Clin Nutr; 82:477-82 Ashlee McMillan; Jason Hicks; Christopher Isabella; Gerald M Higa (2012), "A Critical Analysis of the (Near) Legendary Status of Vitamin D", Medscape Medical new pediatrics. Expert Rev Endocrinol Metab. 2012;7(1): 103-119 Chlebna-Sokol D, Blaszczyk A (2003), Bone mineralization In children with skeletal system abnormalities in relation to dietary intake of some nutrients
Michelle T. Barrack, Mitchell J. Rauh, Jeanne F. Nichols, (2008) "Prevalence of and Trats Associated With Low BMD Among Female Adolescent Runners", Med Sd Sports Exerc.40( 12): 2015-2021, American College of Sports Medicine
GIA TRj CUA FDG PET/CT TRONG CH^N DOAN UNG THlfPHdl KHONG TE OAO NHO
TOM TAT:
Mgc dich nghien cuir. 1. Xic dinh ty le phu hdp giuS PFT/cr (+) vdi k i t quS giai phau b§nh; 2. x i c dinh t / le di cSn vh moi liin quan glij^ mffc do hap thu FDG vdi kfch thu'dc, v( trf t6n thu'dng d b§nh nhan ung thu phoi khong te bao nho. £>dJ tu^ng nghien cdU:
82 benh nhan co chan doin u phoi, dupc chup PET/CT tai Tmng tam Y hpc h?t nhan vh Ung bUdu Benh vi|n Badi Mai, c^ doi c^ieu vdi ket q u i giai phau benh.
Phudng phip nghlin cdU: hoi cffu va tien cffu. Kit qua: 1. Ty le phi hdp giuci PET/CT dffdng tinh (+) va giai phau benh l i ung thff phoi khong \£ bao nho la 94,7%. Dp nhay 94,7%. Op d|c hi?u 57,1%. Ty l | du'dng tinli gia la 3,6%. Ty I? am tfnh gia la 4,8%.2.
Chyp PET/CT toan thin giup phat hi?n dudc cac ton thudng di can, nhiiu nhat vao hgch tnjng that (60%), hach thu'dng don (20%) xffdng (26,7%), nao (18,7%),
Mai Trpng Khoa*
di cSn phoi, gan, tuyfn thddng th§n vdi t / 1 ^ thSp hdn.
3. Ton ttiudng u nguyin phit v i cic tSn thudng di (in deu c6 dp hap thu FDG cao, g i i trj SUV trung binh cua u nguyin phit l i 7,91; ciia cic l^n thUdng dl cin h^ch trung that l i 5,96; di dkn nao la 13,72, di cSn xOdng la 9,21.4. Co moi tudng quan ty i§ thu|n giffa kfch thudc tSn thudng v i mffc d§ hSp thu FDG (qua gii tri SUV) vdi p<0,05. Ton tiiudng co kfch thudc cing Wn thi mffc dp hSp thu FDG cing cao: nhdm u nguySn phitSUV trung binh cua nhom kfch tiiudc l-2cm l i 4,35; nhdm 2-4cm la 6,53 v i nhdm >4cm-8cm la 10,27; nhom hgch dl c3n SUV bung binh oia nhom kfch tiiudc 0,5-lcm la 4,75; nhdm l-2cm l i 5,72;
nhdm 2-3cm la 7,84; nhdm >3cm )i 7,92; nhom t&i thudng di c^n phoi SUV tmng binh ci^a nh6m kich thu'dc <lcm la 1,78; nhdm >l-2cm l i 4,35. 5. Chyp PET/CT lim tiiay dol giai doan benh d 32% b^nh nhSn, giup thay dSl hudng diiu til Qixnq.Kii lu$n: Oiyp
* Trung tSm Y hQC hat nhSn & Ung budu, B$nh vi$n B^ch ^ Phan bi^n khoa hpc: GS.TSKH Phan Sy An 16
