Y HOC VIET NAM THAHG 6 - SO 1/2014 V.KETLUAN
Ty le nhiem virus viem gan B cua can bo vien chu'c den kham SLTC khde tai Benh vien Oai hpc Y Ha Npi la 8 % . Ty ie nhiem virus viem gan B d nam cao hdn cd y nghia so vdi^d nU (59,3%^so vdi 40,7%, p<0,05). Nhdm tuoi cd t / ie nhiern virus viem gan B hay gap tii 18 den 39 tudi, (tir 18-29 tudi ia 38,8% va tir 30-39 tuoi la 41,3%).
Enzym gan tang (ca AST va ALT) d nhdm cd HBsAg du'dng tinh cao hdn nhdm cd HBsAg am tfnh (AST tang d hai nhdm HBsAg du'dng tinh va am tmh la 16,3% so vdi 7%, p<0,001) (ALT tang d hai nhdm HBsAg du'dng tinh va am tfnh la 15,7% so vdi 14,3, p<0,001). Nhdm HBsAg du'dng tinh cd thay ddi ve cau true cua gan tren sieu am nhieu hdn nhdm HBsAg a m tinh ( 2 % so vdi 0 , 1 % , p<0,001).
T A I L I | U T H A M KHAO
1. Hipgrave, D. B., Van, N. T., Huong, V. M., Long, H. T., Dat, D, T., Trung, T. N., Jolley, D., Maynard, 3. E. & Biggs, B.-A. (2003).
Hepatitis B Infection in rural Vietnam and the implications for a national program of infant
immunisation. Am J Trop Med Hyg, 69, 288-94.
2. Jee, S. H., Ohrr, H., Sull, 3. W. & Saitiet, 3. M (2004). Cigarette smoking alcohol dhnkini hepatitis B, and risk for hepatocellular carcinon^
In Korea. J Natl Cancer Inst, 96, 1851-56.
J . Lee, D. H., Kim, 3. H., Nam, 3. 3., Kim, H. R. &
Shin,'H. R. (2002). Epidemiological findings of, hepatitis B infection based on 1998 National' Heaith and Nutrition Survey in Korea. J Korean Med SCI, 17, 457-62.
4. Milich D, L.T.,(2003). Exploring the biological basis of hepatitis B e antigen in hepatitis B virus Infection. Hepatology. 38: p. 1075-1086.^
5. Trinh Thi Ngoc ( 2 0 0 1 ) . Tinh trang nhiem cacvi rut viem gan: A, B,C, D, E d cac benh nhan viem gan vi rut tai mpt sd tinh phfa Bac Viet Nam, LuSn an tien sy y hgc.
6. Pichainarong, N., Chaveepojnkan^orn, W,, Luksamijarulkul, P., Sujirarat, D, ft Keereecamsuk, T. ( 2 0 0 3 ) . Hepatitis 8 carrier among married Hilltribe women in Northern Thailand. Southeast Asian J Trop Med PulDlic Health, 34,114-19.
7. Van T.T.Nguyen (2012). Hepatitis B in%:tion in Vietnam: Cun-ent Issues and Future Challenges.
Asia-Pacific Joumal of Public Health, 24(2) 361- 37
MOT SO DAC DIEM LAM SANG VA DICH TE HOC COA B 6 N H MAY DAY MAN TINH DIEU TRI TAI BENH VJEN 103
J6M TAT
Nghien cCiU 135 benh nhan Ban may day man ti'nh den khdm va dieu h i tai Benh vien 103 tir thang 8/2012 den thang 7/2013, ket qua cho thay; Ti le % b^nh nh3n m&y day man tfnh trong dp tudi tir 20-49 la 66,6%. Ti le benh d nam va nij* bSng nhau. Sd benh nhan cd tiBn sOf dj litig chiem 94,1%. Benh may day man ti'nh cd the xuat hien quanh nam. Benh gSp nhieu nhat vao mua he (37%). Oa so tru'dng iidp mic benh trong vdng 1 n3m chiem 69,6%. So tru'dng hdp mSc tren 5 nSm la 11,1%. Mu'c dp benh nling chiem ti le 65,9%, mu'c dp viia chiem 31,9% va mu'c dp nhe la 2,2%. Cd 14 yeu to thuan ldi cho viec xuat hien benh, trong do yeu td thdi tiet chiem ti le cao nhat 60,7%.
Cd 34,8% tru'dng hdp khong tim thay yeu to lien quan.
TO'khoa: Benh da tieu, Benh may day man tinh.
* B$nh vi$n Da lieu Thanh Hoa
** HQC w$n Quan y
Phan bipn khoa hgc: PGS.TS Tran Dang Quyet
Hoang Van M^nh'^, Pham Hoang Kham**
SUIVIMARY
SOME C L I N I C A L A N D EPIDEMIOLOGICAL CHARACTERISTICS W I T H CHRONIC
U R T I C A R I A WERE TREATED I N 1 0 3 HOSPITAL
Study of 135 patients with chronic urticaria wtio were examined and treated in 103 Hospital, from August, 2012 to July, 2013, the results showed tiiat;
The percentage of the patients with chronic urticaria from 20-49 years old was 66.6%. The rate of males and females was equal. Personal allergic history was;
94.1%, Chronic urticaria occur all year round. Titt percentage of the patients with chronic urticaria in tiie summer was the highest (37%). Most of the patients suffer from Chronic urticaria within a year (69,6%).
The rate of patients who were ill over 5 years was 11,1%. The level of severity disease was 65,9%, moderate: 31,9% and lighter was 2.2%. There were 14 favorable factors to occurrence of the disease.
Y H9C VIET NAM THANG 6 • SO 1/2014 The percentage of the dimatic factor was the
highest: 60.7%. There were 34.8% cases no find relevant factors.
Keywords: ^n diseases. Chronic Urticaria.
I.CATVANDE
May day (Urticaria) la mpt benh da thirdng gap vdi ty le 15 - 20% dan so da tljtig b| cac bieu hien cua benh may day trong cuoc ddi [1]. 03 khoang 80% tru'dng hdp la may day tu" phat, 10% CO nguyen nhan va 10% tru'dng hdp la cac dang dSc bl?t [4]. May day man tinh la si/ tai diln Hen tuc ho$c hau nhu hang ngay cua cac san phil trin da, keo dai tren 6 tuan [7]. Co khoang 50% tru'dng hiJp co kem theo phu mach [3]. Oieu trj benh may day man ti'nh kha phu'c tap ml ty le tai phat van cao [5]. Do do, chan doan sdm b$nh va vile tim ra, Ioai bo can nguyen gay benh co y nghia rat quan trong trong dieu tr! cung nhu' phdng tai phat b|nh [7]. Vi v^y d€ g6p ph^n hieu ro hdn d3c diem lam sang, djch t l hpc b^nh miy day va lam giam ty II cua bpnh, chiing t i l tien hanh nghien cu'u dS tai nliSm mgc tieu: Khio sit d0c diim lim sing
III. K I T Q U A N G H I E N CO'U
Bing 1; Dl|n tich san phu (n= 135) SS lu'dng san
<10sanphiinh6 ^ 10-56 sSn phil nhd hoSc < 10 san phti Idn
>56 sSn phu~nh6 iio$c 10 - 50 sin phil Idn H3u nhu' toin b§ cd the
vi dich te hgc ciia binh miy day man tinh tai Binh vien 103.
II. B 6 | T U O N S V A PHLTCrNG PHAP NGHIEN CUU 2.1. Doi tiftfng nghien cutj: 135 benh nhan diTdc chan doan xac dinh la benh may day man tinh dieu trj tai Vien 103 tir thang 8/2012 den thang 7/2013.
Tieu chuan chan doan: Thu'dng cd ngu^ d ndi sap su^ xuat hien ton thu'Png. Ton thu'dng cd ban: san phii mau hong tu'di hay hong nhat, rai rac hoac tap trung thanh dam, San phti xuat hlln nhanh, mat di nhanh va khong de Ial dau vet.
Thdi gian moi san phti xuat hien cho den khi mat
<24h. Benh tien trien timg ddt hoac liln tiep keo dai >6 tuan den hang nam hoac tai phat theo miia [2].
2.2. Phu'dng phap nghiin cihi: Nghiin CLTU tien cu'u, mo ta cat ngang.
CS mau: Thuan Ipi. Tat ca cic b|nh nhan du'dc chan doan xac dinh la benh miy day man tinh dieu trj tai Benh viln quan y 103 tif thing 8/2012 den thing 7/2013.
2.3. Xir ly so lieu: Theo phu'dng phap thdng ke y hpc phan mem EPI-INFO 6.04.
So lu'gng 3
52 69 "
, Cpng 135 _ T'y li diin b'ch san phu xuat hiin hau nhi/toin bo cd the chiem: 51,1%.
100,0
Bing2:Wiciq ciia ngua (n= 135) Mu'c ag ngu'a
Khong Nhp Nhieu
Via
Cpng
SS lu'dng 17
Binh nhin ngda mit do ning chiem ty le cao nhii la 59,3%.
Ty 16 %
284_
_59,3_ _ 100,0
Y Hpc VI|T NAM THANG 6 - SO 1/2017
BleuddLHiicdp benh (n= 135)
Mit do binh ning chiem 65,9%, vui 31,9% vi nhe li 2,2% phu hdp vdi Hoing Hitu Hao (2007):
77% mic do binh ning, 23% bvng binh [6].
Bing3;lt\eu chutig toin than (n= 135)
Trieu chu'ng toan thanSot Khd thd Dau bung Oau khdp
n
1 _ ' l 5
11
OJ
3,7
Triiu chihg khd thd: 11,1%, dau bung: 8,1%), dau dau chi chiem: 0,7%. Kit qui niy tidng dudng vdi nghiin cii cua Dang Tiin Huyen Thudng (2009) kho thd chiem 8,3%, dau bung chiem 8,3%, dau khdp 2,8%[5].
Bleu do 2. Ty II phan bd benh theo nhdm tuoi v l gidi tinh (n= 135).
25.4%
23.6% 23.8% IND
19 40/, 20.6% 20.8%
9.7%
3.2%
H '^•*^° ^ 15.9%
1 1 1 13.9%
Ty li phin bo binh theo nhdm tuoi khong co si chinh lich glOa nam vini. Binh gip d nhom tuS 20- 49 chiem ty 1$ cao nhat Si khic biet khdng cd y nghia thdng ke giia dc nhdm tu$.
BiSu do 3. Phan bo thdi gian mac benh theo gidl tinh (n= 135).
49.2% ' * ^ - ^ \ 4 %
Wm 19.5% • ° 19 Q„/^ i9,4o/„ ^^ ^^^
* • ^ ^ m ' "'•'°''°
<fi* 6-12th >, c„
^'"^" >5n
• Nam
"••HUBa so benh nhin mic binh trong vong 1 nam (chiem 69,6%), trong dd mdi mac binh <6 thing
chiem 48,1%, d^c biit co tdi 11,1% mic benh tren 5 nam. Thdi gian mac binh tudng dMng gliU
nam vi nu'(p>0,05).
Y HQC VIET NAM THANG 6 - s 6 V20U
Bie'u d S 4. Phan bo theo mua mac benh trong nSm (n= 135).
Dong: 22,2 % ^ m^^^' ^^'^ "/"•
Thu: 10,4% ^ ^ ^ B ^ LHa:38%
Benh may day xuat hien tat ca cac mua trong nam dieo ty le khac nhau. Benh xuat hien it nhat vao mua thu (10,4%). Benh xuat hien cao nhai la mua ha (37%) cao hcfn mua thu (10,4%) vdi p< 0,05.
Benh xuat hien vao mua xuan (30,4%) va mua dong chiem tyle (10,4%) Bieu ^ . 5-_Phan bpthra nghe^nghiep (nf_135).
B a n g 3 . 5 . P h a n b o b i
y"OlBnh chmh ftv do nyi ITV
ter ^^
\^6m mgng J S m h
nh theo
/ -
n g h e n g h i e p
| H H .u&rli
^ ^ B JX eufn nsirln \
^ ^ V p.Ut.) nUM u^iiin r H T i inut) rIfiBfl lOut fi:
^ j finsd touJ Qz nerin r '-.n pb DlJrn i usy UHD
Se/7/j ;7/?i/7 M r ^ e o /T^Ae nghiep: Cong nhan chiem tjf^ lAt?*/t&i«•'4&/jfe^l3fe^ r^itSir^iiiSfsi kli4b':iy te benh: Hanh chinh, sinh vien (14%). HuU tri (13%f)i^Am^3^lC^>Si)i^^upii im^^^wsiW^
ngi trd (7%). ^ _^
Bang4.T^n suTdj uTig ban than (rif^ 135) Tien siy ban than
^iem ket mac dj u'ng _yiem mui di Lfng
Co di Has a
' J 3 finsd GutiD jJ Y 6a to o5 iprr (uH-nsiriT SuflT 6V
I KHSnig
Hen phe quan
10 7,43,7
/^.mMi
Viem da Atopy pi ii'ng thuoc
^^SP di irng
^6ng sue vat
iiruil'l ii'j;ij;q7^"Thu'c an: tom, cua.- Hoa chat: sOn, my pham...
Ph^a,"hQ9„
rlT .pnegn 3ED SJ i f f f l i f i f i f e pnbUriq .nOS TJ3Tt-7IT'=1—T rtngd nsv pnoiiq q s l q priburlq pnsdTangnoil;
f>ln fln6id 51 yT :sup JaX
K& tdfthcH tiet chiem ty le cao nhat: 42,2%, viem mui dj ifif^,^ t^^^:-'&e^79S^
m^
8,9
Wr
Y HOC VIET NAM THANG 6 - SO 1/2014 t lang 5. Yeu to thuan Idi xuat hien benh may
Cac yeu to thuan \d\
Khong Co
Khi thay doi thdi tiet Khi ap da lanh An tom cua Khi bi nong Tiep xuc bui nha Uong bia ru'du Con trung dot Cac nquyen nhan khac Khonq co nquyen nhan
day (n= 135) n 47 88 82 24 40 19 12 13 10 36 45
o/o 38,4 61,6 60,7 17,8 29,6 14,1 8,9 9,6 7,4 26,6 34,8
Tmng so co yeu to Hen quan thi yeu to thay dol thdi tiet co ty le cao nhat (60,7%). khong thay yeu ft lien quan chiem 38,4%.
IV. KET LUAN
Qua nghien culi 135 benh nhan may day man tinh den kham va dieu trj tai Benh vien Quan y 103. Chung toi rut ra mot so ket luan ve dac diem lam sang, yeu to lien quan benh may day man tinh nhu" sau:
- Benh hay gap nhat d tuoi lao dong, trong do tuoi ttr 20 - 49 chiem 6 6 . 6 % . Ty le benh gSp d ca hai gicfi b^ng nhau. Tien sCr ban than co 9 4 , 1 % benh nhan mac cac benh dj ling. Benh xuat hien quanh nam, tuy nhien miia xuan - ha zb so benh nhan mac benh nhieu hcfn ( 3 0 , 4 % va 3 7 % ) . Da so benh nhan co tuoi benh dirdi 1 nam: 6 9 , 6 % , CO 1 1 , 1 % benh nhan co tuoi benh tren 5 nam.
I^LTC do benh chu yeu d mii'c do nang chiem 65,9%, vi/S 31,9% va nhe 2 , 2 % .
- Co 14 yeu to thuan ldi lam khdi phat benh may day man tinh. Trong do, thay doi thdi tiet chiem ty le cao nhat: 6 0 , 7 % va co tdi 3 4 , 8 % khong tim ra yeu to lien quan.
TAI L l | U T H A M K H A O
1 . Nguyen Nang An (2003), "May day va phu Quincke", Bach khoa thu" vien hpc tap 3, Nha xuat ban tiy dien bach khoa Ha Ngi, trang 266-269. "
2. Bo mdn da lieu Tru'dng d^j hpc y Ha Noi (1994), "May day va phu mach", Benh da lieii, Nha xuat ban y hgc, trang 81-85.
3. Bo mon Da U e u Hpc vien Quan y (2001), "May day va phu mach", Giao trinh benh da va hoa iieu dao tao sau dai hoc, Nha xuat ban quan doi niian dan, trang 225-229.
4. Bo m d n Dj u'ng-Tru'dng dai hoc y Ha N ^ (2008), "^May day va phu Quincke ", Bai giang "
liYig - mien djch lam sang ( Sach danh cho bac va hpc vien sau dai hoc), Nha xuat ban y ' trang: 55-70.
5. Dang Tran Huyen Thu'dng (2009), Nghien ciili tinh hinh, dac diem lam sang va anh hu'dng oJa benh may day man tmh den chat lu'dng cuoc song cua ngu'di benh, Luan van thac syy hoc, trangl?
6. Hoang Hffu Hao(2007)," Nghien diw tac dung cua que chi thang gia v| trong dieu trj may day ifi utig man ti'nh do bui nha', Luan an tien sT y hp^
Oai hgc y Ha Noi.
/ . Asero R..,ribbldi P,.et al (2007), " Chronic urticaria" A diseasea at a reviews 7, pp 71-76.
DANH GIA CHAT LITCTNG KHAM CHU'A BENH C O A B A C SI GIA DINH
a Y TE TUYEN C a SO* TAI DAC LAC v A THCTA THIEN - HUE N A M 2 0 1 1Nguyen Phu-ong Hoa*, Nguyen Thi Tuyet Nhung*
Danh gia chat lu'dng kham chu'a benh aia bac sT g | dinh tCr phfa benh nhan, d mgt so cd sd y te tuySn)§
va huyen tai t'nh Dac Lic va Thifa Thien-Hue, ^m 2011. Phu'dng phap: mo ta cat ngang. Thu tfiSp thong tin bang phu'dng phap phong van benh nhSn.
Ket qua: Ty le benh nhan dUdc BSGD giai thich ti mi T O M TAT
Hien nay, hoat dgng cua mang lu'di y te cd sd dang gap nhieu kho khan va thach thu'c. Muc Beu;
* Tnfdng Dai hqc YHa Noi
Phan bien khoa hgc: PGS.TS Pham Thj Lan
