^ ^ / '
V i m i A M MEPICAI. JOUPIIti M l • P E Q E I I B F R - gum frong loai hinh di iing We ttii, khang the IgE iuu
hanh being huyet ttianh ed val frd het siit quan ti;ong va ed b'nh chat quyet djnh, frnng khi loai hinh dj ling cham 06 vai trd ciia mien dich qua trung gian te bao Iai ddng vai trd qua bong.
Nhiing trudng hdp st^ dung thuoc tiem, nguy cd gly ra nhiing phin ling h i t thi cao hdn so v * frudng htfp dung dudng uong vi khi diing Uiuoc qua dudnp ti'em, thuoc nhanh ehdng tiep xiic vdi khing the luu hinh va g l y ra nhiing phan ung tile till. Vdl nhDng trUdng hdp dimg thuoe uong phll cd thdl glan hap ttiu, chuyen hda v i van chuyen de tiep xiic v a te b i o lympho da man cim sau dd mdi x i y ra phan ting giiis khang nguyln_(UiuSc) v * khang ttie (lympho da m i n cam) g l y ra mpt loat eic phin iing hda hpe v i gill phdng ra ele lymphokine, g l y n l n benh canh lam sing cua dj iing mupn. Dieu n i y giii thich tai sao dudng tilm hay g l y ra ioai hinh di ung nhanh v i dudng uong hay g l y ra loai hinh dj iing ehlm. Ket q u i nghien ciili eiia chting tdi phii htjp vdl nhan xet cita Nguyin Van Doin[4].
cac tac gla d i u Uiong nhat cho ring thuoc duang tiem gay ra cae benh cita loai hinh dl ting nhanh, thudc dudng uong thudng gay ra cac benh loai hinh dj ling ehlm. Tuy nhien khi ditng thuoe theo dudng uong eung ed the g l y ra loai hinh dj ling nhanh v i ditng Uiuoc theo dudng tilm cung cd the gay ra dj ting chim.
Thi! lam s i n g va mol IiSn quan vdl t u o i : Cac dau hi|u sdm nghi ngd do dj (ing sau khi b?nh nhan dung thuoc ttiudng g i p la ngijs, m i y day, dd da,... d c fri?u ehiing n i y cd the keo dai s u a qua binh bi benh den khi blnh nhan khdi.
Nhung cung ed the d e frieu ehiing n i y chi cd tinh chit bio hieu cho mot benh d n h lam sing
Hep theo ciia dj iing khing sinh. K i t q u i nghien cilu eho thay trieu chting m i y day g i p d 50%
benh nhan, shock phin v l g i p d 33,3% blnli nhan, dd da l i 15% va hong ban nhiem sic co dinh l i ^ 1,7%. Trong cac the lam sing thi tiig h|ng ne nhat chinh l i shock phin ve, nd de doa den tinh mang ngudi benh, cung la noi i m inh d a vdl nhiing ngiKH ttiay thuSc va SU lo Ilng cua gia dinh blnh nhan.
V.KETLUiJN
^ Dl iJng khang sinh l i van de ttiudng gly to lang cho benh nhan va b i c sT. Phat hien sdm d c trieu chu'ng l l m sing gitip d e bae sf cd hudng xiJ tri kip thdi d c ttirdng htfp nghi ngd dl tlho
thudc. ^ TAIUIUTHAMKHAO
1. Nguyin Th| ThOy Ninh (2014). Nghiin olu tUi bang soc phan ve d Benh vien Bach Mai LuSn vin tot nghiip bac sT noi frii. '
•'• "V?- ) ? " ? ° * " <^'"''»)' """> hilu nguyen nhan va djc dilm lam sang d| i?ng Uiudc tsi Kiioa Dj Ung - MDLS Benh vl|n Bach l>lal. YltocHM hanh, 6; 25-28.
3. BS rndn Nhl B?! h,c Y H i N$l (2009). Bai giii,}
nA/*AcB, NXB y hoc tap 1, 7-12.
4. Nguyen V i n Boan (1996). Gdp phin nghUi, dk
tlaT(mi"?99%, **'" °" " "° *^* " ^ * *
5. Anne S v i Reiman R.E (2001). Risk of adrninistenng cephalosporin antibiotics of patelnts with tilstorles of penicillin allergy. Ann Mem Asthma Immunol, T\l.n),fii.lS?--na 6. Phan (^uang B o i n (2001). "Phit hi|n ngu* Oi
tien su d! ung frong d c frudng hap dl tltts 327 329*' * ' '' '"'^ "''^ • ^^<^'^i'
^IJ^^^ QUAN LYDIEU TRI BENH NHA\ DAI T H A O DiraNG TYP 2
TAI PHONG KHAM BAC SI GIA DINH YEN HOA, cAu GIAY 2014-2016
T6MTAT
Nguyin Thi Thu Thuy*, Trkn Kh4nh Toin**, Nguyin Phirffng Hoa"
•Tnitmg Bai hqc YDupc Thai Binh
••Tmdng Bai hqc YHaNqi.
Chju bach nhilm chinh: Tiin Khanh TnSn Email: llctoan@yaltoo.asm Ngay nhan bai: 3.10.2016 Ngiy phan bi|n khoa hpc: 23.11.2016 Ngay duyet bai: 29.11.2016
Nghien cUU Uieo ddi dijc nhSm dinh gii ka qui quin ly dISu frj b|nh nhin dil ttijo dudng typ 2 1 * phdng khim Sic s" gia dlnh yin Hoi, O u GiJy. 98 blnh nhin quin ly dieu frj tU 7/2014 din 5/2016 tJllB:
Uieo da djc kit hop hBI ciiu v i bin ciiu. Benh nliln dUdc quan ly dilu fr) Oieo hudng din ciJa Bd y tf v4 i p dung nguyin 1;> y hpc gia dlnh. Kit qui cho thty hau hft d c (Jil so lim sing v l can lam sing ciia ts6t, nhin deu giam c6 y nghia ttidng ke sau mSi s 7 t i l 108
to dlcu bl DTO ttieo olu chuan oja ADA 2014 ve ca
111" ?„"">"? "•=" "^ ""»* ip tin i r t S
B T O ^ O T H . - " ; ? " ' " ° . ' ' ' * ' " = " 'y « " h Shin BTD typ 2 tai cac phong khim BSGO
MSX^'^-'^" '* ^ ^ ^ t^' " * * = " l i ^ n g typ 2, phong kham bac Sl gia dinh.
SUIVIMARY
EFFECTS OF MANAGEMENT AND TREATMENT OF PATIENTS WITH TYPE 2
° r , M ^ ^ * " ^ ^ ^ " ° * " " " - Y MEDICINE CUNIC, CAU GIAY DISTRICT 2014-2016
A cohort StiJdy aims to assess effects of management and freafrnent of patients ivitti tvne 2
? * = S =t the fiimilv medicine clinic of Ven Hoa, Cau S ' i g t i e n t s were followed from :uly 2014 to Mav t ^ ' i T ^ ^ ^ ' " " prospectively, m e pSenb T M " 2 ^ ! " " ™Pitored according to Uie gSellne of Mmlsfry of HealUi and applying Family MMSnl
S E f H?-^ Tf? "^ ^^ ™« "< the diniS
signltonUy decreased after eadi visit. The probability
? ' r f ! * i n g Uie targeted blood sugar was 96 7%
ffi i S ' f S ^ ^^'^^- ™= '8.6% (9S%a 67^0% - S a S n f ^ ^ V * " - ' " ' • ^ * °f P'^e'-ts achieving freabnent targets according to ttie ADA 2014
^ £ ^ ' ° ' ' " » " « " « 0 I 3 of HbAIC, btood 4 fr»t^S^ ' i ' ^ ' ^ - ™= " ' P " ' ' °f management and medicine dinlcs shouM be considered to expand rfi.hJfT"?''' ^"sasment and freafrnent, type 2 diabetes, family medicine clinic.
Y HOC VIET HAM Tip 449-THANG 12. so I.,,..,;
I.BiJlTViNoE
« n i ? * ' ' ^ ' ° j i ' * " 5 ' " P J '* ' ^ "rang ba can
^ . V ^ " ^ P'l^' " ^ " "hanh nhat va la mot d S . ' £ ' 'P"^^" "!'^'' t l * ™ng hing dau a cic nude dang phat frien, frong dd cd Viet ta™^^H''-r'5" * " V=" « nhiing ngJ'S frong d^tt«,l lao d$ng v i dang cd xu h t ^ g tie chim Stic DTB d nhieu nuSc dang phit frign frong tuang lai Oilu may m i n l i blnh DTO noan toSn cti^ttig phdng va quin ly cd hleu q u i (CSSKSD)*?!?" * * ' ^ ^ ^^ * ° * ^ ^ "
Md hinh Bac sT gla dinh (BSGD) da chting
^^v,S^. i " ? ,'™"9 S™9 <*P ' ^ dich v2 U.SKBD CO Chat Iutfng vol miit: ehi phi htfp lv is d c nuac phat friln. BSGO d hiyen CSSKBD cd
'Sr 9 i j i •'"y^.Wwang 80% yeu tSu cham sdc sue ktoe va CO vai frd ttien chot bTjng quin ly dieu til benh nhin DTO [2].
S - n ^ n ^ ' J T ^ ' " * 300 phdng kham BSGD tf 8_frnh ttianh pho. Tuy nhien, chua cd nhieu nghten eun danh g l l hllu q u i ctia quin ly S S h T ^ " f . ^ . P f i n g khim niy. chdng tdi fren hanh nghien cuu nay v « mue Heu danh gla ket qua quan ly dieu fri benh nhin DTO tai n l m l o l S ^ S r ' ' ^ ^ " " ' ' * ' ' ^ " ^ ^ ^ . " ' ^ ^ ' II. OOI TUpNG VA PHU'ONG PHAP NGHIEN CCru
2.1. BSl tutdng nghien edit nh-'^?,™" ^ ^"'^ * ^ ' : •'l^n tien d c blnh S y^°u^^^'^"? ='2016 tai Phdng khim
? n ? ^ I, 1 ° ? ' ^^ '^'^^t " * '^>- « 'Sng edng 101 benh nhan DTO duOe quin 1^ dieu tri tai te I * * " ! K = « . ' ' « n H ^ frong thdi glan
FtS,S'J'°"?i-°' '? "^"'^ ""«" ^S til khim
It nhat m ^ lan va dong y tham gla nghiin eiin.
2.2. PhUdng phip nghiin cufu K S „ ! 3 ! f ' I ? nghien ctiu ttieo doi doe ket hop duSc S « r „ •' " " * ^^^ " " = ^ 9 ^'" nhin d l d S M L ° l " "'^'^ ° ™ ^ 2 dUde quan ly 7 o n , ? „ ? ' i',^,°"9 I * ™ BSGO Yen Hoa t ^ 7/2014 den 5/2016. Cic b?nh nhin niy dutfc kham va dieu frj djnh ky ttieo ttiudng quy eiia BS y te va dUtft: quin ly bing ho stf blnh an quin I?
benh man tinh YHGD. Thong tin ve vile kham oAi va_ ttiong tin hr 6/2015-5/2016 dudc thu ttiap Uen cuu hang ttiang.
So lieu dUtfc nhlp v i o miy ti'nh dudl dang T ^ ' ™ ^ " ^ ^^" P*'=n n-Sm STATA 14.0 r S ^ l "£•""- * ° " 9 "^ " • " • " S ™ l<h°ang tin c?y 95% Vdl cae test thong k l ttidng dung. Muc 5m4 H l " : ! / ' ^ ^ . " l " " 9'= * " « = ' * " = h ADA h n J i ^ ^ fren ch, so dudng mau, HbAlc, tri so huyet ap va md mau. . ' i =u III. K f r QUA N G H l l N CO'U
nghiin ^ ^ ^ "" '*""' "' '« ^^9 H-rd?!?- tS') * ™ Sia nghiin ciiU cd do tuSi h/ 43 den 80 (frung binh 60,1 tuoi) vdl 63 3% a nu gioi 100% BN cd BHYT. 34,7% BNcd tten sd d!nh S'n " K * - * ° . ' " ' * " 9 ™ 3 V * cd tifn sd gia CNnh teng huyet ap; 8 , 1 % BN nil cb tien sti' sinh Sa"n d J n - n i ? ? ' '?>' "^ " " « * " " l dUtfc Chan doan OTO la met mdi khdng r3 nguyin
VIETNAM MEPtCAL JOURHAL HH - PECEMBER - 2016
nhan_(43,9%); 78,3% BN co rot loan it nhat 1 ke «!• khi b i t dau dutfc q u i n ly la 12 (dao ding chi so md mau va 45,9% ed tang huya I p kem til 2-22 Bn).
theo. G i i tri trung vi so lan t i l kham a i a BNBN
Bing 3.1. Diin biSi lam sing, can lim sang theo thdl tiian auin ly Oleu trf
Glucose m l u khi ddj HbAlc Triglycerid Cholesterol t o i n phan
He so hol guy
Chua hleu chinh
0,035
-0,034
P a hieu chinh
-0,052-0,122 -0,331 - -0,075
-0,171 - 0,002 -0,055 - -0,022 -0,069 - -O.OOF"
-0,059 - -0,0087"
-0,044 -0,063 - -0,029'
-0,038 -0,05
-0,155 - 0,188 -0,06 - -0,027' -0,077 - -O.OT -0,063 - -0.0"12' -0,066 - -0,03f HDL
LDL
Ghl chu; p<0,05; -0,019
0,008 - 0,022 -0,034 - -0,003'"
0,013
*Hieu chinh theo tuoi, gidi, blnh kem -0,018
0,006 - 0,020' -0,033 - -0,003*
Cae chi_so huyet ap tam thu, glucose mau khi ddi, HbAlc, va 3 thinh phan md m l u xu hudng giam, ehl so HDL xu hudng tang qua moi lan tai khim. Khic bilt cd y nghia thong k l vdi p<0,05.
3.2. Kit aui dieu tri benh nhan BTB
l=MAn to<5 Q,A t > tUtfrl Q i a n .^161,
-"^ f * Tt. « ..'s - ^ ' ~ -'^ - „ • * " ^ ..-^ -"a A A •
Biiu do 3.1. Phin bSgli trt Glucose miu khi dil theo thdl gian quin If tliu trf Glucose m i u frung binh khi ddi giam dan Oieo thdi gian quin ly dieu fri, tir 7,2mmol/l d lan dlti tai kham xuong cdn 6,4mmol/l d lan tal khim ttiii 20 trd dl. Khoang phan b« gia tri Glucose miu khi dot ttiu hep dan ttieo ttidi glan. Gla tin Glucose m l u cao nhat eung ed xu hudng glim theo thdl glan dieu til, tuy nhien ed lang nhe d d c lan t i l khim 14-16.
1
1 "
1^
ud83.:
D<j doAn t
S.70-I
* t* dot myc UAu Glucova mdu chao thdi elan audn li diSu
—1 0.793^
LBn khdm vA dl»u CD
1 SS"M. Cl TV 1* dwt mye a*u\
„
1 8
-#; .r i ^ - "•!••. H t « .t,ui,voK ,i,au tuy UMI UICV unn gian quah 111OliU tTt Sm Ty le d?t muc tteu kiem scat Glucose m i u t i n g d i n qua cac Bn t i l kham v i dat tv I I luv tfcli li 96,7% (95%a91,5%-95,l%) sau 10 Bn tal khim dSt ty 1^ luy Uch «
YHOCVieTNA»Tap4<9.THAMG12-s6l.Z1116
«r:^^l^^Si^i«;)khi
ttlli'20. _ ^ J " ^"^ '"" ' ^ ' 5 * 71'2%) 0 Bn ttiu 10, va 78,6% (95% a 67% - 88,3%) d Bn
BN dat muc tieu diiu fri
Ttnh ^-''SL'^'^'1'-^'f"'"'^''"<"^''^'"''^''M theo Ueu Chuan ADA 2014
i.<ircii-J:^.^,f.^rS2.t'tit^^''^^^^^^^
IV. BAN LUAN
4.1. Dgn blen dc chi so lam sing, dn lim sing theo thil glan quin If '
Kft qui d bing 3.1 cho tiiay d e chi so huyet ap tam ttiu, glucose mau, HbAlc, friglycen'd, choleslerol hian phan, LDL cd xu hudng giim cti y nghia thong k l vdi p<0,05 sau mol Bn t i l m m . Kel qua nay hidng tU nhu mpt nghiin eiln J l Iran n i m 2015 [3]. Oieu ttiii vl l i cung hrtfng b/ nhu nghien ciJu niy [3], chi so BMI ciia BN cung Sng ttieo ttidi gian dieu fri, mac dii frong nghten ctru eua ehiing tdl, sU khic bilt sau mSl ian tal kham ehu^ cdjj nghTa thong k l .
4.2. Ket qua Uim soit dudng miu Xetjighllm Glucose cd y nghla quan fronq frong vi?c phit hiln, ehan doin v l theo doi dieu bicua b?nh nhin OTO. ADA khuyen d o blnh nhan dal ttiao dudng tan no luc dat dudc chi so Glucose m i u khi ddi frung binh t i r 3 9 - 7,2mmo|/L cung nhu HbAlc<7%. Nghiin'eiHi cua chiing iSi cho thay nong dd Glucose mau frung binh khi ddi ciia BN glam dan tir 7 2 mmol/L liic b i t d i u dUde quin ly dieu fri xuoiig con 6,4 mmol/L liic t i l kham fin ttiii' 20' fr* Si Chi so Gluose mau bung blnh trong nghiin ciili
cua Chung toi ttiap hdn nhieu nghien cii'u khac txfi phan Idn d c blnh nhan trUdc khi dUtfc quan ly dteu frj 1^1 PK Yin Hoi da dUtfc dieu fri tal d c ntfl khae vtfi ttidi glan frung binh 3,5 nim'. Bdi vjy, toe do giim ctia nong dd Glucose m l u frung binh luc dot cung la dieu d l hieu. CBng vdl ly do do, ty 11 BN dat dudc mue t i l u kiem soat Glucose mau luc ddi trong nghien ciiu ciia chung till la 96,7%, cao hdn nhieu so vdi nghiin ciiu cua Dao Bich^Hudng (31%) [4].
4.3. DiSn blen chi sS HbAlc theo thdl gian quan If
HbAlc l i muc ti'eu quan frong eiia kiem soit dutfng mau, cung cap mot ttiudc do d i i han hiiu ich eua kiem soat dudng mau. ADA khuyin d o rang BN DTO n l n duy fri nong dd HbAlc eua hp dU0i_7% tong so hemoglobin frong d e te bao.
Nghien cuu eua ehiing tdl eho thay tJ 11 dat muc tieu HbAlc tang dan Uieo ttidi glan quin ly dlSu tn; hr 33,5% ( g 5 % a : 25% - 44%) is L tal kham ttiu 5 den 60% ( 9 5 % a ; 50%-71%) d Bn tai kham ttiu 10 v i 79% ( 9 5 % a : 67% - 88%) d ta ttiu 20. Ty le dat muc tieu HbAlc tich iu?
nong nghieii cUu cila chiing tdi eao hdn so vdl Sv?.?!."-,*!^" "^ ' ™ ' * ^^ * Viet Nam vdi 31,9%[4] va 38,8% [5].
T*/
VIETNAM MEDIC/U. JOURNAL N'l • OEOFMBER • 2015 4.4. Tf l i dat muc Ueu kiem soat BTB
theo Ueu chuan ADA
Tinh den thdi diem ket thiic nghien ciru, cd 40,8% ^benh nhan dat dutfc d 3 mue tieu kiem soat benh theo tieu ehuan ADA 2014. Ket q u i nay I I kha eao so vdi nhieu nghien cirtj khic d frong v i ngoii nUde nhU nghien cUu ciia D i o Bieh HUdng tai Blnh viln Bach Mai vdi 12,4%
[4]; nghiin cirtj tai Itan vcifi 7,7% ( 9 5 % a 6,7- 8,8)[3]; nghiin cirti aia Trung t i m CDC AUanta tir 1999-2010 v a 14,3% [6] v i nghien ctiu ciia Emily_B. Schroeder vdi 16% va 30% [7].
Ben canh sU khae biet ve Idi song, tinh trang kinh te xa hdi, he thdng y te tai d e dia ban nghien ctlu khac nhau, ty I I dat muc tieu dieu tri eao trong nghien eiiU n i y cd the'do da so BN deu dan^ d mu'c do nhe, mdt so BN da dutfc quin ly on djnh tir ndi khic cliuyen den. Mae dii v i y , ket q u i bude dau ve quin ly dieu fri benh nhin DTO typ 2 tal PK BSGD Yen Hoa B rat ding khich le, d?t ra y l u cau phii ti'ep tuc nghiin ctiti de nhin rong md hinh niy.
V. Kfr VLSIH
Da so d e chi so lam sang va d n Bm sing ciia BN nhu huyet I p , glucose miu,' HbAlc, md m i u deu giim cd y nghia thdng ke sau moi Bn t i l khim. Kha ning d?t muc tieu kiem soit dudng mau B 96,7% (95%ci 91,5% - 95,1%) sau 10 Bn kham v i dat muc tilu kiem soat HbAIC B 78,6% ( 9 5 % a 67% - 88,3%) sau 20 fin kham. Tinh den thdi diem ket thiic nghien eiin, 40,8% b^nh nhin dat mue Beu dieu tri DTO
tileo ti'eu ehuan eua /U)A 2014 ve d ba y l i i tS HbAIC, md m i u v i huyet i p . Can tiep tuc nghiin ciiu, xem xet md rang md hinh quan ly dieu tri BN DTO tai d e PK BSGD.
TAI L l f u THAM KHAO
1. Inzucchi S. E., Bergenstal R. M., Buse J. B., et aL (2012), Management of hyperglycemia in type 2 diabetes: a patient-centered approadi: position statement of the Amencan Diabetes Assoaation (ADA) and tfie European Association fbr the Study of Diabetes (EASD). Diabetes care, 35(6), 1364-79 2. Starneld B., Shi L., Macinko 3. (200S).
Contribution of pnmary care to health systems anti healtii. TheMilbankquaitedy, 83(3), 457-502 o. Janghorbani M., Papi B., AmInI M. (2015).
Current status of glucose, blood pressure and lipid management in type 2 diabetes dinic attendees in Isfahan, Iran. J Diabetes Investig, 6(6), 716-25 4. Bao Bich HUdng (2014). Thqc bang kiem scat
da yeu td dbenh nhan dal thao du&ng typ 2 dlSu tri ngoai tn! lai hqnh viin Bach Mal, Luan v5n Thac sT Y hoc, Trudng Oai hoc Y Hi N$i.
5. HirohideYokokawa, Nguyen Thy Khue, Aya Goto, et al. (2010). Diabetes Oxitioi among \fletnamese Patlente in Ho Oil Minh oty: An Obsenatanai Cress- Sectional Stuciy. intemationai Bectrcnc Journal d Health Educabon, 2010,13:1-13.
6. Ali M. K., Bullard K. M., Saaddlne 3. B., et al.
(2013). Achievement of goals In U.S. diabetes care, 1999-2010. N EnglJ Med, 368(17), 1613-24 / . Schroeder E. B., Hanratty R, Beaty B. L, et
aL (2012). Simultaneous control of diabetes mellitus, hypertension, and hyperiipidemla in 2 health systems, (jrc Cardiovasc Quai Outcomes, 5(5), 645-53.
BANH GIA KIEN THU'C v l HEN P H g Q U A \
CUA NGU-ffI TRU-C TIEP CHAM SOC TRfi (MAC BfiNH) DU-ffl 5 T U d l
Pham The HiJn*, Tnrong Thi Bich Uylil*
T6MTAT
B i t vSn d l : Hen phe quan l i van de sUc khde c?ng iBng fren tijan die gidl, tic dong den nhilu ngudl d mol lua Uioi, ty l | mic blnh co xu hudng ngay i^ng ting fren ttie gidi cung nhU is Vift Nam, die biet l i fre em. Mifc tieu: Xac dmh kien ttiUc ctia
•Khoa YDUdc Tnidng Dal hoc Tra V,nh Chju bach nhilm chinh: Pham The Hfien Email: hien_fr@tvu.edu.vn Ngiy nhin bai: 5.9.2016 Ngay phan bi|n khoa hoc: 4.11.2016 Ngay duyet bai: 15.11.2016
ngUdi fri^ tilp ehlm sdc Be ve bjnh hen phi quin i fre em dudl 5 tii3l tal Blnh vien Sin - Nhi Tri Vlnli.
Phutfng p h i p : CSt ngang phan tich. Ket q u i : Ty ^ NTTCST hieu bia rSt ttiap ve b|nh HPQ: blnh viem man tinh dudng Bid l i 27,7%, ylu to lim xult hiln cdn HPQ l i 17%, bleu hi|n ciia HPQ IS 71,3% HPQ cfi Oie chOa duljc l i 62,8%, khi fre b| HPQ c6 ho khSnj nen cho fre uong thuoc ho l i 51,1%, ttidi gian rfiQa HPQ l i 67%, HPQ cd B l l phdng dUtfc l i 76,6%, t»
phip phdng HPQ l i 10,6%, fchdi Biuoc la cd nguy to dSn den HPQ d fri l i 95,7%, deh dung Biudc oh6ng HPQ l i 17%. Kien BllJC Qia NTTCST v l benh, cAJl dilu fri vi dU Phong HPQ: t « : 0, khi: 22,3% frung
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