after ischemic stroke' the role of stroke syndrome and subtype, Stmke, 29(10): 2118-2124.
8. Sacco R, L., Shi T., et al (1994). Predictors of mortality and recurrence after hospitalized cerebral infarction In an urban community: the Northern Manhattan Stroke Study, Neurology, 44(4)' 626-634.
9. Soda T., Nakayasu H., Maeda M , Kusumi M., Kowa H., Awaki E., etal. (2004): Stroke recurrence within
the first year following cerebral infarction-Tottori University Lacunar Infarction Prognosis Study (TULIPS).
Acta Neurol Scand, 110(6): 343-349.
10, Wang Y., Xu J., Zhao X., Wang D„ Wang C„ Liu L„ ef al. (2013). Association of hypertension with stroke recurrence depends on ischemic stroke subtype. Stmke, 44(5), 1232-1237.
XAC DjNH GEN MA HOA EXFOLIATIVE TOXIN CUA CAC CHUNG STAPHYLOCOCCUS AUREUS GAY BONG VAY DA TAI BENH VIEN DA LlIu TRUNG UONG
TOM T A T
Di phdt hien nhanh cdc chdng Staphylococcus aureus gay benh bong viy da trdn ngudi, ky thuat PCR vdi cdp mdi dugc thiit ki di nhan ddc hieu cho gen md hda (eta, eib) ngoai dde td exfoliative toxin (ETA, ETB). DNA khudn dung irong phin Ung PCR dugc tdeh chiit td 24 ehdng vi khuin S aureus phan ldp td benh nhdn bj hdi ehdng bong viy da lai Benh vidn Da lieu Tmng udng. Kit qui cho thiy, 24 chOng ndy diu mang ci hai gen ma hda cho dde td ETA va ETB. Tp Id mang gen eta va etb cQa de chdng gdy bdnh tren benh nhin ndcao gip 1,5 lan so vdi nam, ngdi ra cd tdi han 83%, benh nhan mdc benh cd dd tuoi <3. Trinh lu nucleotid eda doan gen ma hda ETA va ETB cOa cae chdng S. aureus tmng nghien cifu nay tuang ddng 100% vdi vdi cae trinh tu gen da cdng bd trdn ngan hang gen qudc ti.
Tdkhda: Ngoai ddc id. Enzyme pmtease, ETA, ETB
SUMMARY
For mpid detection of Staphylococcus aureus causing Staphylococcal scalded skin syndrome (SSSS), a PCR test with primers was applied specific to genes encoding exfoliative toxins (ETA and ETB).
DNA template used in the PCR reaction was extmeted from 24 stmins of S. aureus isolated from patients with SSSS admifted to the National Hospital of Dennatology and Venerelogy. Results of PCR showed that all strains have both genes coding for toxins ETA and ETB. The rate of having the gene in female patients was 1.5 times higher than men. In addition, more than 83%, of patients aged <3 were seen Sequencing results showed the nucleotide sequences of the genes coding for ETA and ETB wem 100%, simiiar to those in the international gene bank.
Keywords: Exotoxin, ETA, ETB, gene.
OATVAN DE
Hpi chifng bong vd'y da do tu c l u (Staphylococcal scalded skin syndrome -SSSS) lan dau tidn dudc Baron Gottfried Ritter Von Ritterstam md ta nam 1878[1]. Tuy nhien, vai trd eua dde td den 1970 m^i , dLfoc Melish va Glasgow ehifiig minh [21, Benh bieu hien d moi lira tudi ddc biet la d tre sd sinh va tre nhd, Cac bleu hien gdm ban do dang tinh hdng nhiet xung . quanh cac hdc ti/ nhien, tren dd nhanh chdng hinh
• thanh cac bong nudc rd't ndng, sau lien k i t thanh mang
PHAM THj MAI HUONG, N G U Y I N VU TRUNG, TRAN LAN ANH, L^ V A N D U Y E T bong nude lan rong. Sau 24-48h bong nudc v6, vay da d ria bong nudc cudn lai quan mep nhu cudn thudc Id.
Bong nUde vd se lam mat di phan Idn Idp da ngodi eija ngudi bdnh [31, Bdnh khdi phat khi cd the bl nhidm_S.
aureus tai eac v\ tri xdy xudc va gay nen cac o nhidm tnjng, tai dd vi khuan tiet ra cde ngoai ddc td ETA va ETB [41, Ngoai ddc td nay bam vdo cdc thu the TCR (T Cell Receptor) vd MHC (Major Histocompatibility Complex) tren cdc te bao midn dich va giiip chimg di chuyen den viing da ton thUdng [31, Tai day, chimg phan eat eac protein desmoglein (protein lien kit cac te bdo da) tach ldp sifng rdi khdi Idp hat gay ndn cdc bong nudc [51,
S, aureus tao ra it nhd't bdn loai exfoliative toxin, trong sd do ETA vd ETB ehii yeu gay benh SSSS tren ngudi [61. ETA la mdt protein dupc cau tao ty 242 axit amin, cd kich thude phdn tif xap xi 27 kilo Dalton (kDa)^
gen ma hda eho ETA thudng nam trdn nhidm sac the eiia S. areus. Nguoc lai, gen md hda ETB thudng nam trdn plasmid, Phan tich cau triie tinh the eua ETA va ETB eho thay, ca hai protein deu cd ca'u true kha tUdng ddng, bao gdm hai viing chuyen biet S1 va S2, mdi viing chifa sdu chudi Beta - sheet va mdt viing C- tennmal Alpha - helix. Su gidng nhau ve mat c l u tme cung phan nao phan anh diing mife dp tuting ddng eao ve trinh tu axit amin giira hai gen eta va etb [7].
Theo nhilu nghien eiifu, cd sa khdc biet ve ty le phan bd gen eta va etb d cdc chung S. aureus gdy benh tren the gidi, 6 chdu Au, My va chdu Phi, eta xud't hien phd bid'n d hdn 80% cac chung S.aureus [41 Tuy nhien d Nhat Ban. cae chimg mang gen etb xuat hien phd bie'n hdn, Ngoai ra, mdt sd ehiing S. aureus phan Idp tai eac vung tdn thUdng mang ea hai gen md hda cho ddc td ndy, Dieu do chimg td rang eae chiing nay cd doc lUc cao vd tao ra nhieu tdn thuong tren lam sang,
6 Viet Nam, cde nghien ciiu ve hdi ehdng SSSS do S, aureus vdn ehi difng lai d mife dd lam sang, ehua cd ede nghien eifu ve gen ma hda dpc td exfoliative toxin, Chinh vi vay, chiing tdi tien hanh i3e tai nay nham muc tidu' Xac dmh sy cd mat va phan bd gen eta va etb d cae chimg S. aureus phdn lap dUdc tif benh nhdn bi hdi chimg bong vay da.
Y HOC THUC HANH (879) - SO 9/2013
D 6 I TUpNG VA PHUONG PHAP NGHIAN COU 1. Ooi tu^ng
Cde bdnh nhdn cd tndu chiimg eiia Hdi chifng bong vay da.
24 chiing S. aumus phdn ldp tCf bdnh nhdn bi m i c Hdi chimg bong v i y da d i l u tri ndi toi tal Bdnh vidn Da hdu Trung udng,
2. Phuong phdp nghidn ctiru 2.1. Tiiu chuin chpn h$nh nhdn:
- Bdnh khdi phdt c i p tinh dang ban do tinh hdng nhidt d mdt, cd. vd eae n i p g i p , Sau 24-48h, t r i n ddt dd nhanh ehdng xud't hidn bong nyde ndng, m I m , sau trpt ra thdnh dam tnJt udt. bong viiy da mdng qudn nhi/
giay cudn thudc la, ed t h i Nikolsky (+),
- Nudi cd'y dieh thudng tdn da hodc djch ngody mOi cd tu elu vdng.
" Tieu ehuln loai trin Cac bdnh phat ban do virus, dl iifng thud'c. benh da bong nudc khac nhu chd'c, vidm da tidp xue edn triing,,.Bdnh nhdn, cha/me hode ngodi bao trd khdng ddng y tham gia nghien cifu,
2.2. Phdn ldp chung Staphylococcus aureus Bdnh pham mil tai vung da ton thudng va djch ngody mui dupe cd'y trdn mdi trudng thach mau, d nhiet do 35"C trong 18-24h S.aureus dude xac djnh theo thudng qui vi smh Idm sang.
2.3 Tdch chiit ADN cua S. aureus
Quy trinh tach chilt ADN dutJc thyc hien theo md ta trudc ddy [8], vi khuan dUde trdn deu vdi 300^1 lysis buffer (100 mM Tns-HCI pH 8 0, 20 mM Na^EDTA, 0.5 M NaCl. 10% SDS) vd ii d nhiet do 70''C trong 10 phiit.
Protein dUOc loai bd bang hdn hdp dung dich Phenol-Chloroform-1so-amyI alcohol (2524 1). ADN dUde tiia bang I v / l v dung dich Isopropanol vd ly tdm d tde dp 13.000 vdng/phiit trong 15 phiit Cdn ADN dype rufa lai bang 500|jl Ethanol 70% vd Idm khd d nhiet dd phdng, sau dd hda lai trong 50^1 H^O hodc TAE buffer,
2.4 Phan dng chudi (PCR)
H d n h o p p h a n i f n g P C R b a o g d m 1 2 , 5 p l 2 X K A P A 2 G R o b u s t H o t S t a r t R e a d y M i x , 0 , 5 n M F o n w a r d p r i m e r , 0 , 5 ^ M R e v e r s e p n m e r , 5 % D M S O , 5 0 n g A D N t d n g s d , d d n H^O tdi t d n g t h e t i e h p h a n i f n g Id 2 5 | i l . P h a n i f n g P C R d u a c t h u c h i e n t h e o c h u t r i n h n h i e t nhu s a u : b i e n t i n h 9 5 ° C 1 5 p h i i t , 3 5 e h u k y 9 5 ° C 1 p h u t , 5 7 ' ' C - 3 0 g i a y , 7 2 ° C - 3 0 g i a y , ke't t h u c 7 2 ' ' C 10 p h i i t [ 8 ] .
eta Forward: 5' - GCA GGT G H GAT TTA GCA H - 3 Reverse- 5' - AGA TGT CCC TAT TTT TGC TG - 3' etb Forward: 5 - ACA AGC AAA AGA ATA CAG CG - 3 Reverse: 5' - GTT TTT GGC TGC TTC TCT TG - 3 2.5. Dign di tren gel agarose
Bjil san phim PCR dude trdn d i u vdi 2pl 5x loading dye buffer, sau dd chuyen vdo gieng tren gel agarose 2% da dupc bd sung 1x TAE buffer BU6e dien di dUdc thuc hien nhu sau. hieu didn the 100 Volts, thdi gian la 30 phiit. Sau khi k i t thiie dien di.
gel dUdc nhuom vdi Ethidium bromide trong 5 phut vd dpc k i t qua bangtia UV
2.6. Giai trinh tugen
Hdn hpp phan img sequencing dodc chuan bj nhi/
sau: 4p.\ Bigdye sequencing buffer, 2nl Ready reaction
premix, 3,2 pmol Forward primer (hode Reve^
primer), 5 ng ADN template, dan HjO tdi tdng the tf^
Id 20jil, Phan ifng PCR sequencing duUc thub hidn theo chu trinh nhidt nhir sau: 95°C 1 phOt, 25 c h u j j gS^C - 1 0 gidy, SCC - 1 0 gidy, 60° - 4 phiit. San pham sau dd duoe tinh sach bang bd kit ZR DNA Sequencing Clean-up Kit"™ ciia hang Zymo research, dpc trdn may glal trinh t u gen 3130 ciia har^
AppllBiosystem. Trinh t i / ADN thu nhan vd phdn tich trdn p h i n m I m sequemcing analysis v5.4.
K£'T QUA L K e t q u S P C R .
T i t ca 24 chOng S. aureus d i u ed san phim co kfch thudc khoang 90 bp ddt vdi gen eta vd khoang 220 bp ddi vdi gen etb. [hinh 11,
Hinh 1: K«t qud PCR ptifl hien gen etavi eOt cua 5 chiing £ aureus. Thang ADN chu^n (gllng s£ 6).
Tir 1 d^n 5 \k san pirfm PCR ciia gen «&c6 Mch UiifOc kho Jng 90 bp. Tif gieng so 7 din so 11 la san p h ^ PCR
cua gen etbc6 kich thi/dc khoang 220 bp
2. Phan bo gen eta va etb
Cd 7/24 chijng phdn Idp dUdc tai mui vd 17/24 chimg phdn Idp tat vi tri da tdn thuOng
Bang 1 Phan bo gen eta va etb d 24 ehiing S aureus
Stl 1 2 3 4 5 6 7 8 9 10 f t 12
Vitri l^vmau
MOi MOI MOi Tdn tfiironq
T6n thiionq
T6n thifonc]
T6n thironq
Mu<
Tdn IhlATnq
Tdn Ihiranq
Tdn Ihiranq
Tdn Ihiranq
ETA
'
+
*
*
+
*
+ +
ETB + + +
" +
•
+ +
+ sit 13 14 15 16 17 18 19 20 21 22 23 24
M m l ^ m a u
Tdn Ihuonq
Tdn Ihiranq
MGl Tdn thiranq
Tdn Ihiranq
Tdn thiranq
MOi MOI Tdn Ihuonq
Tdn thuonq
TSn thuonq
Tdn thuonq
ETA
•
'
+
'
+
+ +
+
*
ETB
T h e o b a n g t r e n , "bdc chCing S . aumus phan lap d u o c d v u n g t o n t h u o n g v a n i e m m a c m u i d b d n h nhan m a c h d i chufng b o n g v a y d a .
Y HOC THirc HANH (879) - S6 9/20i8
3. Ket qua gidi trinh tu-.
_So sanh trinh ty ctia doan gen eta vd etb cCia 24 chCing S.aureus vdi cde trinh tu trdn ngan hang du" lieu gen quoc te (National Centre for Biotechnology Information - NCBI cho thay do tudng ddng 100% vdi eae ehiing S.areus phan lap tai My, va Nhdt Ban (Hinh 2),
30 40
VN S.are-ji.3 ETB S. a-Ee-.i3 SAP057A, ET3 S. a-jre.:3 IY4. Er=
S.aureus ETB
TTCCACCTACAGA7AAAGAOCTTTATACACACATTACGOATAATGCAAGAAGTCCTTATA TTCCACCTACAQATAAAGAGCTTTATACACACATTACOQATAATGCAAOAAGTCCTTATA TTCCACCTACAGArAAAGAGCVTTATACACACATTACGaATAATGCAAGAAGTCCTTATA TTCCACCTACAGATAAAGAGC TT TATACACACATTACOOATAATGCAAGAAGTCCTTATA
\-N S.areus EX3 S. d-re--;3 SAP057A, ETB S. aureus IY4, ETS S.aureus EI5
70 80 90 1 0 0
. I . 1 1 0
1 . 1 2 0 ATTCTGTTGGTACAGTGTTTGTCAAAGGTAGTACATTAGCTACCGGAGTTTTAATTGGTA ATTCTGTTGGTACAGTOTT'i G "CAAAGGTAGTACATTAGCTACCGGAGTTTTAATTGGTA ATTCTOTTOOTACAOTOTTTGTCAAAGOTAOTACATTAOCTACCOOAOTTTTAATTGGTA ATTCTOTTOOTACAOTOTTTOTCAAAOOTAGTACATTAOCrACCOGAGTTTTAATTGGTA
1 4 0 1 5 0 1 « 0 VN S.areus EX3 A A A A T A C A A T TGT TACT AAT T A C C A C O T T G C A A Q A O A A C J C A O C C A A A A A S. aureus SAP057A, ETa AAAATACAATTGTTACTAATTACCACGTTGCAAGAGAAGCAGCCAAAAA 3. aureus TY4, ETB AAAATACAAT TGT TAC TAAT TACCACGTTGCAAGAGAAGCAGCCAAAAA
S . aureus ET3 AAAATACAATTOTTACTAATTACCACGTTGCAAGAGAAGCAGCCAAAAA
Hinh 2: So sanh trinh ty nucleotide gen «J&cua chiJng S aureusphan lap tai Viet Nam (ky hieu: VN S. aureusEJB]
vi cac chOng S. aureus SAPQ57A phan lap tal My, S. aureusTTA phan lap is Nhat BSn, S. aureus ETB phan lap tai My
4. Phan bo tuoi va gidi.
Tudi mac bdnh tmng binh Id 2,75, trong dd, benh nhan Idn tudi nhd't Id 14 va nhd tudi nhat la 1, hau het cac bdnh nhdn deu cd do tudi < 6. Tre < 3 tuoi chiem tdi 83% trong tdng so 24 bdnh nhan, Ket qua trong nghien cifu nay ciing cho thay ty le nam/nCf la 1,5,
BAN LUAN
1. Phan b d gen eta va etb b cac chung S.aureus gay benh.
Vide ed mat ca hai gen ma hda cho ETA va ETB cho thay doc lUe ciia ede ehung S. aureus gay benh tai Viet Nam la rat eao Su xuat hien ddng thdi ca hai gen ma hda ddc td exfoliative toxin tren tat ca 24 chimg S.
aureus gay bdnh trdn ngudi tai Viet Nam phan lap tif thang 3 nam 2011 den thang 3 nam 2012 cho thay vai tro gay benh ciia cac chiing vi khuan nay,
Theo Ladhani, chi cd 3 1 % trUdng hdp dUdng tinh v6i exfoliative toxin vd 69% khdng cho thay cd su tdn tai ciia doc td. Nghien eifu tai VuWng qudc Anh vd Ai- so-len thay, 32% so chCing ehi mang gen eta, 12%
mang gen etb va 27% mang ea hai gen [9]. Ngoai ra, cac sd lieu nghien eiifu tai Diifc, Phap vd My cung eho ket qua tUdng ty [11, Ket qua nghien eifu eua chiing tdi CO sy khac biet khd rd ret v l ty le mang gen doe td giua eac chiing S.aureus gay benh d Viet Nam vdi mdt sd nudc khac. Gieu nay ed the do dde thii phan t>d loai VI khuan nay tai cac vimg dia ly, ddc diem phan bd trdn cac ddi tuong bdnh nhdn cd the khac nhau,
2. Phan b d gen eta va etb vdi tuoi va gidi tinh.
Ty le bdnh nhdn bi mac SSSS do S. areus cd do
tudi <3 chiem 83%, dieu dd cd the khien cac benh nhan nho tuoi thudng ed kha ndng bi SSSS cao so vdi lya tudi Idn Nghien cifu ciia Ladhani eho thay, tp le benh nhdn cd khdng the khdng ETA, ETB d tre cd do tudi ty 3 dd'n 24 thang la 30%, sau dd tang len 50% d tre 10 tudi vd 9 1 % d dd tudi tren 40 [10] Mdt nghien eiru khac cijng cho ket qua tUdng tu vdi 78% cac benh nhdn cd van de ve sire khde vd bi suy yeu he mien dich deu cd ty le mang khang the khdng exfoliative toxin thap [4]. Dilu nay cd the duoc giai thich rang, benh nhdn cang nhd tudi thi he midn djch chua phdt trien vd ehua dii kha ndng smh khang the khdng lai exfoliative toxin vd do vdy nguy ed mac benh cao hon so vdi cdc IC^ tudi khac khien ty le phdn lap dUOc vi khuin thudng cao d lifa tudi ndy nhung ty le phat hien khang the lai thd'p,
Khi xem xet yeu td gidi tinh, k i t qua nghien cifu cua ehiing tdi cho thd'y, ty Id cdc chimg S. aureus mang gen efa va etb tren ddi tUdng bdnh nhan la rxH eao gap 1,5 l l n so vdi nam, Theo nghien cifu eua Cnbier nam 1994 tai Phap, trong sd 32 trudng hdp SSSS t:^ le nam chiem 66% (21 tmdng hdp) [11]. Ket qua trong nghien ciOi eua chiing tdi ed sy chenh lech rat Idn so vdi nghien eifu ciia Cribier, tuy nhien, sy khdc bidt nay cd the Id do ed mdu trong nghien ciru eiia chiing tdi nho hon nen chua the danh gia day dii du'dc ty Id nam/nCf, Ngoai ra sU khac nhau d thdi diem, vi tri dia ly va ddc diem sinh hoe cOa ddi tuong khi thuc hien nghien eifu cung cd the la nguyen nhan ddn den sy chenh lech ve k i t qua
Y HOC THl/C HANH (879) - S6 9/2013
3. Moi lien quan giiJra cdc chi so xdt nghiam va 31/ xud't hi^n gen eta vd etb d cac chung S. aureus phdn lap tir benh nhan.
Qua phdn tieh cdc chi sd xdt nghidm nhi/ Cdng thO'c mdu, chye ndng gan, didn giSi, sinh hda nudc tilu ciia cdc bdnh nhdn SSSS mang chOng S. aureus.
chiing tdi khdng I h l y cd sy thay ddi bdnh ly ndo c6 y nghTa thdng kd, Theo chiing tdi, d i l u ndy cdn phu thudc vdo tinh trang chung ciia cd the, ddc bidt Id vai trd gdy nhi§m trimg eua ede ehiing S. aureus mang gen eta vd etb. Theo mdt sd nghidn cifu, cd thd chimg S. aumus sinh dde td vd gdy ra cdc tdn thUdng tai cho nhung khdng gdy nhiem triing todn thdn, ddc bidt Id nhilm khuin huylt. nhu vdy, cd thd khdng c6 nhufng bien ddi huylt hpc vd sinh hda dang k l .
K £ T LUA.U
24 ch^ng S. aumus gdy bdnh SSSS phdn ldp tai Benh vien Da lidu Trung udng tir thdng 3 ndm 2011 den thdng 3 ndm 2012, K i t qua cho thiy, 24 chimg deu mang ca hai gen efa vd efd.
- Trinh t l / nucleotide eua eta va etb ti/dng ddng 100% vdi ede chiing qud'c t l .
- 83% tre bj hdi chimg bong vay da va cd S. aureus mang gen eta va etb d dd tudi nhd hdn 3,
- Cac tre bj hdi chimg bong vay da vd cd S, aureus khdng ed cdc bien ddi cd y nghTa thd'ng kd ve xdt nghidm huylt hoc vd sinh hda.
TAI LIEU THAM KHAO
1 Miles, F , et al,. Review of Staphylococcus aureus infections requiring admission to a paediatric intensive care unit Arch Dis Child. 2005. 90(12)' p. 1274-8,
2. Raulin, O., et al., Toxin pmfiling of Staphylococcus aureus strains involved in varicella supennfeetion. J Clin Microbiol 48(5)' p, 1696-700,
3. Kato, F., et a l , Regulatory mechanism for exfoliative toxin production In Staphylococcus aureus.
Infect Immun. 79(4): p. 1660-70,
4. Ladhani, S., et a l , Clinical, micmbial, and biochemical aspects of the exfoliative toxins causing staphylococcal scalded-skin syndrome Clin Microbiol Rev, 1999, 12(2): p. 224-42.
5. Dinges, M M , P.M. Orwin, and P.M. Schlievert, Exotoxins of Staphylococcus aureus. Clin Microbiol Rev, 2000, 13(1), p. 16-34, table of contents.
6. De Azavedo, J, and J.R, Arbuthnott, Prevalence <^
epidermolytie toxin in clinical isolates of Staphylococcus aureus. J Med Microbiol. 1981, 14(3)' p. 341-4.
7. Lee, CY., et al.. Sequence determination and companson of the exfoliative toxin A and toxin B genes from Staphylococcus aureus. J Bacterid, 1987. 169(9): p, 3904-9.
8. Mehrotra, M,, G. W/ang, and W.M. Johnson, Multiplex PCR for detection of genes for Staphylococcus aureus entemtoxins. exfoliative toxins, toxic shock syndmme toxin 1,
9. Yamasaki, 0., et a l , Clinical manifestations of staphylococcal scalded-skin syndrome depend on serotypes of exfdiative toxins. J Clin Microbiol, 2005, 43(4): p. 1890-3.
10. Ladhani, S., Understanding the mechanism of action of the exfoliative toxins of Staphylococcus aureus FEMS Immunol Med Microbiol, 2003 39(2): p. 181-9.
11. Cribier, B., Y. Piemont, and E. Grosshans, Staphylococcal scalded skin syndmme in adults. A clinical review illustrated with a new case J Am Acad Dermatol, 1994 30(2 R 2): p 319-24.
KHAO SAT DAC DIEM VA TY LE MAC DENH PHOI TAC NGHEN MAN TINH TAI THANH PHO VINH-NGHE AN
DUONG DINH CHiNH, N G U Y I N OINH HOI, NGO D Q C K ^ Bpnh vi^n HNDK Nghe An
TOM T A T
Benh phit tie nghen man tinh (COPD) ngay mdt gia tdng vd id mdt trong nhdng nguydn nhdn hang diu gay td vong hien nay. Chi phi cho diiu tri rat Idn. neu khdng dugc phat hidn va diiu tn sdm sd gay hiu qua ndng ni cho benh nhan, gia dinh vd xa hdi.
Muc tidu: xac dmh tp Id mic COPD tren dia ban thanh phd Vinh.
^ Phuang phap nghien edu: diiu tra md ta dt ngang, tiin citu.
Tat ea eae doi tuang duge phdt phiiu diiu tm. sau dd ehon Igc nhung ddi tugng cd yiu td nguy ddi vdi COPD khdm sing loc va do chdc ndng hd hd'p bdng mdy Chest H1105.
Chin doan va phan giai doan COPD theo GOLD 2010.
Kit qua: Tp Id bi COPD la 6,42%, trong dd nOchiim 16,87%, va nam chiem 83.13%,. nhdm tudi mic bdnh eao nhat > 60 tu6i chiem 59,81%,. Theo GOLD 2010 thi
bdnh nhdn bi COPD giai doan 2 chiim tp li cao nhat la 41,44%,.
SUMMARY
Chmnie obstmctive pulmonary disease (COPD) is increasing and one of the leading causes of death today. The cost of tmatment is very large, if not detected and tmated eariy will cause serious consequences for patients, their families and society.
Objective: To determine the prevalence of COPD in the city of Vinh.
Methods: cross-sectional descriptive sun/ey.
All subjects sun/ey forms, then select those with risk factors for screening COPD and respiratory function measumd by HI Chest 105 machines
Diagnosis and staging of COPD according to GOLD 2010.
Results: The prevalence of COPD was 6.42%
which accounted for 16.87%o females and males accounted for 83.13%,. The group with the highest disease> 60 yearn of age accounted for 59.81%. The
Y HOC THl/C HANH (879) - SO 9/20ir
