Y HOC VIET NAM THANG 8 - S01/2014
PHAN TICH TirCTNG QUAN GIITA NONG DO ACID URIC HUYET THANH V a i TlNH TRANG DINH DU'O'NG, HUYET AP
VA MOT SO CHI SO HOA SINH MAU
TOIVl TAT
Nghien ciili mo ta cat ngang tren 1910 doi tu'dng (935 nam va 975 nu) trong dp tuoi 30 trd len tei khu VI/C nfing thon nham phan tich mpt so yeu^ to tUPng quan den tang acid uric mau, ket qua cho thay:
Nong dp add uric mau co moi lien quan thuan c6
^ nghia thoiig ke (p<0,001) vdi vong eo, chi so vong eo/v6ng mfing, BMI, triglycerid, cholesterol, LDL-C.
Nghien ciiti da xay dutig dUdc 2 mo hinh tien lu'dng nong dp acid uric huyit thanh nhu sau:
AU (umol/l)= 48,7-62,2*gia (l:nam, 2:Na')+
1,17» tuoi (nam)+5,9*BMI(kg/m^) + 161,8 WHR AU (Mmol/l)=102,7-63,2«giiii (l.nam, 2 nil)+
l,22«tu6i (n8m)+4,92*BMI(kg/m') + 1,37* VE (cm).
Tit khoi: t3ng add uric mau, tu'dng quan, BMI, huyet dp, lipid mau.
SUMMARY
CORREUTION ANALYSIS OF SERUM URIC ACID LEVEL AND NUTRITION STATUS,
BLOOD PRESSURE AND SOME BLOOD BIOCHEMICAL INDICATORS This was a study conducted among 1910 subjects (935 males and 975 females) aged 30 and over at rural area to analyze factors associated with the increase uric acid in serum. Results showed that uric acid level had positive association with waist circumference, waist / hip , BMI, triglycerides, cholesterol, and LDL-C ((p<0,001). This study developed two models to predict serum uric acid levels as follows:
UA (pmol/l) = 48,7 - 62,2» gender (1: male, 2:
female) + 1,17* age (year) + 5,9*BMI (kg/m^) + 161,8 WHR
UA (pmol/i) = 102,7 - 63,2* gender (1: male, 2:
female) +,22* age (year) + 4,92*BMI (kg/m^) -i-1,37*
VE (cm).
Keywords: increase serum uric acid, association, BMI, blood pressure, blood lipid.
I.DATVANCI
Sif biing no ciia cac benh man tinh khpng lay dang xay ra manh me is cac nu'dc Nam A trong
* Truing Dal hoc Y Dudc Thai Binh
**flpYte
Chju trkh nhi^m chinh: Pham Thj Dung Email: DUNGFTaTBMCEDII.VN Ot: 0989.981.359 Phan bi?n khoa hoc: PGS.TS Ninh TTii Nhung Ngay nhSn bai: 24.5.2014
Pham Thi Dung*, TrSn Thi Giang Huomg**
do CO Viet nam. Trong may thap ky gan day, nhom beiih nay cang ngay can^ co chieu hu'dng gia tang ro ret. Hdn nii^, xu the gia tang nay so vdi cac nu'dc trong khu vu'c, cac nu'dc cd digu kien kinh te giong Viet Nam, thi cac bSnh kh6m lay man ti'nh tai Viet Nam cd xu the tang m nhanh. Nguyen nhan do ty le ngu'di Idn tuoi ngay mpt gia rang trpng dan so, tmh trang kinh te du'dc cai thien ro ret, mpt so hp gia dinh tir nglieo ddi chuyen qua sun^ tiie kha nhanh nhUnp nhifng hanh vl van hoa ve mat sifc khoS chuyen bien khong theo kjp vdi nhifng thay dS do kinh te mang^ lal, trd thanh nhiing rap Coin, nhifng yeu td bat idi ve mat sifc khoe mpt bp phan dan cu' [7]. Trong khi do nhieu dif lieu cho thay rang nong dp acid uric huyet thanh da t3ng len trong vai thap ky qua va nhieu bang chirng khoa hoc da khang djnh moi lien quan giQS nong dp acid uric Ijuyet thanh vdi cac benh man tmh kliong lay nhiem.
Tai Viet Nam, trpng thdi gian qua da co nhieu tac gia da quan tam nqhien cull ve tSng acid uric (AU) huyet thanh va cac yeu to lien quan nhufig chii yeu la nghien cifli tren cac doi tu'dng (juan ly sifc khde hoac nghien cifu tal benh vien. VI the, thiet ke nghien cifu tal cpng dong nham tim hieu mol tu'dng quan giifa nong dp add uric huyet thanh vdi tinh trang nhan trSci huyet ap va cac rol loan chuyen hda khac la ran thiet. Do dd, chiinp toi tien hanh nghien ciifu vdi muc tieu: Phan bch mffi tu'dng quan glifa non^
dp acid uric huyet thanh vdi mpt sff yiu to lien quan tdi tinh trang dinh dddng, hda sinh vs huyit ip.
II. OOI TUpNG VA PHUOfNG PHAP NGHIEN CUU 2.1. S&l tu'dng nghien cifu: Ngu'di tru'dng thanh 30 tuoi trd len hien dang sinh song t^i dja ban nghien ciTu.
Tieu chuan loai trif: Ngu'di dang mac cac benh nhiem triing cap ti'nh, benh ly than, benh ly tuyen giap, can glap, phu nif co thai va dang cho con bii.
2.2. Dja diem nghiSn cij'u v^ thdi glan nghien cii'u:
Nghien ciju du'dc tien hanh tai 4 xa Tan Phong, Song Lang, Minh Khai, Viet Hiing huyen Vu Thu' tinh Thai Binh trong thdi gian tir thaiig 11- thang 12 nam 2012.
66
Y HOC Vl|T NAMTHANG8-S61J2014 2.3. T h i i t ke nghien cu'u: Phu'dng phap
nghien ciJu djch t l hoc mo ta cSt ngang. ^ 2.4. Cach tinh c3 m i u va chon mau cho nghien cu'u
^ 2.4.1. Cd mMir. SCr dung cong thu'c tfnh cB mau cho dieu tra cat ngang:
^ < ' - " ' " iepY Trong do:
n: cd mau nghien culi
Z: Dp tin cay lay 6 ngu9ng a=0,05 (Z = 1,96) p: Ty le tang acid uric huyet thanh trong cpng dong, u'dc tinh p = 0,09
e: la he so tu'dng doi so vdi p, chpn E= 0,15 C3 mau theo tinh toan la 1727 doi tu'dng. di/
phong 15% bo cupc, loai trir, nen lam iron c8 mau chpn trong dieu tra la 2000 d6i tu'dng. Thi/c Is, chung toi da tien hanh nghien culi va phan tfch tren 1910 doi tu'dng.
2.4.2. Phu'dng piiap ciion mau. Chpn chu dgng huyen Vu Thu' dai dien cho vung thuan nong cua tinh Thai Binh, chon ngau nhien 4 xa trong vung de tien hanh nghien culi. Lap danh sach tat ca doi tu'dng 30 tuoi trd len hien dang sinh song tai dia banjighien cii'u lan lu'dt theo gHffi tinh va nhom tuoi. Chpn ngau nhien ddn bang phan mem R sao cho du cd mau 500 doi tu'dng/xa.
2.5. Xuf^ly va phan tich so lieu: So lieu du'dc nhap bang phan mem Epi data 3.1 va phan ti'ch bang Steta 10.0 vdi cac test thong ke sii' dung trong nghien culj y sinh hpc. Cac so lieu cua bien lien tuc du'dc kiem tra phan bo chuan tru'dc khi phan ti'ch. SCr dung cac test thong ke tham so: test t, test Anova vdi so lieu phan bo chuan, So lieu khong phan bo chuan sii' dung cac test thong ke phi tham so. Nhan djnh co su" khac biet khi ^ia tn p <0,05. Su' dung phu'dng phap Bayes de xay di/ng va lu'a chpn mo hinh toi uli tien lu'dng nong dp acid uric mau.
I I I . K ^ Q U A
Bang 3.1. Gia tn trung binh mot so chi so nhan trac, huyet ap va xet nghiem cua doi tu'dng nghien cCru -
c i c bien s6i Tuoi (nam) BMI (kg/mO Vpng eo (cm) WHR Acid uric Glucose mau (mmol/l)
Triglycerid (mmol/l) Cholesterol (mmol/l)
HDL-C (mmol/l) LDL-C (mmol/l) HATD (mmHg) HATT (mmHg)
G i i tri trung binh theo gidi tinh ( ^ ± SD) Nam
(n=935) 56,5±12,9
21,2±2,7 75,0±7,5 0,86±0,05 316,1±79,7
5,1±1,4 2,2±2,1 4,7±1,2 1,14±0,3 2,7±1,0 130,8±22,3 80,4±12,1
Nif (n=975) S6,2±12,9
20,9±2,7 72,0±7,5 D,83±0,a6 247,1±64,1
4,9±1,3 1,96±1,5
4,9±1,2 1,15±0,24 2,9±1,14 125,8±22,8
78,1 ±12,2
Chung (n=1910) 56,4±12,9 21,1±2,7 73,5±7,7 0,84±0,06 280,9±79,9
5,0±1,4 2,1±1,8 4,8±1,2 1,14±0,27
2,8±1,07 128,3±22,7 79,2±12,2
P
>0,05
<0,05
<0,001
< 0,001
<0,001
<0,01
>0,05
<0,01
<0,05
<0,01
<0,01
<0,01 nghien cifu la 55,4, khong co si/ khk biet giifa
nam va nif (Bang 3.1). Gia trj BMI trung binh d nam la 21,2 cao iidn so vdi d ni? la 20,9. Sir khac blpt cd y nghia thonq ke viS p^ <0,05. Tu'dng tif, vong eo trung binh va chi so vong eo/vdng m6ng (WHR) d nam cung cao hdn so vdi nif. Sir khac biet cd y nghTa thong ke vdi p <0,001. Cac chi so hoa sinh nhif cholesterol, glucose mau, LDL-C,
chi so huyet ap d nam cung cao hdn so vdi nif mpt each c6 y nghTa thong ke. Nong dp add uric huyet thanh trung binh la 280,9 jiitipl/1, nam (316,1 ^mol/l) cao hdn so vdi nif (247,lnmol/l).
Sif khac biet cd y nghTa thong ke vdi p<0,001.
C^c doi tu'dng nghien cifu cd BMI trung binh la 21,1 kg/m^; vong eo trung binh ta 73,6cm; niong dp glucose mau la 5,0mmol/l; ham lu'dng cholesterol trung binh la 4,8 mmol/l.
Bing 3.2. He s5 tu'dng quan gliia nong dp acid uric mau vdi mpt so chi so nhan trSc, huyet p va hiia sinh mau
men so Tudi BMI Vdnqeo
He s6 tu'dng quan 0,21 ^ 0,28 0,33
P
<0,001
<o,ooi
<0,001
Y HOC VIET NAM T H A N G 8 - SO 1/2014
Chi so W/HR Huyet ap tdi da Huyet ap toi thieu Glucose mau Cholesterol mau Triqiycerid
0,34 0,18 0,16 0,02 0,2 0,26
(*Testti
<0.001
<0,001
<0,001
<0,4
<0,001
<0.001»
Idng ke phi tham so: bl Qua bang 3.2 cho thay bien so vong^ eo va
chi so vong eo/vong^ m6ng|WHR} co he so tu'dng quan thuan cao nhat vdi nong do acid uric huyet thanh (r=0,34 va 0,33), tiep den la chi so Bivil, triglycerid, tuoi, cholesterol mau, huyet ap toi da.
Cac bien so ve tuoi, nhan trac va huyet ap deu co
tu'dng guan thuan vdi nong do acid uric mau mot each CO y nghTa thong ke vdi p<0,001. Tnang cac chi so sinh hda mau thi glucose co moi tu'dng quan rat yeu so vdi nong do acid uric mau. S\i khac biet khong cd y nghia thong ke vdi p>0,05."
Bieu do 3.1, Tu'dng quan giu:a nong d6 acid uric mau va mot so chi so nhan trSc, huyet ap va hda sinh mau
| , j J [ 0 2 8 j [ 0 3 3 j [ 0 3 4 j [ 0 ^ | 0 2 0 j [ 0 2 8 j L 0 1 6 ^
iSHaanHHS:
IBBEI
Bleu do 3.1 biiu dien mol tu'dng quan da bien glO^ nong dp add une huyit thanh vituol, BMI, vongeo, WHR, hu)rit ip, dddng miu vi lipid miu. Kit gua eho thiy ngoai mol tddng quan glifa add uric huyk thanh vdi dc yiu tff trin, bleu dd cdn chd thay cd mol tudng quan khi chit chi gluti BMI vi vong eo (r=0,69) vong eo va ehi sff WHR (r=0,85) cholesterol vi triglycend (r=0,43) tuoi va huyit ip.
^ng3.3. Mo hinh hoi quy tuyen tinh da bien tien lu'dng nong dp acid uric mau theo mpt sp tupi, gidi, nhan trac, huyet a
BiSn so Hang sp Tuoi Gidi BMI Vong eo WHR HA toi da HA toi thieu
H$ so R (%) Xac suat xuat hien mo hinh
p
He so anh hu'dngMo hinh 1 48,7 1,17 -62,3 5,9
0 161,8
0 0 30,2
0,46
Mo hinh 2 102,7
1,22 -63,2 4,9 1,37
0 0 0 30,2 0,43
Mo hinh 3 66,6
1,2 -62,3
5,1 0,76 91,5 0 0 30,3 0,04
M6 hinh 4 38,4 1,12 -61,9 5,7
0 159,9
0 0,21 30,3 0,04
Mo hinh 5 92,6 1,17 -62,8 4,8 1,35 0 0 0,2 30,3 0,03
Y HOC V l | T NAM THANG 8 - SO 1/2014 Trong nghien cifu nay, chiing toi sif dung
phu'dng phag Bayes de lu'a chon mo hinh toi u'u tien IUdng nong do acid uric theo cac yeu to lien quan. Cac bien so du'dc du'a vao mo hmh la tuoi, gidi, BMI, vong eo, WHR, huyet ap toi da, huyet ap toi thieu. Ket qua cd 5 mo hinh tot nhat dUdc phu'dng phap Bayes lu^ chon, cac mo hinh nay CKu giai thich du'dc khoang 30% sif thay doi nong do^acid uric giifa cac doi tu'dng (bang 3.3).
Chung toi lira chon 2 mo hinh nhu''sau:
M6 hinh 1 vdi kha nang xuat hien la 0,46 bao gom gidl tinh, tuoi, BMI, WHR. Mo hinh du'dc viet nhu sau:
AU (|Jmol/l)= 48,7-62,2*gidi (l:nam, 2:nif)+
1,17* tuoi (nam)+5,9*BMI (kg/m*) •(• 161,8 WHR MS hinh 2 vdi kha nSng xuat hi^n la 0,43 bao gom gidi tinh, tuoi, BMI, vong eo. Mo hinh du'dc Viet nhu'sau:
AU (Mmol/l)=102,7-63,2*gldl ( 1 : nam, 2:
nif)+ l,22*tuoi (nam)+4,92*BMI (kg/m^) + 1,37* VE (cm).
IV. BAN LU$N
Nghien cihj tren 1910 doi tu'png tuoi tif 30 trd len d khu vifc nong thdn da cho thay nong dp add uric huyet thanh trung binh la 280,9 )imol/l, nam (316,1 pmol/l) cao hdn so vdi nif (247,lnmol/l). Sif khac biet cd y nghTa thong ke vdi p<0,001. Danh gia tu'dng quan giifa nong dp acid uric mau vdi mpt so bien so ve tuoi, gidi, nhan trSc, huyet ap va hda sinh mau, chung toi thay cac bien so nay deu cd tu'dng quan thuan vdi nong dp acid uric mau. He so tu'dng quan gap cao nhat d nhdm nhan trac (0,28 den 0,34), sau do dgn triglycerid (0,26), tuoi (0,21), cholesterol (0,2), huyet ap toi da (0,18) va huy^et ap toi thieu (0,16). Ket qua nay cua chung toi cung tu'dng du'dng vdi mot so nghiSn cifu trong va ngoai nu'dc. Tac gia Pham Ngpc Kieu nghien ciJu tai An Giang cung khSng djnii mpi tu'dng quan thuan chieu va rat ch|t che giij^ cac chi so nhan trac va huyet ap vdi nong dp acid uric huyet thanh [2].
Nghien ciiu ciia Chau Ngpc Hoa cung cho thay moi lien quan thuan chieu, chit che giiia tSng acid uric huyet thanh vi tang huyet ap [1].
Nghien cifu tal Thai Lan tren nhdm doi tu'png trong life lu'dng quan dpi, ket qua chp thay nong dp add uric huyet thanh cd sif tuUng quan thuan kha chSt che vdi gia trj huyet ap tim thu [6].
Nhieu righien cifu da dua ra nhifng bang chung cho thay su' ket hdp gliia tang triglycerid va add uric mau du'dc xac djnh chac chan. Cd den 80%
ngu'di ting triglycerid cd t3ng add uric huyet thanh va cd tdl 50-70% benh nhan giit cd triglycerid tSng.
Tuy v$y, ngoai mol tu'dng quan thuan vdi acid uric huyit thanh, ket qua nghien cifu ciia
chung toi the hien tren bieu do tu'dng quan da bien cho thay ngoai tu'dng quan thuan giiia nong dp add uric vdi cac bien so tuoi, gidi, nhan trac, huyet ap va hda sinh mau thi cac bien so nay cung cd tu'dng quan rieng vdi nhau. Do vay, khi xac dinh moi lien quan giifa acid uric huyet thanh va cac yeu to trong mo hinh hoi quy tuyen tinh da bien can can nhac, danh gia anh hu'dng tu'dng tac va cpng hu'dng giifa cac yeu to lien quan de loai bd nhieu. Do dd, khi xac djnh mol lien quan giiia nong dp acid uric va cac yeu to nay, chung toi da sir dung phu'dng phap Bayes de loai trir tu'dng tac, cpng hu'dng va yeu to nhieu.' Xay difng mo hinh tien lu'dng nong do acid uric, diiing toi chi sif dung cic yeu to tuoi, gidi, nhan trSc va huyet ap. Cac chi so hda sinh mau chung toi khong dua vao mo hinh do tinh den y nghTa thifc tien cua van de nghien cim.
Ket qua da xay dufig du'dc 2 mo hinh tien luang. Tuy yeu to huyet ap cd lien quan chat che den nong dp acid uric huyet thanh nhdng 2 mo hinh tien lu'dng tot nhat ma phu'dng phap Bayes chpn lua da loal_trif ca yeu to huyet ap toi da va huyet ap toi thieu. Hal md hinh du'dc xay dimg giong nhau 3 yeu to tuoi, gidi va BMI, chi khac nhau yeu to danh gia beo bung (mpt mo hinh sir dung chi so vong eo, mpt m6 hinh sif dung chi so vdng eo/vdng mong). Va vdi 4 yeu to nay, ca 2 mo hinli deu giai thich dudc khoang 30% sif khac biet ve nong dp acid uric giifa cac dpi tu'dng. (jua 2 mo hinli cho thay, nong dp acid uric huyet thanh tang dan theo tuoi, BMI, vdng eo, chi sd vdng eo/vong mong. Day cung la cac y§u to lien quan den cac bpnh man tinh khdng lay nhiem. Trong khi dd,^ganh nang cua cac binh mpn ti'nh khong lay nhiem dang gia tSng nhanh tren khap the gidi. Cac benh man tfnh da dong gdp khoang 46% ganh nang benh tat toan eSu nam 2001 va ty le nay se tang len den 57% vao nSm 2020 va chiem tdi VA SO nguyen nhan tiJ vong tren toan the gidi [7]. Nhieu nghien ciJu da xac djnh cd mdi lien he kha ro r^ng glifa tinh trang tang add uric hu^et thanh vdi mpt Sd bSnh man tinh khong lay nhiem nhat la cac tienh iy tim mach nhu' suy tim, nhoi mau cd tim, dot quy.
T2ng acid uric huyet thanh du'dc tim thay d khoang 60% benh nhan nhap vien vl suy tim man tinh mat b'ii. Them vao dd, tang acid uric huyet thanh cung cd lien quan tdl tinh trang de khang insulin, thieu oxy mo, tancj san xuat cytokine va cac goc tif do nen co the anh hu'dng den he thong tim niach va lam tien lu'dng d nhiitig benh nhan nay xau di^ Nguy cd ting huyet ap cung cao hdn dang ke d nhifng benh nhan cd acid uric huyet thanh cao > 400pmbl/l so vdi nhiilig ngu'di cd add uric mau <200pmol/l.
Trong so nhihig benh nhan tSng huyet ap khong
Y HOC VlgT NAM T H A N G 8 - SO 1/2014 dieu tri, hien tu'dng suy giam dong mau dpng
mach vanh d ngu'di co kem tang acid uric mau cao hdn nhieu so vdi ngu'di cd acid uric huyet thanh binh thu'dng. Mat Wiac, ngay cang cd nhieu nghien cuU cho ket qua thuyet phuc rang tang acid uric huyet thanh co lien quan chat che vdi hpi chutig chuyen hda va xd vuei dpng mach canh do lam ton thu'dng Idp noi mo mach mau [3],[4],[5]. Nong dp acid uric cao trong huyet thanh cijng cd lien^quan vdi tang nguy cd phat trien cua gan nhiem md khong do ru'du, lien quan tdi beo phi va roi loan lipid mau. Do vay, kiem soat nong dp acid uric huyet thanh nhat la d cac doi tu'dng thCra can, beo phi, tang huyet ap va roi lo^n lipid mau la mpt trong nhu'ng bien phap ki^m soat, phong chdng cac benh man tinh khong iSy nhiem.
V. K i t LU^N
Nong dp add uric mau cd moi lien quan tiiu^n CO y nghTa thong ke (p<0,001] vdi vong eo, chi so vong eo/v6ng mong, BMI, triglycerid, cholesterol, LDL-C. Nghien culi da xay dirng du'dc 2 mo hinh tien lu'dng nong dp acid uric huyet thanh nhu" sau:
AU (iimol/l)= 48,7-62,2*gidi (l;nam, 2:NuO+
1,17* tuoi (nam)+5,9*BMI(kg/m^) + 161,8 WHR AU {|jmol/l)=102,7-63,2*gidi {l.nani, 2 niJO+
l,22*tu6i Cnam)+4,92*BMI(kg/m^) + 1,37* VE (an), VI. KI^N NGHI
Trong chien lu^c giam ty le mSc va tif vong do cac benh man tinh Wiong lay nhiem, can quan
tam kiem soat nong dp acid uric huyet thanh nhat la d cac ddi tu'dng thu^ can, beo phi, tang huyet ap va roi loan lipid mau,
TAI LIEU THAM KHAO
1. Chau Ngpc Hoa, Le Hoai Nam (2009), "Khao sat nong dp add uric huyet Oianh 6 benh nhan tSng huyet ap va nguicfi twnh thu&ng", tap dii Y hoc thanh pho Ho Chi Minh, I3(phu ban s61), tr. 1-5.' 2. Pham Ngpc Kiiu, Pham Ngoc Trung and Ngd
Van Truyen (2012), "Nghien ciTu nong do add uric huy^ thanh is ngu'di t5ng huyet ap nguySn phat", Tap chi N5i ti^ - Dal thao du'dng, 6, tr.
695-699,
3. Alexander S. and T. Bernard (2010), "Uric acid transport and disease", J Clin Invest, 120(6), pp.
1791-1799.
4. Baliarsingh S. and N. Sharma (2012), "Semm uric acid level is an Indicator of total cholesterol and low density lipoprotein cholesterol in men below 45 years in age but not older males", Clin Lab, 58(5-6), pp. 545-550.
5. Chlou W. K., D. H. Huang, M. H. Wang, Y. J.
Lee and J. D. Lln (2012), "Significance and association of semm uric acid (UA) levels with components of metabolic syndrome (MS) in the elderly". Arch Gerontol Geriatr, 55(3), pp. 724-728, 6. Ouppatham S., 5. Bancha and P. Choovichlan
(2008), 'The reiationship of hyperurlramia and blood pressure in the Thai army population", ] Postgrad Med, 54(4), pp. 259-262.
7. WHO (2011), Global status report on noncommunicable diseases 2010, WHO press, Geneva, Switzerland.
NGHIEN CU'U GAN BACH CAU DIEU TRI BACH CAU CAP D6NG LYMPHO sir DUNG MAY TACH TE BAO TIT DONG
T 6 M TAT
0§t vSn de: Tinh b?ing iT tr? bgch cau thiTdng g9p trong b^nh ALL co SLBC cao. Mi^c tieu: Nghien
* Trudng D^i hoc Y Ha Npi
** Vl?n Huyet hpc - Truyen mau Tmng u'dng Chju trach nhiem chinh: Nguyen Ha Thanh Eniail: ha thanh nouven vhhtmfflyahoQ.com Ot:0913.086.463
PhSn bi?n khoa hpc: PGS.TS Bach Khanh Hoa Ngay nhan bai: 11.6.2014
Nguyin Ha Thanh*, Nguyin Qu6c Nh^t**
cuiU sir thay doi SLBC, mot so chi so tS bSo wh sinh h6a mau d b^nh nhan ALL co SLBC cao dieu trj bSng phudng ph^p gan bach cau. Ooi tu'dng vd phu'dng phdp: 25 b$nh nhan ALL co SLBC cao diieu tri bSng g^n bach cau si^ dung may COBE SPECTRA tai Vl§n HH-TM TW tCr 2/2011 - 1/2012. Nghien cilU can thiip lam sang. KSt qua: (1) Sy thay doi SLBC vh hemoglobin sau gan: (a) SLBC gISm dang ke ngay sau gan v^ sau 24 gid vdi trj so tu'dng utig la: 306, 208 v5 187 X :OVL (P<0,01); (b) Hieu su3[t l^m giam SLBC ngay sau gan va sau 24 gid ^n luipt Ih: 32,1% vS 38,9%; (c) Nong dp Hb giam ngay sau gan (tri sfi 70
