Y HOC VigT HAM T H A W G 8 • s 6 2/2014 134,0 ± 5,56 mmol/l. Co mdt so BN cd ha natri
mau thffdng xay ra d trong cac trffdng hdp VTC tang triglyceride do Iffdng lipid mau tang cao.
Mffc canxi mau toan phan trung binh la 1,8 ± 0,48 mmol/l. Dieu nay tffdng tff nghien cffu ciia Bui Van Khich [4] va cao hdn ket qua cua Nguyen Thi Hang [ 3 ] . Ket qua nay Idn hdn cac nghien cffu khac cd the do BN den mudn va ty le BN bj VTC hoai tff nhieu.
Chup CTscanner 6 bung cho cac BN trong vong 24 gid dau nhap vien va thay phan Idn BN VTC cd diem CTSI I^ 3 diem (29,6%), phili hdp vdi k ^ qua nghien diu cua Vu Dffc Djnh [ 2 ] . BN cua chunci toi phan Idn den sdm trffdc 72 gid va chu yeu la VTC tiie nhe, tuy nhien mpt so tac gia cung nh$n djnh rang: trong 72 gid dau mffc dp hoai tff chu^ danh gia day du mffc dd nSng ciia VTC. Si§u am d bung la mpt phffdng pliap can Iam sang^ khdng xam nhap dffdc sff dung nhieu trong chan doan benh cung nhff cac dau hieu khSc, dac biet d nhiitig trffdng hdp cd chong chi dinh doi vdi chup CLVT nhff suy tiian cap, phy nu"
cd thai. Ket qiia nghien culi cua chiing toi thap hdn so vdi nghfen cffu khac cd the do cac BN trong nghien cuff ciia chung ^ 1 chu yeu d pha d i p ti'nh vao vien sdm hdn. Tran dich mang phdi cd the gay tinh trang khd t h d , giam oxy hoa mau, suy hd hap. Day dffdc coi la dau hieu tien lu^ng nang trong VTC.
Nghien cffu 115 benh nhan viem tuy cap thay t y j e nam/nff la 6 , 1 / 1 ; trung binh 45)16 ± 13,5 tuSi. Hau het benh nhan cd trieu chiihg dau bung (99,1%), buon ndn (89,6%), diem sudn Iffng dau (74,8%) va chffdng bung (87,0%).
Ve can Iam sang thay hau het benh nhan co amylase mau tang > 3 I3n binh thffdng (72,3%).
Ngoai ra, cdn cd tang CRP, tang ure, creatinin, rdi loan md mau, dffdng mau va giam natri mau.
Chup CTscanner 6 bung trong vdng 24 gid dau nhap vien va thay 2 9 , 6 % benh nhan cd dian CTSI la 3 diem (29,6%). Tren sieu am thay ed soi mat (14,8%) va dich mang phdi (57,4%)
TAI LIEU T H A M KHAO
1 . Cao^Xuan Cd ( 2 0 1 2 ) , Nghien cilU gia tii ciia ap iiTc 6 bung trong chan doan mffc dd vci theo doi dien bien cua viem tuy cap, Luan dn Ti^n sT y hoc, Tru'dng Oai hoc Y Ha N^i.
2. Vu Dffc Djnh ( 2 0 1 2 ) , Nghien ciili d i e diem lam sang, mpt so chi so can lam sang va hieu qud dieu tri ciia lieu phap Ipc mau lien tuc d b^nh nhan viem tuy cap n^ing, Luan an Tien s9 y hpc, Trff&ng Oai hpc Y Ha Noi.
3. Nguygn Thj H^ng ( 2 0 0 2 ) , Nghien cuff d3c diem lam sdng - can lam sang va hinh dnh sieu am cua viem tgy cap, Lu^n vdn ^ t nghiep bac s9 chuyen khoa cap I I , Tn/dng Oai hoc Y Hd Ndi.
4 . Bui Van Khich (2004),' Nghien cuff d$c di^m lam sdng, c|in lam sang vd ket qua dieu bi viem tuy cap nSng tai khoa Hoi sffc cap dtu - Benh vi^n Bach Mai", Luan vSn tSt nghiep bac si chuyen khoa I I , Trffdng Dai hoc Y Ha Npi.
5. Chang M. C. et a l . ( 2 0 0 3 ) , "Etiology of acute pancreatrtis--a multi-center study in Taiwan.", Hepatogastroenterology. 50(53), tr. 1655 - 7 6. Fabio Cesare Campanile (2013),
"aassification of acute pancreatitis-2012:
revision of the Atlanta classification and definitions by international consensus" Gut. 62, tr. 102 - H I 7. Jordanov P., Grigorov G. ( 2 0 1 2 ) , "Predictors
of Mortality in Acute Pancreatitis: A Retrospective Study", Pancreatology, 3(1), WMC002925.
NGHIEN ClhJ MOT S6 VEU T 6 LIEN QUAN TRONG BfiNH ZONA
T6MTAT
NghiSn cuff 170 benh nhdn zona di€u tri tai Khoa Da lieu-Dj ling Benh vien TL/QO 108 tff 02/2013 den 03/2014 cho ket qud: nam bi benh 67,6%, nff Id 32,4%; 88,8% benh nhan ffeii 50 tuoi, benh nhdn cdng cao tuoi thi cdng hay bj zona mffc dp n$ng
* Khoa Da liSu-Dj img EVn/QO 108 Chju trach nhiem diinh: B u i T h i V a n Email: [email protected] Dt; 0983.661.030 Phdn bien khoa hpc: PGS.TS Ddng VSn Em Ngdy nhdn bdi: 3U.6.2UI4
Biii Thj Van*
(p<0,05);78,2% benh nhan cd tien bieu va co tien trieu khdng dnh hffdng den mffc dp b^nh zona.
Td khoa: zona, ygu to lien quan.
S U M M A R Y
RESEARCH OF FACTORS RELATED SHINGLES The study of 170 shingles patients freated at Department of Dermatology-Allergology Hoaiital 108 from 02/2013 to 03/2014 result: 67.6% male patients, women 32.4%; 88.8% of patiente over 50 years of age, more etderiy patients are more severe (p<0 05), 78.2% in patients with prodromal pain and prodromal pain does not affect the severity of shingles.
58
Y HOC VrET NAM THANG 8 - s 6 2/2D14 Keywords: shingles, factors related shingles.
I. CAT VAN o t
Benh zona la mpt benh da hay gap, do virus hu'dng da va than kinh Varicella Zoster Virus (VZV) gay nen. Hang nam tren the gicli co l<hoang 600000-850000 ngu'di bj benh Zona. Tal Viet nam benh zona chiem 5,33% tong so cac benh da dieu tri tai Benh Vien Da lieu Trung l/dng tir nam 1994 den 1998 [trich dan theo 1].
Lim sang benh zona la mun nu'dc thanh chum tren nen da viem do doc theo mot day than Idnh ngoai bien. Dau la mot tneu chCrng quan trang tiong benh zona. Bau co the co tru'dc khi co ton thuHng ngoai da (tien trieu) va keo dai ke ca khi ton thu'dng da da lanh seo (dau sau zona). Qieu tri benh c^ng scfm thi han che du'dc dau sau zona.
6 Viet nam GO it nghien cutj di sau tim hieu cac yeu to lien quan cua benh zona. Chung toi tien hanh de t3i nay nham muc tieu: "Nghiin c&u mot so cic y&j to lien quan trong ttenhztma".
II. o d l TirONG VA PHirOTMG PHAP NGHIEN CIJU - Doi ti/dng: 170 benh nhan zona dieu trj tai Khoa Da Iliu-Dj ulig BSnh vien Tt/QB 108 Xit 02/2012 den 03/2013.
- Phircng phap nghi§n cuti: Tien culJ, mo ta cat ngang. Mau thuan tien, chpn tat ca benh nhan du'^c chan doan xac djnh la Zona dieu trj tai Khoa Da lieu-Dj iJTig BVTLTQB 108 tit thang 02/2012 den thang 03/2012.
- Xu' ly so lieu: Tat ca so lieu du'dc xit ly bSng phan mem SPSS 16.0 for windows.
III. KfrQUANGHl£N CU'U Bang 3,1. Phan bo theo qldi
Gidi
%
Ty le nam/nij' 67,6 ~TIA'
T6na
Nh$n xit: Bang 3.1 cho ket qua lEi Benh zona gap chu yeu d nam gidl (nam chiem 67,6%, ni? chlan 32,4%).
Bing 3.2. Phan bo theo tuoi ' Nhom tuoi
40-49
60-69Tonq
50 170
J , 2 _
.Al_
J92I
T W T
100,0Nhin xit: Ket qua tai bang 3.2 cho thay du'di 20 tudi khong gap ca nao, benh gap chu yeu d nhdm benli nhan tren 50 tuoi (tren 50 tuoi co 88,8%).
Bing 3.3. Lien quan gliia tuoi va mu'c do benh (n=170) TSffi
<3ir
50-69
JMi T T T
NBe 0 (0%) 0 (0%) 4 (3,9%)
1 (2,1%)Mita
1 (50,0%) 9 (52,9%) 55 (53,4%;12 j25;0%)
Nang
1 (50,0' 8 (47,1%)44 (42,7%)
35 (72.9%)T6ng
2 (100,0%) 17(100,0%) 103 (io6,o%T48 (100,6%)
I u I 0)044 (y^= 12,928) i Hh^n xet: Qua bang 3.3 cho thay benh zona d benh nhan du'di 70 tudi gap deu d mii'c do viia va
nSng, con tren 70 tuoi gap chu yeu d mut do nang (p<0,05).
Bina 3.4. PhSn bo theo thdl qian nhap vien ' Thdi giaiT
l\lh^n xit: qua
<3 nqay 3-5 nqay
>5 nqay Tonq bang 3.4 cho thay benli tixing dd truHc 3 ngay cd 25,3%
170 nhan nhap vien sau kh
313:
T S r
38,8
~m(r
bj benh triklc 5 ngay chiem 61,2%,
Y HOC VIET NAM THANG a . SO 212014 Bing 3,5. Lien quan giiia thdi qian nhap vien va mu'c do benh Thdi gian~
2 (4,7%) Vu'a Nang Tong
<3 nqay 16 (37,2%; 25 (58,1%; 43 (100,0%)
61 (100,0% "
3-5 nqay 1(1,6%) 31 (50,8%: 29 (47,5%:
66 (100,0%)"
>5 nqay 2 (3,0%) 30 (45,5% 34 (51,5%
p I 0.67 (/=2,361)
Nhin Jf^fr Ket qua tai bang 3.5 cho thay thdi gian bi benh tru'dc khi vao vien khong anh hu'dng tdi mu'c dp benh (p>0,05).
Bing3.6.'\an suat qgip trieu chutig ti^n trieu
Nhinxiti
Co tien trieu Khonq cd tien trieu
Tonq
"ny
Qua bang 3.6. cho thay 78,2% benh nhan cd trieu chirtig tien trieu.
Bing 3.7. Phan bo theo thdi qian tien trieu (n=133) Thdi gian (ngay)
0 1 2 3 4 5
>5 Trunq binh
Tonq ua tai bang 3.7 la da sd ben
n
32 0
60 15 12 5 92,47 133 h nhan cd thdi gian
%
024,1 45,1 11,3 9,0 3,8 6,7
±1,59 100,0 tien tri?u 2 ngay (en cd 6,7% binh nhan co thdl glan tien trieu tren 5 ngay.
Bang 3.8. Phan bo theo trieu chiilig tien trieu (n=133) Bau nhifc
Trigu chu'ng Rat
Ngua_
So Itfdt gap 92
35 26,3
I "rang cam ' ] 1 I OTT"
Nh$n x^t/Qua kjt qua tal bang^3.8 ta thay cac trieu chimg tien trieu hay gap la dau nhirc va rat tai viing da se moc ton thu'dng vdi tan suat gap lan Wdt la 69,2% va 26,3%.
Bing 3.9. LISn quan qiPa tien trieu va mifc do benh
Tlilntrl$u
Mifc ap benh""'""f Nhe I Viia I Nanq ' ° " g P Khdng 2 (5,4%)" 18 (48,6%) 17(45,9%) 37 100.0%) S;496—
I Co" ) 3(2,3%) I 59 i44'4%) | 71 (53,4%) I 133 (100,0%) I (x'= 1,403) Nh$nxit:ca va khdng cd tien trieu ciing khdng anh hu'dng tdi mifc dd benh (p>0,05).
IV. BAN LUAN 4.1. GIdl b'nh
Mpt so nghien cdli tren the gidi cho thay ty
\k m k benh zona d ca nam va nLf la tifdng duUng nhau [6]. Tai Viet nam, theo nghien ciili ciia Nguyen Manh Cudng (2001), ty le mac benh d nam gidi la 69,2%, nif gidi la 30,8%i [3], theo Bang Vln Em va cpng sif (2005) thi ty ie mac benh d nam gidi cao gap 3 i n d ni? gidi [4].Theo Nguyen Lan Anh (2011), ty I? mac benh zona d nam gidi la 68%, ni? gidi la 32% [1]'. Theo ket qua nghien cufu ciia chiing toi thi ty le mac benh
ciia nam gidi la 67,6%, ciia nif gidi la 32,4%
(bang 3.1) phii hdp vdi cac tac gia trong nu'dc.
4.2. Tuoi mac b|nh
Benh_zona co the gap d bat ky lifa tuoi nSo, trong suot cupc ddi nguy cd bj zona dao dpng tii 10-30% va nd lien quan chit che vdi tuSi. Ty 18 nay tang dang ke theo tuoi. theo GabuttI (2010), CO 61,9% benh nhan zona trln 65 tu6l( trong do 26% benh nhan cd tuoi tif 65 den 74 va 35,9%
benh nhan tren 75 tuoi) [6].
Trong nghien cifu ciia chiing toi khong gSp benh nhan nao nhd hdn 20 tuoi va benh gip cliil
Y HOC VlgT NAM THAHG 8 • s6 2/2014
yeu d ngu'di tren 50 tuoi (88,8%), trong dd tren
70 tuoi chiem 30,0% (bang 3.2). Bleu nay cung cd the du'dc giai thich vi Benh vien Tl/QB 108 la b^nh vien tuyen cuoi toan quan nen doi tu'dng phuc vu d day chii yeu la can bp cao cap nen so ngifdi cao tuoi gip nhieu hdn.
Lien quan gii?a mifc dp benh va tuoi ddi ciia ngu'di benh; Qua nghien cdu ciia chiing tdi cho thay benh nhan du'di 70 tuoi thi ty le giOa nhdm benh nhan mifc dp vim va mifc dp nang la tifdng du'dng nhau. Cu the la d nhdm benli nhan du^l 30 tupl cd 2 benli nhan thi nhom binh nhan mii'c dp nhe khong cd benh nhan nao, cd 1 benh nhin d, mifc dp vifa va 1 b^nh nhan d mii'c dp ning. O nhdm benh nhan tupl ddi tif 30 den 49 cd 17 benh nhan cd 9 (52,9%) benh nhan d mifc dp viia va 8 (47,1%) E>§nh nhan d mifc dp ning.
6 nhdm benh nhan tuoi ddi tif 50 den 69 tiiudi cd 44 benh nhan thi 55 (53,4%) benh nhan d mifc dp viia va 44 (42,7%) b^nh nhan d mifc dp ning. Cdn nhdm benh nhan tren 70 tuoi cd 48 benh nhan thi cd 35 (72,9%) benh nhan d mu'c dd nang, cd 25,0% benh nhan d mifc dp viia va 2,1% binh nhan d miJc dp nhe (bang 3.3). Nhu' v|y, benh nhan cang cao tuoi thi cang hay bj zona d mifc dp ning (p=0,044).
4.3. Then glan mac b^nh (tuSi b|nh)
Theo Nguyen Manh Cu'dng (2001), ty I? benh nhan bj benh du'di 7 ngay II 38,5% va tj* II benh nhin bj binh tren 7 ngay la 61,5% [3]. Kit qua t?l bing 3.4 ciia chiing toi cho thay t / le benh nhan bj benh d u ^ 5 ngay la 61,2% (trong dd bj binh difdi 3 ngay la 25,3%, tif 3 den 5 ngay la 35,9%) va trln 5 ngay la 38,8%. Bieu nay cho thay theo thdi gian nh$n thifc cda benh nhan ve b|nh tot dan len va ho den binh vien dieu trj sdm hdn.
Lien quan glQa thdl glan tru'dc khi vao vien dieu trj va mii'c dp benh: Qua kit qua tai bang 3.5 ta thay khong cd sif khac biet ve sif phan bo mii'c do benh gii?a cac nhdm vao vien dieu tri sau khi bj benh truidc 3 ngay, tif 3-5 ngay hay sau 5 ngay (p>0,05).
4.4. Tien tii|u
d c trieu chihig cd the gip trong glal doan khdl phat gSm; dau nhiJc, rat nhu' phai bon^
dau gilt tifng cdn, ngiia hole ting cam tai cho sip mdc ton thudng. Cac trieii chiing nay thu'dng c6 bTiliic khi noi ton thu'dng da tif 1 den 5 ngay, nhutig cung cd the keo dai tdi 30 ngay [7]
Ket qua nghien ciJu ciia chiing toi cho thay cd 78,2% b?nh nhin cd trieu chutig tien trifu (bang 3.6). Ket qua nay cung phii hdp vdi nghien cilli cda Benbemou (2011) so ngu'di cd trieu chiitig tien tri|u la 74% [5] va nghien cxiu cua lOaus Wolff (2005) 84%^l]^nh nhin zona cd bleu hlln dau tru'dc khi noi ton thu'dng [7]. Theo Trln
The Cong trong so 150 benh nhan zona thi cd 87 (58%) benh nhan cd tien trieu con 63 (42%) benh nhan khong co tien trieu [2].
Thdi gian tien trieu; Theo ket qua ciia chiing toi tai bang 3.7 trong 133 ca cd trieu chiitig tien trieu thi thdi gian tien trieu chii yeu tru'dc 2 ngay chiem 69,2% (trong dd i ngay chiem 24,1%, 2 ngay chiem 45,1%), tren 5 ngay chi cd 6,7% va thdi gian tien trieu trung binh la 2,47 ± 1,59. So sanh vdi tac gia'Benbernou (2011) thi thdi gian tien trieu trung binhja 4,7 thi ciia chiing toi thap hdn [5]. Theo Nguyen Lan Anh (2011}, thdi gian tru'dc kht noi tdn thu'dng hay gip nhat la tif 1-3 ngay (60%). [1].
Cac trieu cliutig tien trieu; Theo ket qua t§l bang 3.8 thi trieu chiitig t^n trieu hay gap nhat la dau nhifc tai cho se nol ton thu'dng vdi tin suat ^Ip la 69,2%, tiefi theo la rat nhu' phai bdng gip d 26,3% benh nhan, dau gilt timg cdn §lp d'l4,3% benh nhin, ngua cung gap d 3,0 beiih nhan va cd 1 benh nhin (0,7%) co t|ng cam tal cho se moc tori thu'dng. Tlieo Nguyen Lan Anh trieu chiitig bin tri|u hay gap nhat la dau nhiic (58%), cdn dau rat chi gip do 6%, ngiia gap 4%
[1], Theo Dang Vln Em va cpng sir (2005), 100% benh rihan cd tien trieu trUdc 1-3 ngay vdi cac trieu chutig tien trieu la dau rat, dau e Im viing sip mpc ton thu'dng [4J.
Liin quan gliia thdi tien tri|u va mi?c d&
benh: Qua kit qua tai bang 3.9 ta thay khdng co su' khac biet ve sif phan bd mifc dp benh giDa cac nhdm cp va khpng cd tien trieu (p>0,"05).
V. K f r LU$N
- Ty le mic benh zona ciia nam gidi la 67,6%, ciia nifgldj la 32,4%.
- Ty II mIc binh zona d ngu'di trln 50 tuoi la 88,8%, ngu;Si trln 70 tuoi la 30%, benh nhan cang cao tudi thi cang hay bj zona d mii'c dp nang (p<0,05).
- 25,3% benh nhin nhap vien truidc 3 ngay, 74,7% benh nhin nhap vien sau 3 ngay bj benh, thdi glan nhap vien khong anh hu'dng tdi riiirc dp benh zpna (p>0,d5).
- 78,2% benh nhin cd dau xuat hlln tru'dc khi cd ton thudng da trun^ binh 2,47 ± 1,59 ngay, trong dd hay gap nhat la dau nhifc: 69,2%, dau rat:
26,3%, dau glat: 14,3%, cd triiu chilTig tlin trieu khdng anh hifcing tdi mifc dp benh zona (p>0,05).
TAI LIfUTHAM K H A O
1. Nguyen Lan Anh (2011), Nghiin cifu tinh hinh,
die diem lam sang va dinh gli hl$u qua dlSu tti tienh 2ona bing kem Lo hgl AL-Q4 kit hdp Acyclovir, Luln v3n th?c sy y hgc, Hpc vien Quan y. Ha npi.
2. TiSn The Cong (20D7), Nghien ctiU tinh hinh,
dac diem iam sang va tac dung giam dau bing
phic do Acyclovir phdl hdp Neurontln tren binh
Y HQC VItT NAM THAHG 3 • s 6 212014 nhan Zona, Luan vSn thac sy y hpc, Hpc vien
Quan y, Ha npi.
Nguyen Manh Ctrdng (2001), Nghien atu hinh thai lim sang va danh gia kit gua dieu tn benh zona tal, Lu|n van thac sT y hpc, Dai hpc Y iia Npi.
Dang VSn Em, Ngo Xuan N g u y ^ (2005),
"Nghien cuU mot so dnh hinh va dac diem lim sang benh Zona dieu th nol tru tal Khoa Da ilSu BVU/QD 108", Tap dii Y hoc Biyc ha'nh so 3, tr. 27-29.
Benbemou A., Droiet M., Levin m. va CS.
(2011), "Assodation between prodromal pain and the severity of acute herpeszoster and utilization of
health care resources", Eumpean Journal of Pain, Volume 15, Issue 10, Novemlier, pp. 1100-1106.
Gabutti G., Serenelli C , Sarno O. va CS.
(2010), "Epidemiologic features of patients aifected by herpeszoster: Database analysis of the Fen'ara University Dennatology Unit, Italy", Medeane et Maladies Infectieuses, Volume 40, Issue 5, i^ay, pp. 268-272.
Gary J Bennett and C Peter N Watson (2009), "Herpes zoster and postherpetic neuralgia: Past, present and futur", Pain Res Manag. Jul-Aug; 14(4), pp. 275-282e.
NGHIEN CO'U DAP U'NG MU'C DO PHAN TU"
6" BENH NHAN LO Xfi MI KINH DONG BACH CAU HAT DU'O'C DIEU TRI BANG IMATINIB
T(5M TAT
Imatinib I I thuoc dj€u tn nhim dich dieu trj benh CML, giup bgnh nhan dat lui benh mifc dp te bao di tnjyin v i phan tOi. Mvc t i i u : Xac djnh ty le va thdi gian dat bjl dap iilig mifc dp phan tif, co yeu td can t h i ^ lam sing. 061 tu'dng; 97 b^nh nhin CML giai do?n man ttnh dieu 01 tai Vi?n HH-TM TW tir 2010- 2013. Phu'dng p h i p : Nghien aiti mo ta cSt ngang ben ot\i, cd y€u t d can thl|p lam sing. K€t qua:
45,3% bgnh nhan dat lui b^nh hoan t o i n mifc dp phan tif (CMR). Thdi glan bung binh d ; t CMR tif Iiic dieu trj Imatinib la 16,7 thing. Bap iilig miiC dd phan bi' ting din theo thdl gian dieu tri.
Tir khda: CML, Imatinib, lui binh miit dp phan tif S U M M A R Y
STUDY OF MOLECULAR RESPONEIN CML PATIENTS TREATED W I T H I M A T I N I B Imatinib is the TKI using for treatment of CML, with high rate of cytogenetic and molecular response.
Directive: (1) To evaluate molecular respone of Imabnlb treatment. Sul^ect; 97 CML patients treated liom 2009 to 2013 in NIHBT Methodology: cross- sectional study, with dinicai inten/ention. Results:
There were 45.3% patients got complete molecular respone and the median time to reach CMR from starting treabnent was 16.7 months.
•VIenHH-TMTW
" T n i S n g O a l h p c y H I N d l Chju b l d i nhl^m chinh; Nguyen H I Thanh Email: [email protected] Bt; 0913086463
Phan bl$n khoa hpc: PGS.TS B^ch Khinh Hda Ngiy nh|n bai; 30.6.2014
Nguyen Thj Thao*, Le Xuin Hai*, Nguyen Ha Thanh**
I.OATVANOI
Ld-xe-mi kinh ddng bach c3u hat (chronic myeloid leukemia - CML) la mpt b i n h ly ac tinh he tap mau cd d i e diem chinh la tang sinh ddng bach cau hat vdi c d che benh sinh la ddt bien t^o ra NST Phi va gen to hdp BCR-ABL.
Imatinib (IM) la thudc n h l m dich iiic c h i ho^t tinh tyrosin kinase (TKI) dieu trj CML dem Iai sif cai thien nhanh chong sir lui benh khong nhiitig ve mat huyet hpc ma cdn d mifc do di truyen te bao va phan tif. Dap u'ng lui benh p h i n tiir I I muc t l i u ciia cac nha l l m sang hien nay n h l m d ^ du'^c sif lui b|nh Sn djnh va l l i i dai. Van d l niy tu'dng doi mdi tai V l i t Nam vl de theo dpi d i p litig Tui benh nay phai diing ky thuat PCR dlnh lu'dnq (RQ- PCR). Do d d v i | c nghien cifu d i p ifhg lui benh p h i n t * cua b i n h n h i n CML dieu tij b i n g IM la mdt v i l e cap t h i S .
Vi vay Chung tdi tien h i n h de t i l vdi muc tiiu: Xac dinh ty le v l thdi gian d i p litig miic (16 phan tijf ciia b i n h h h i n CML d l l u tri imatinib.
II. edi TMcim vA PHUcmG PHAP NGHIEN cCru
2 . 1 . Doii t u ' d n g n g h i e n c i h i : 97 b i n h nhan CML glal doan man tinh dieu tri IM tal V i i n HH- TM TW t i f 4 / 2 0 1 0 - 4 / 2 0 1 3 .
2 . 2 . P h i r o n g p h a p n q h i i n c i h i : mo t l d t ngang, tien c i i \ i , cd yeu t o can t h i l p l l m sang (dieu tri IM).
Cac, b|nh n h i n du'dc thu thap n g h i i n cOV theo m a u ^ c l c bien so n g h i i n ciiii gom cd ty I I lui benh ve miic dp p h i n tif, thdi gian trung binli dat lui benh v l phan tif, t y 1^ dat lui benh vS p h i n t i f theo thdi c|lan. Danh o i l miic do liii b i n h v l p h i n t i f diia vao Heu chuan cua NCCN 2013.
Xu' l y so l i l u b a n g phan mSm SPSS 16.0
