TAP CHi Y HOC VigT NAM T^P 459 - THANG 10 - SO 1 - 2017 - Sau 1 thang ^ e u tri khdng phat hien du'dc tae
dung khdng mong mudn ciia bai thude Ban ha bach truat thien ma ttiang ket hdp phu'dng phap laser ndi mach tren lam sang va can lam sang.
TAI UEU T H A M KHAO
1. Nguyen Quang Bay (200S),_^/?d?/oa/7 chuyen hoa lipid, Chuyen de noi tiet chuyen hoa, nha xuat ban Y hoc. Ha Noi, tr.386-403.
2. Pham Tif Du'dng (ig94),M6i chuhg tang lipid mail, Bach khoa thifbenh hoc, tap 2, tr.289- 294.
3. Le Thj En (2010), Danh gia tac dung dieu tri hoi diiihg roi loan lipid mau cua bai thuoc TMPl, Luan van tot nghiep bac sy chuyen khoa II Hoc vien quan y.
4. Tran Thj Hfen (1996), Gap phan nqhien cuXi cua ddn NT'trotip dieu chinhhgi diuhg tang lipid mau the dap thapj Luan van thae sy Y hoc.
5. Nguyen Thuy Hu'dng (2004), Nghien ciiiJ tac dyng cua vien nen "Ha mdtrong dieu tri hgi chu'ng roi loan lipid mau, Luan van tot nghiep' Bae sy Chuyen khoa I I .
6. Hoang Khanh Toan, Chu Quoc Tru'dng (1999), Nghien ciru tac dung dieuchinh hgi ehimg roi loan lipid mau the phong dam ciia Ban ha bach truatthien ma thang, Tap chf YHCT, so 300, tr.9-i2.
7. Nguyen Lan Viet (2007), ThuC hanh benh tim mach, Nha xuat ban Y hoc Ha Noi, tr.lOl-103.
NGHIEN Ciru MOT SO NGUYEN NHAN VA DAC DIEM LAM SANG
C O A B E N H N H A N S U Y D A TANGHuynh Thi Ngoc T h u y \ Do Quoc Huy', Hoang Trung Vinh^
sectional study in 77 patients diagnosed MOF by SOFA score. Data were received from medical history, clinical examination and diagnostic tests. ResultsXhere was 4 groups of cause for MOF, sepsis accompanied with septic shock was the highest (77,9%), hemorrhagic shock was the lowest (1,3%). The ratio of injured organs was reduced as follow: Kidney - 100%, Cardiovascular - 93,5%, Lung - 84,4%, Brain - 42,9%, Coagulation - 27,3% and Liver - 18,2%. The number of declined organ was fnam 2 to 5 for one patient, but the incidence of 4-organ failure was the highest (37,6%) and 2-organ failurewas the lowest (10,4%). There was not the correlation between the number of organ failure with male or female, age > 55 or < 65. Condusion: Infection was the main cause of MOF. Patients with 4-organ failure accounted for the highest proportion and there was not the correlation between age and sex withthe number ofinjured organ.
Key words: multiple organ failure, acute renal injury, sepsis, SOFA score.
TOM TAT
Mgc tieu: Khao sat mot sd nguyen nhan va cae dSc diem lam sang ciia benh nhan suy da tang tai B^nh vien Nhan Dan 115. Doi twong va phWOiig phap: Nghien edu cat ngang 77 bf nh nhan dUdc chan doan suy da tang theo thang diem SOFA. Cac thong so thu du'dc dUa vao khai thac benh su", kham lam sang va lam cae xet nghiem chan doan. Ket gua: co 4 nhdm nguyen nhan gay suy da tang trong do nhiem khuan vdi bieu hien soc chiem ty le cao nhat (77,9%), soc mat mau ehiem ty le thap nhat (1,3%). Cac tang hok CO quan bi ton thu'dng gap vdi ty le giam dan:
Than - 100%; tim mach - 93,5%; Ho hfp - 84,4%;
Than kinh - 42,9%; Dong mau - 27,3% va Gan - 18,2%. So luUng tang suy tren 1 benh nhan dao dong tir 2 - 5 trdng do 4 tang gap vdi ty le cao nhat (37,6%), 2 tang chlem ty le thap nhat (i0,4%). Sd lUBng tang suy lien quan khong cd y nghTa giiJa nam vS ni?, > 65 va < 65 tudi./fie? luan: Suy da tang do nhiem khuan la nguyen nhan hay gap nhat. Suy 4 t?ng ehiem ty le eao nhat. So lu'dng tang suy lien quan khong c6 y nghTa vdi gidt va lira tuoi < 65 va > 65.
TiJf khoa: Suy da^ tang, ton thUdng than cap, nhiem khuan, thang diem SOFA.
SUMMARY
RESEARCHING SOME CAUSES AND CUNICAL MANIFESTATIONS OF PATIENTS
W I T H MULHPLE ORGAN FAILURE Objective: To study some causes and diaracterlstics of patients with multi-organ failure (MOF) at People's Hospital t\.5.Methods:zxoss- 'Benh vien Nhan dan 115
^Hgc vien Quan y
Chju traeh nhiem chinh: Hoang Trung Vinh Email; [email protected] Ngay nhan bai: 17.7.2017 Ngay phan bien khoa hoc: 5.9.2017 Ngay duyet bai: 14.9.2017
I. DAT VAN BE
Suy da tang la suy cimg luc hoac lien tiep it nhat 2 tang. Mac dii cdnhieu tien bd trong dieu tn nhutig ty le tir vong van edn rat cao, do do muc tieu dieu tn la ho trd chiTc nang cac tang va phdng ngira cae bien chiTng do dieu tri cho den khi eae tang hoi phue.Tai Viet Nam da ed nhieu nghien ciTu danh gia ve benh nhan suy da tang nhuYig eho den nay van chu^a cd nghien eiili eliinh thife nao tai benh vien Nhan Dan 115. De tai thi/c hien nham muc tieu: khao sat mot sd nguyen nhan va dac di&n lam sang cua benh nhan suy da tang dieu tri tai Benh win Nhan Dan 115.
II. o d l TU'ONG VA PHU'aNG PHAP NGHIEN CUOJ 2.1 Bail tu'dng: 77 benh nhan du'dc chan doan suy da tang dieu trj tai khoa Hoi siTc tich ClTc - Chong ddc Benh vien Nhan dan 115 tiT
VIETNAM MEDICAL JOURNAL N'l - OCTOBER - 2017 thang 02/2014 den het thang 02/2016.
*Tieu chuan lu'a chon benh nhan:
+ Chan doan suy da tang theo thang diem SOFA:
- Danh gia 6 tang: tim mach, hd hap, than, gan, ddng mau va than kinh.
- T i e u chuan suy tang: diem SOFA > 2 va tdng diem SOFA tang it nhat 1 diem so vdi liic vao vien.
- Chan doan suy da tang khi ed it nhat 2 tang suy va keo dai tren 24 gid.
+ Cd tdn thu'dng than cap theo tieu chuan RIFLE:
- Nong dp creatinin mau tang 2 lan so vdi mufc binh thu'dng
- hoac the tich nu'de tieu < 0,5mL/kg/gid trong 12 gid.
+ Cd nguyen nhan gay suy da tang khac nhau; nhiem khuan, sdc, viem tuy cap.
+ Cd hay khdng cd cac benh man tinh da xac djnh.
*Tieu chui'n loai truT:
+ Cd ehi dinh can thiep ngoai khoa nhu'ng chu'a du'dc dieu tri hieu qua.
+ Cd benh ly nang giai doan cudi nhu": xd gan mat bii, ung thu' di can.
+ Benh nhan cdthai hoac dang cho eon bu.
2.2 Phu'dng phap
*Thiet ke nghien cu'u: Tien cifu, md ta, quan sat cat ngang.
*Noi dung nghien cu'u:
-I- khai thac benh sd dac biet lien quan den nguyen nhan dan den suy da tang.
•+ Kham phat hien cac trieu chu'ng va dau hieu lam sang ton thu'dng cac cd quan.
-I- Xet nghiem danh gia tdn thu'dng cac cd quan tu'dng dng.
*Cac tieu chuan chan doan su* dung trong nghien cu'u
-I- Chan doan suy da tang diTa vao thang diem SOFA.
-^ Chan doan ton thu'dng than cap theo tieu chuan RIFLE.
•Xu" ly so lieu: Sd dung phan mem SPSS 22.0 xac djnh va so sanh t^ le phan tram, gia trj trung binh.
III. KET QUA
Bang 2.1. Dac diem chung ddi tu'dng nghien edu (n=77)
1 S a l i r a n g ( n ) 1 T y l e C/o) Tuoi ( n a m )
> 6 5
< 6 5
47 1 61 30 1 39
Gi6i Nu- Nam
45 32 Benh man tinh da xac dinh
Tanq huvet ap Dai thao dudng Benh than man COPD, Hen phe
quan Benh mach vanh
man Suy tim man Dot quy nao cu Benh qan man + Benh nhan >
28 22 13 10 10 8 8 4 65 tuoi, nO" chie
"
—S4
41,6 36,4 28,6 16,9 ^
13 13 10,4 10,4 5,2 hdn so vdi < 65, nam,
+ Mdt sd benh man tinh da du'dc xac dmh trong dd "TTIA chiem ty ie cao nhat, benh gan man tinh ehiem ty le thap nhat.
Bang 2.2. Ty IS benh nhin du^ vao an nguyin giy suy da tang (n=77)
Benh ly can nguyen So lu'dng Ty le (%) Nhiem khuan
Sdc mat mau Viem tuy cap hoai tu*
60 1
77,9 1,3"^
10,4 Co 4 nhom nguyen nhan gay suy da ...
vdi cac ty le khac nhau. ' | + Nhiem khuan chiem ty le eao nhat, soc r t i
mau ehiem ty le thap nhat.
Bang 2.3. Tyle t^ng td'n thu'dng (n=77) Tang/cd quan
ton thu'dng Than Tim mach
Ho hap Than l<lnh Donq mau Gan
So lu'dng
(nj
77 72 65 33 21 14
Tyle
(%)
100 93,5 84,4 42,9 27,3 1 18,2 ; -I- Cd 6 tang hoac cd quan tdn thu'dng vdi'c^^
ty le khac nliau.
+ Tat ca eac tru'dng hdp deu cd tdn thu'dng, than. Ton thu'dng gan chlem ty le thap nhat. , Bang 2.4. Ty IS bSnh nhan theo sofddiig tang {ed quan)ton thddng (n=77)
So lu'dng tang So lu'dng ( n ) 25 29
Tvlfe(%)^
1 0 , 4 , 32,5 37,6 _ 1 9 , 5 , -r Suy da tang du'dc tao thanh khi cd ton thuHfig tir 2 - 5 tang trong sd benh nhan nghien culi. ^
+ Ton thu'dng 4 tang chiem ty le cao nhat, tdn thu'dng 2 tang chlem ty le thap nhat.
TAP CHl Y H p c VIET NAM TAP 459 - THANG 10 - SO 1 - 2017
Bang 2.5. Oac dlS'm lam sang tang ton Mdttg(n=77)
So lu'cing
T y l S (»/oj Than ( n = 7 7 )
Vo nieu Thieu nieu Tanq ure mau Tanq creatinin mau
17 25 76 76
22,1 32,5 98,7 98,7 Tim mach ( n = 7 2 )
HATB < 65mmHq Nhip nhanh Nhip cham Bloc nht that
Runq nht
72 57 1 6 2
100 79,2 1,4 8,3 2,8 Ho hSp (n = 6 5 )
Thd oxy qua mat na Thd may
ALI ARDS Donq -cam mau Than l<inh trunq udnq
Gan (n = 14) Tang SGOT Tanq SGPT Tanq bilirubin true tiep Tanq bilirubin toan phan
TanqINR
9 56 57 8 21 33 14 12 14 14 11
13,8 86,2 87,7 12,3 27,3 42,9 100 85,7 100 100 78,6 + Da so cac trudng hdp CO bieu hien suy than (98,7%).
+ Tat ca cac trudng hdp cd bieu hien ton thUdng tim mach deu cd i^ATB d miic tiiap (<
65mmHg).
Bang 2.6. Moi lien guan glOa so lifting tang ton thwong vdi tuoi (n=77) So lu'dng tang
> 65 (n = 47) Tuoi (nam)
< 65 (n = 30) Px' 2 (n = 8)
3 (n = 25)
5 (10,6%) 4 (n = 29)
17 (36,2%)
3 (10%)
5(n = 15)
19 (40,4%
3 (26,7%) 6 (12,8%)
10 (33,3%) 9 (30%)
Ty le benh nhan suy da tang dUa vao so tang ton thudng iien quan ithong cd y nghTa vdi tuoi.
So lu'dng tang 2 (n = 8) 3 (n = 25) 4 (n = 29) 5 ( n = 15)
Gidl mt 8 (100%) 15 (60%) 15 (51,7%)
7 (46,6%)
Nam 0 10 (40%) 14 (48,3%) 8 (53,3%)
P x '
>0,05 Ty ie benh nhan suy da tang dUa vao s
Bang 2.8. Moi lien guan gl&a loai t T f n g / c o quan
Than (n = 77) Tim mach (n = 72)
Ho hap (n = 65) Than kinh trunq Udnq (n = 33)
Dong - cam mau (n = 21) Gan (n = 14)
5 tang ton thUdng lien quan khong cd y nghTa
^ng b ton thu'dng vdi tudi (n=77) Tuoi ( n a m )
> 6 5 ( n = 4 7 ) 47 (61%) 45 (62,5%) 41 (63,1%) 20 (60,6%) 10 ( 4 ^ % ) 4 (28,6%)
< 6 5 0 1 = 3 0 ) 30 (39%) 27 (37,5%) 24 (36,9%) 13 (39,4%) 11152,4%) 10 (71,4%)
vdi gidi.
P
>0,05
>0,05
> 0 , 0 5
> 0 , 0 5
<0,05 BN < 65 tuoi ed ty le ton thu'dng gan nhieu hdn so vdi > 65 tudi. Ton thu'dng cac cd quan khac ien quan khdng cd y nghTa vdi tuoi.
Bang 2.9. I^diliin quan gida loai tang tdn thu'dng vdi gidi (n=77) T a n g / c d quan
Than (n = 77) Tim mach (n = 72)
Ho hap (n = 65) Than kinh trunq Udnq (n = 33)
Donq - cam mau (n = 21) Gan (n = 14)
BN nam co ty le ton thUdng gan nhieu
Gidi N u ' ( n = 3 2 ) ^ 45 (58,4%) 42 (58,3%) 38 (58,5%) 18 (54,5%) 10 (47,6%) 3 (21,4%)
^dn so vdi nu'. Ton
Nam ( n = 4 5 ) 32 (41,6%) 30 (41,7%) 27 (41,5%) 15 (45,5%) 11 (52,4%) 11 (78,6%) thudng cac za quan
P
> 0 , 0 5
> 0 , 0 5
> 0 , 0 5
> 0 , 0 5
< 0 , 0 1 khac iien quan hdng cd y nghTa vdi gidl.
VIETNAM MEDICAL JOURNAL N°1 - OCTOBER - 2017 III. BAN LUAN
Trong thdi gian tir thang 02/2014 den thang 02/2016, tai khoa Hdl siTc tich cu'c-chdng ddc Benh vien Nhan Dan 115, chung ^di da tien hanh nghien cii'u 77 benh nhan vdi chan doan suy da tang. Nhdm tudi > 65 ehiem ty le cao nhat (61%) va t / le nO" nhieu hdn nam. Ket qua nay tu'dng tiT nghien cu'u eiia HV.Quang [3] nhuhg trong nghien eiTu ciia Derek[4] thi ty^ le nam nhieu hdn nu'. Cae nghien ciTu ve dieh te hgc cho thay SLT chenh lech t / le nii'/nam thay ddi tiiy theo qudc gia.
Benh nhan Idn tuoi thu'dng cd nhieu benh man tinh; dae biet la tang huyet ap, benh phoi man, dai thao du'dng, benh mach vanh man, dot quy. Nghien cii'u eiia ehiing tdighi nhan sd benh man tinh da du'dc xac djnh gap vdi t / le khac nhau, trong dd t^ng huyet ap ed ty le cao nhat (36,4%) va thap nhat la benh gan man (5,2%).Nghien ciTu ciia HV. Quang cho thay t / le cae benh man tinh lan lu'dt la tang huyet ap (48,8%), dai thao du'dng_(19,5%), benh phoi man (9,8%), suy giam m i l n dich (8,5%), benh mach vanh (7,3%), benh gan man ^4,9%)[3].
Trong cac benh ly can nguyen dan den suy da tang thi nghien ciTu eua chung toi cho thay nhiem khuan va sdc nhllm khuan ehiem 77,9%.
Ket qua nay eting phii hdp vdi nhieu nghien eiTu khac. Nghien edu eua NG. Binh va edng SLT[1] ghi nhan nhiim khuan la nguyen nhan ehinh dan den suy da tang chiem 93,8%. Ket qua tiT nghien ciTu eiia John[6] cho thay nhiem khuan chlem ty le 80% trong cac nguyen nhan dan den suy da tang. Nhu' vay, viee kiem soat tdt nhiim khuan tai eac khoa hdi siTc ddng vai trd quan trpng trong phdng ngii^ tien trien suy da tang va gdp phan cai thien tien lu'dng cho cac BN nang.
Tat ca cac BN trong I^C du'dc dieu trj ho trd cac tang theo diing cae khuyen eao.Tuy theo tinh trang BN, viee sir dung khang sinh, an than, bit djch, ehdng soc, hd trd hd hap, bao ve ^ a n , can bang dich - dien giai va cac bien phap hd trd khac da du'dc thiTc hien thich hdp. Ket qua nghien eiTu ghi nhan ty le suy cae tang lan lu'dt la than, tim mach, hd hap, than kinh, ddng mau va gan. Nghien ciTu eiia I^arshali[7] cho thay ty le suy cac tang theo thd tu" la hd hap, tim mach, than kinh, than, ddng mau va gan. SLT khac biet cd the do tac gia chpn tat ca cac benh nhan suy da tang nam dieu trj tai khoa Hoi sire tieh ciTc trong khi chung tdi chi lay nhdm benh nhan suy da tang cd chi dinh Ipe mau lien tue.
Hien nay tieu chuan RIFLE (Risk, Injury,
Failure, Loss, Endstage kidney disease) duOc sii dung tren lam sang nham xac djnh sdm cac ton thu'dng than cap va dieu trj ti'ch CLTC. Tat ca cac BN trong nghien ciru deu cdton thu'dng thincap, trong dd 54,6% BN cd thieu/vd nieu. Nhu ^ u thdng khi cd hoc chiem 86,2% va cd 8 BN (12,3%) cd ARDS khi chan doan suy da tang, Ket qua eiia ehimg tdi cung tu'dng tiT cac tac gia khac, ty le BN can thdng khi ed hpc ia 94,4% va 82,3% trong nghien edu ciia Elizabeth va Zhang ghi nhan ty le tiT vong khi suy than cap ddn doc la 10% tang ien 45-50% khi ed kem suy ho hap, va neu cd kem suy them tu" 2 tang trd len till ly le tir vong len den 95%. Nhieu nghien culi da chirng minh tdn thu'dng than cap la yeu td tien lu'dng tiT vong ddc lap.
Khi chan doan SDT, nghien eiTu ghi nhan ty le rdi loan nhip tim la 91,6%. Bieu hien chii yeu eiia suy tuan hoan la tut huyet ap vdi HATB <
65mmHg va nhjp tim nhanh. Ket qua NC cho thay tdn thu'dng he tim maehduYig hang thir hai trong sd cac tang suy vdi ty le 93,5%. Nghien eiru eung eho thay tdn thu'dng gan ed tan suat thap nhat (18,2%) va 78,6% BN ed INR tang khi bj tdn thu'dng gan.
Ket qua nghien ciTu cungghi nhan suy 4 tang chiem ty le eao nhat (37,6%) vao thdi diem chan doan va khdng ed BN nao suy 6 tang. Khong co mdi lien quan glti'a sd lu'dng tang suy vdi tudi va gidi tinh, nhu'ng BN nam hoac tuoi < 65 thi c6 ton thu'dng gan nhieu hdn so vdi BN nO" hoac tudi > 65. Ket qua nay eung tu'dng tiT eae nghien ciru khac. Nghien ciTu cua NG. Binh va cs cho thay sd tang suy trung binh la 3,12 ± 0,96 tang, edn cita TN. Hai la 3,53 ± 0,12 tang[l],i:2].
V. KET LUAN
-1- 4 nguyen nhan gay suy da tang bao gom nhllm khuan, sdc tim, sdc mat mau, viem tuy hoai tiT cap trong dd nhiem khuan chiem t/ le cao nhat sdc mat mau chiem ty ie thap nhat. _
+ Cd 6 tang bj tdn thu'dng gap vcfi eac ty^le khac nhau bao gom than, tim maeh,_ hd hap, than kinh, ddng mau va gan trong dd tdn thu'dng than gap vdi t / le cao nhat (100%), tdn thu'dng gan gap vdi ty le thap nhat (18,2%).
-I- So lu'dng ed quan hoac tang tdn thu'dng tren 1 benh nhan dao ddng tir 2 - 5 trong dd suy dong thdi 4 tang gap vdi ty le eao nhat (37,6%), suy 2 tang chiem ty le thap nhat (10,4%).
+ Sd lu'dng tang suy va ed quan hoac tang tdn thu'dng lien quan khdng ed y nghia vdi gidi, tud'i < 65 va > 65.
TAP CHi Y HOC VIET NAM TAP 459 • THANG 10 • SO 1 • 2017 TAI UEU T H A M KHAO
1. Nguyen Gia Binh, Dang Quoc Tuan, Do Tat Cu'dng, Tran Duy Anh, Do Quoc Huy va cs (2008): "Nghien culi dnq^ dung mot so ky thuat loc mau hien dai trong cap ciTu, dieu trj mot so benh", De tai cap nha nude, Bp Khoa hoe va Cong nghe - Bp Y te.
2. Tru'dng Ngpc Hai i^2009): "Nghien cuTu lam sang, can lam sang va hieu qua dieu tri ciia lieu phap ipc mau lien tue d benh nhan suy da tang", Luan anTien si yhoc, Hoc vien Quan y.
3. Hoang Van Quan^ (2009^: "Nghien CLTU dac ijiem lam san^ va tet qua dieu tri suy da tang d benh nhan soc nhiem khuan", Luan anTien sf y hoc, Tn/dng dai hpc Y Ha Npi.
4. Derek C. Angus, MD; Walter T. Linde-Zwirble et al (2001): "Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome,
and associated costs of care", Crit C^re Med, 29 (27): 1303-1310.
5. Elizabetli B, Desanica D, Sanja D, Sebastiao A, Antonio, Renato G.G, Terzi (2001): "Multiple organ failure in septic patients", Brazilian journal of infectious diseases," Brazilian joumal of infectious diseases, 5(3), Salvado lune: 1-8.
6. ;iohn S, Griesbach D, Baumgartel M, Weihprecht H, Schmieder R.E, Geiger H
|[2001): "Effect of continuous haemoftltration vs intermittent haemodialysls on systemic haemodynamies and splanchnic regional perfusion in septic shock patients: a prospective, randomized clinical trial", Nephrol Dial Transplant, 16: 320-327.
/ . Marsliall, John C, Coolc, Deborah J, Christou, Nicolas V, Gordon R, Sprung, Charles, Sibbald, William (1995): 'Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome", Crit Care Med, " Crit Care Med, 23(10): 1638-1652.
NGHIEN Ciru Sir BIEN DOI MOT SO CHI SO HOA SINH MAU COA CHUOT N H I I M DOC CHI ACETAT BAN TRircrNG DIEN
VA T A C D U N G COA SAM NGOC LINH SINH KHOI
TOM TAT
Muc (/et/.'Tim hieu SLT bien doi mot so chi so sinh hoa mau d chuot nhat b| gay dpc chi acetat ban tniftng dien va tae dung bao ve ciia SNLSK. Odl tdOng va phu'dng phap nghien edu: 120 chuot nhat trang, 20 - 25 gam gom 12 chupt giet va lay mau xet nghiem nong dp ehi mau, sinli hoa ^mau ngay tr\idc khi gay ddc; 108 chupt du'dc gay nhiem doe chi acetat ban tru'dng dien (lieu 20 mg/kg/ngay) d ngay 15, 30 va 45) ehia thanh 3 16: id ehiTng (16 1: 36 chuot), 16 gay d5c (16 2: 36 chudt), 16 gay doe ed dimg sSm Ngpc Linh sinh khdi (SNLSK) (Id 3: 36 chuot);
danh gia tac dung bao ve cua SNLSK (lieu 375 mg/kg/ngay). Kdtgua: Hoat do AST, ALT, GCT d 16 2 cao hdn 16 1 ciing thdi diem nghien ciTu (p<0,05); d 16 3 (55,78 ± 9,75; 291,0 ± 59,5; 3,10 ± 0,98 U/L) thap hon 16 1 d ngay 45 (66,14 ± 10,85; 351,9 ± 64,6;
4,26 ± 1,09 U/L) (p<0,05). L6 2: Bilirubin toan phan, ure 6 ngay 45 (4,26 ± 1,09 pmol/L; 3,02 ± 0^32 mmol/L) cao hdn so vdi thdi diem tru'dc khi gay nhiem doc (3,18 ± 1,15 pmol/L; 2,75 ± 0,27 mmol/L) va so viJi lo 1 (3,20 ± 1,14 pmoL/L; 2,78 ± 0,16 mmol/L) (p<0,05). L62: creatinin d ngSy 30, 45 cao hdn 16 1^ d ngay 45, creatinin cao hdn so vdi ijUdc khi gay nhiem doc (p<0,05). Kdt luan: Hoat dp AST, ALT^ GGT huySt tu'dng; nong d6 ure, creatinin mau d 16 gay dpc cao hdn 16 doi chiTng (p<0,05). Hoat d6 AST, ALT,
*Benh vien Quan y 103
**Hgc viin Quan y ^ Chju trach nhiem ehinh: Nguyen Thanh Xuan Email: [email protected] Ngay nhan bai: 17.7.2017 Ngay phan bien khoa hoc: 30.8.2017 Ngay duyet b^i: 8.9.2017
Nguyen Van Bang*, Nguyen Thanh Xuan**
GGT huyet tUdng d 16 gay d6c c6 uong SNLSK thap hOn 16 gay d6c khong uong SNLSK (p<0,05).
Tir kiioa: Nhiem d6c ban trUcJng dien, sam ngpc linh sinh khoi.
SUMMARY
STUDY THE CHANGE OF SOME BLOOD BIOCHEMICAL INDEXES OF MICE W I T H
SUBCHRONIC LEAD TOXICATION AND EFFECT OF NGOC LINH GINSENG MASS
Objectives: study the change of some blood biochemical indexes of mice with subchronic lead toxication and effect of Ngoc Linh ginseng mass.
Subjects and methods: 120 male white house-mice, 20 - 25 gram (12 mice were killed and taken blood to expenment immediately pnor to testing). 108 mice infected lead acetate (20 mg/kg/day), on date of 15, 30, 45; divided into 3 lots: control lot (36 mice: lot 1);
lot infected lead acetate (36 mice: lot 2); lot infected lead acetate and drinking with NLG M to protect (36 mice: lot 3) and study effect of Panax vietnamensis biomass solution (375 mg/kg/day). Results: activity of ALT, AST, GGT of lot 2 is higher than lot 1 in the same time (p<0.05); iot 3 (56.78 ± 9.75; 291.0 ± 59.5;
3.10 ± 0.98 U/L) is lower than lot 1 on date of 45 (66.14 ± 10.85; 351.9 ± 64.6; 4.26 ± 1.09 U/L) (p<0.05). Lot 2: total bilirubin, ure on date of 45 (4.26 i 1.09 pmol/L; 3.02 ± 0.32 mmol/L) is higher than experiment immediately pnor to testing (3.18 ± 1.15 pmol/L; 2.75 ± 0.27 mmol/L) and lot 1 (3.20 ± 1.14 pmoL/L; 2.78 ± 0.16 mmol/L) (p<0.05). Lot 2:
ereabnin on date of 30,45 is higher than lot 1, on date of 45, creatinin is higher than experiment immediately prior to testing (p<0.05). Conclusion: activity of plasma ALT, AST, GGT; concentration of ure, creatinin of lot
