VIETNAM MEDICAL JOURNAL N*^ - MARCH - 2017 mdt nguyen nhan hinh thanh sdi Wit nieu. Trojig
nghien cuH eiia ehung tdi gap 8,5% NKTN thap, 20,7% VTBT cap va 2 4 , 4 % VTBT m?n. VTBT man eung se gay hiiy hoai nhu md thanj^tif dd dan den suy giam ehffc nang than va cuoi ciing la suy than man giai doan eudi doi hdi phai dieu tri thay the than.Trong nghien eutj eiia chung tdi chi gap cd 2 benh nhan suy than cap, chi§n ty le 2,4%. Ty l i nay thap hdn so vdi nghien cffu ciia Bo Gia tuyen vdi ty' le suy than cap ia 10% [ 1 ] , Sdi tiet nieu Uiffdng t i i n trien am tham rat it trieu chffng, theo thdi gian sdi gay tdn thffdng dan dan eau true than lam suy giam nghiem trpng chffe nang than. Sdi nieu quan cd xu hffdng gay ra cae bien chffng cap tinii va hiiy hoai chffe nang than nhanh hdn sdi than.
Khoang 61,46% sd benh nhan cd ehffc nang than giam va 2,32% than khdng bai xuat tren phim UIV. Sff suy giam chffe nang than d BN sdi tiet nieu do nhieu yeu to gay nen, nhieu tac gia da chiitig minh tinh trang tac nghen keo dai gay gay d nu'dc, d mil be than thi ehi sau 6 tuan nhu md than khdng edn phuc hoi dffdc thi se dan tdi suy than nhanh chdng. Tuy nhien chung tdi khdng thay cd sff khac biet ve ehffc nang than giij^ 2 nhdm sdi than va sdi nieu quan, cung nhff khdng thay lien quan giffa thdi gian mac sdi va tinh trang gian dai be than vdi mffe Ipc eau thqln nhutig thay ro chffe nang than suy giam rd r i t d nhdm BN ed sdi than ca 2 b^n, ed the bdi sd Iffdng BN chffa dii Idn nen khdng tim ra sff khae biet (bang 5).
V.KET LUjQkN
Sdi than chiem ty le cao nhat 75,6%, sdi nl quan: 6 , i % , sdi than va nieu quan;15,9'}fe'|
Wet nieu gay bien chffng: gian dai be tt^
viem than be than cap va man, ff mu t h a n ^
than cap, suy than man. % TAI L l | U T H A M KHAO
1. 00 Gia Tuyen ( 2 0 1 2 ) . Nghien cffuty le^mac:
tiet nieu va mot sd biin chifng do sdi giy nen khoa than - l i e t nieu benh vien Bach Mai. f chl Y hoc Viet Nam th'ang 5, 2, fr 46-47. •;
2. Trichieri A, Rovera F, Nespoli R, et al. (199) Clinical observations on 2QB6 patients with upf urinary tract stone. Arch Ital Urol Androl 1995 st 68, 251-262.
3. Jungers P, Joly O, Barbey F, et al. (2004). ESI caused by nephrolithiasis: prevalence, mechanisi andtprevention. Am J kidney dis, 44,7997805.
4. Nguyen Thyy Linh (2001). Mot sd dac diem it sang chan doan benh sdi dffdng tlefc nieu tren CO bien chirrig suy than. Tap chi Y hoc Viet Na 4, tr 125-131.
5. Nguyin K9 (1994). Tlnh hinh dieu trj phau ttii soi t i ^ nieu tai benh vien V i i t Qffc trong 10 n;
(1982-1991). HgoBi khoa, 1, tr 10-23.
6. Hoang Thj Mai t r a n g (1999). Lien quan gi sdi tiet nieu va t§ng huyet ap. Tap tri y hoc V Nam (12), 43.
7. Nguyen Thanh Du'c (1997). Mot so nhan xet dac diem lam sang va xff tri cac trffdng hdp da suy than do sol. Tap chi y hpc thu'c hanh, so 4-t 333, tr' 12-14.
CAC KIEU DOT BIEN GEN GAY BENH BETA-THALASSEIWIA TREN BENH N H A N NHI KHU VU'C DONG BANG SONG CUU LONG
NAM 2 0 1 4 - 2 0 1 6
T O M TAT
D$t van de; Beta Thalassemia (p-Thal) la binh di truyen ddn gen tren nhiem sac the thu'dng pho bien nhSt tren the gidl. Muc tieu: Xac djnh ti le cac kiiu dot bien gen ga^ benh p-Thal tren benh nlian nhi d Wiu vifc Ddng Bang Song Cffu Long. Doi tu'dng va phu'dng phap: Nghien cffu md ta c i t ngang du'dc
*TrWdng d?ihgc YDUgc dn Thd.
Chju trach nhiem chinh: Pham Thj Ngpc Nga Email: [email protected] Ngay nhan bai: 23.12.2016 Ngay phan bien khoa hpc: 3.2.2017 Ngay duygt bai: 14.2.2017
Pham Thi Ngoc Nga*, Nguyen Trung Kit
thyc hien tren 211 doi tu'dng la cac benh nhan;
(<15 tudi) mac benh p-Thal, cd ho khau tai 13 t thanh pho thupe Wiu vu'c Dong bang Song Cffu Ix Ket qua: Co 11 kieu dot bien dffdc phat hiSn. 97, cac d6t bien du'dc tim thay thupc 8 loai dot biin;
bien d mien bac Vipt Nam. Trong do, 03 dot bien;
26 G>A (36,6%), Cd 41/42 -TTCT (22,8%) va Cc A > T (20,7%) chiem ti le cao nhat. Ben c?riH nghien cffu cung phat hien 03 (2,6%) kieu dot- hiem gap: Cd 95 -l-A (1,7%), Cd 15 G>A (0,7%) Vi 26 G>T. Ket luan; Nen sff dung nhieu ky thuat hpc phan tff khac nhau trong chan doan trffcfc^
benh [(-Thai trong khu vffc.
TWkhoa: Beta-Thalassemia, Benh nhi, Oongt Song Cffu.Long.
140
TAP CHi Y HOC VigT HAM TAP 452 - THANG 3 - SO 2 - 2017
1MARY
3ENE MUTANT TYPE CAUSING BETA- ALASSEMIA IN CHILDREN PATIENT OF
MEKONG DELTA AREA, 2014-2016 adtground: Beta Thalassemia (p-Thal) is the : commonly Inherited genetic disorders In the 1. Objective: To determine the prevalence of the mutation types that cause ^Thal anemia in jtiic patients in the Mekong Delta. Subjects and liods: Cross-sectional descriptive study was ucted on 211 subjects tiiat pediatric patients i years) with p-Thal disease, residents in 13 inces and cities in the area of Mekong Delta.
Hits: There are 11 types of mutations were rted. 97.4% of mutations were found in 8 -non mutations in nortiiem Vietnam. In particular,
; mutations: Cd 26 G> A (36.6%), Cd 41/42 - r (22.8%) and Cd 17 A> T (20.7%) accounted for lighest percentage. Besides, the study also found 03 (2.6%) types of rare mutation: Cd 95 + A (1.7%), 15 G> A (0.7%) and Cd 26 G> T. Condusions:
ikl use tiie variety of molecular biology techniques in atal diagnosis of p-Thal disease.
f^^rds: Beta-Thalassemia, Pediatric patient,
I^P'Delta.
ATVANOE
Jenh p-Thal la mot benh di truyen ddn gen bien tren the gidi. Tff nam 1983, To ehffc Y [^e gidi da xac dinh Thalassemia la van de
khoe toan rau. Tren the gidi, eo Wioang .000 - 400.000 tre mac benh Thalassemia d nang moi nam. Trong do, Viet Nam la mpt ig nhQYig nffdc co ty le mac benh va mang ,benh cao [1], [2], [3], [4].
j Viet Nam, benh nhan dau tien dffdc phat 1 vao nam 1960 tai Benh vien Bach P^ai.
hig nghien cffu dffdc tien hanh tff do den nay 'tiiay tan suat mang gen benh Thalassemia ang 1.7 - 25% tuy tffng viJng mien va dan [3], [7]. Theo hiep hpi Tan huyet Viet Nam, 1 CO khoang hdn 20.000 benh nhan nang can i tri, moi^ nam co khoang gan 2.000 tre sinh )i benh. U'dc b'nh, ehi phi ^ u trj mpt ca benh ilassemia tff luc sinh ra den 30 tuoi la khoang ' dong. Vi vay. Thalassemia la mot ganh nang vdi gia dinh va xa hpi. Do vay, cac nghien tim ra cae kieu dot bien gay benh pho bien m muc dfch ho trd chan doan trffdc sinh la thiet nham giup giam ti le benh. V! vay, ng toi thffc hien nghien cffu tff nam 2014 d^n 6 nham muc tieu:
<ac djnh ti le cac kieu dot bien gen gay benh
"hai tren benh nhan nhi d khu vffc Dong Bang g Cffu Long.
II. OOI TUONG VA PHl/OWG PHAP NGHIEN CUU 2.1. Doi tu'dng nghien cihi: Benh nhan dffdc chan doan mac benh p-Thal du^ theo ket qua dien di Hemoglobin. Doi tffdng chpn khong phan biet dan tpc, gidi tfnh, co tuoi <i5 va hp khau tai 13 tinh: Long An, Tien Giang, VTnh Ixng, Dong Thap, Ben Tre, Tra Vinh, HailGiang, Bac Lieu, Ca Mau, Kien Giang, Soc Trang, An Giang va Thanh pho Can Thd. Loai trff:
- Nhiitig ngffdi dang bj mac cae benh cap eulJ.
- NhQhg ngu&i khong dong y tham gia nghien cdu.
2.2. Phu'cfng phap nghien cu'u
- Thiet ke nghien cffu: Sff dung thiet ke nghien cffu mo ta eat ngang
- Phffdng pliap chpn mau: chgn mau thuan tiai Trong thdi gian nghien cffu: tff thang 1/2014 den thang 12/2016, co 211 benh nhan nhi dffdc Chan doan mae benh p-Thal cf the tmyen mau phu thupc tham gia.
- Npi dung nghien cffu:
+ f i le cac kieu dot bien gen gay t>enh p-Thal tren benli nhan nhi.
+ Phan loai cac the benh p-Thal dda tren cac kieu dot bien.
III. KET QUA
Tff thang 01/2014 den thang 12/2016 co 211 benh nhan nhi vdi ti le nam: nff la 0,79 dffdc chan doan mac benh p-fhal tham gia vao nghien cffu. 100% doi tffdng thupc dang truyen mau phu thupc. Hau het cac doi tffdng la dan tpc Kinh, ehi co 3/211 (1,4%) doi tffdng la dan toe Hoa, 7/211 (3,3%) la dan toe Khmer. Tuoi trung binh eua cac benh nhi la 7,2 ± 3,9.
3.1. Ti le cac kieu dot bien gen p-globin tren benh nhan nhi
Co 421 alen/21i benh nhan nhi dffdc tim thay dot bien. Co 11 kieu dot bien dffdc phat hien tren 211 benh nhan. Trong do, 3 dot bien: Cd 26 G>A (36,6%), Cd 41/42 -TTCT (22,8%) va Cd 17 A > T (20,7%) chiem ti le cao nhat. 97,4%
cae dot bien dutfc tim thay thupe 8 loai dot bien pho blen d phia bac Viet Nam. 03 (2,6%) kieu dot bien hiem gap: Cd 95 -i-A (1,7%), Cd 15 O A (0,7%) va Cd 26 G>T. Ket qua ehi tiet cf bang 3.1.
- Sff dung kit p-Thal StripAssay: co 207/211 (98,1%) iDenh nhan mang hai dot bien dude tim thay,
- 4/211(1,9%) benh nhaii chi tim" thay mpt
dot bien qua kit dddc tiep tuc giai trinh tff tim
cae dot bien khac. Ket qua co 7/8 alen du'dc phat
hien dot bien. Nhff vay, co 01 benh nhan chi
mang mot dot bien Cdl7 A>T du lam sang la
thieu mau nang.
VIETMAM MEDICAL JOURHAL H'2 - MARCH • 2017 Chon ngau nhien 43 (20%) benh nhan
mang 02 flot bien dildc tim thay bang l<ft p-Thal StripAssay idem tra Iai bang ky thuat giai trinh
tli. Ket qua cac dot bien tim gap tu'dng m 100% tren ca hai ky thuat. T i le cac k l e u l bien duOc trinh bay trong l3ang 3 . 1 . J Bing 3.1.
S 6 T T 1 2 3 4 5 6 7 8 9 10 11 3.2. K i e u g
rile dckleu dot blen gen B-alobin K i e u d o t b i e n
Ddt blen pho blen Cd 26 G>A Cd 41/42 -TTCT
Cd 17 A > T -28 A>G Cd 71/72 +A IVS 2.654 C>T
IVS 1.1 G>T IVS 1.5 G>C Ddt bien khdng phd bien
Cd 95 +A Cd 15 G>A Cd 26 G>T TSng
n 410 154 96 87 19 18 17 16 3 11 7 3 1 4 2 1 e n p - T h a l du'a t h e o I d e u d o t b i S n : 211 benh nhan nhi tham g
g?^ 1
%
36,6 22,8 20,7
A i 4,5 -i 4,3 4,0 3,8 0,7 2,e 1,7 0,7 0,2 1 0 0 , 0 a deu is dang t i%e mau phu thupe, hay dang thieu mau di truyen p-Thal the nang. Tuy nhien, vdi ket qua eac dot bie tim gap, co 4 kieu phoi hdp gen dffdc tim gap tren 211 benh nhan nhi, chiem ti le eao nhat ia;S;ie phoi hdp^ p-Thal/HbE 7 3 % , the dj hdp tff kep 23,2%, the dSng hdp tff 3 , 3 % va chi co 1 trffdngVhd (0,5%) la the dj hdp tff. Ket qua dddc ghi nhan trong bang 3.2. i '
Bang3.2. Cac the benh p-Thal du'a tlieo kieu dot biin •-•^
S o T T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Cac k i e u p h o i h(jp g e n The ddng hdp ttf Cd 1 7 A > T / C d 1 7 A > T Cd 41/42 -TTCT / Cd 41/42 -TTCT
The dl hdp ttf kep Cd 17 A > T / C d 41/42-TTCT
C d l 7 A > T / - 2 8 A > G -28 A>G / Cd 41/42 -TTCT
C d l 7 A > T / I V S l . l G > T -28 A>G / Cd 71/72 +A Cd 41/42 -TTCT / IVS 2.654 C>T
Cd 41/42 -TTCT / Cd 71/72 +A Cd 41/42 -TTCT / IVS 1.1 G>T -28 A>G / IVS 2.654 C>T
-28 A>G / IVS 1.1 G>T Cd 1 7 A > T / I V S 1 . 5 G > C C d l 7 A > T / C d 7 1 / 7 2 - h A Cd 4 1 / 4 2 - T T C T / C d 9 5 + A
Cd 17 A>T / Cd 95 +A ThS P-Thal phdi hdp Hbg Cd 41/42 -TTCT / Cd 26 G>A (HbE)
Cd 17 A>T / HbE IVS 2.654 O T / H b E
Cd 71/72 +A / HbE IVS 1.1 G > T / H b E Cd 95 -^A / HbE Cd 1 5 G > A / H b E C d I V S 1 . 5 G > C / H b E
C d 2 6 G > T / H b E
n 7 4 3 4 9 11 5 5 5 4 4 3 3 2 2 2 1 1 1 1S4
63 53 11 10 6 5
^
11
o/o « 3,3 1,9 1,4 23,2 1
5,2 2,4 2,4 2,4 1,9 =:
1,9 ''- 1,4 1,4 0,9™
0,9i^>A ni^-^iiH 0,5 . ^ H 0,5 J H
73,6wa
29,9 J «
25,1 i H
5,2 V 4,7 a 2,8 m 2,4 « 1,4 M 0,5 » 0,5 %
TAP CHi Y HOC VlgT HAM T A P 452 - THANG 3 - SO 2 - 2D17
26
27
-28 A>G / HbE
ThSdIhdptu'Cd 17 A>T Tong
1
11
0,5
0,50,5 211 100,0 r. BAN LUAN
Khi sff dung kit p-Thal StripAssay co 207/211 18,1%) benh nhan mang hai dot bien dffdc tim lay. Co 4/211(1,9%) benh nhan mang mpt dot ien va dffdc tiep tuc giai trinh tff tim eac dot ien khac. Chpn ngau nhien 43/207 (20%) berth
^lan mang 02 dot bien dffdc tim thay bang kit Thai. StripAssay kiem tra Iai bang ky thuat giai inh tif. Ket qua cae dot bien tim gap tffdng ong 100% tren ca hai k9 thuat. Dieu nay khang jnh tinh dac hieu eao cua phffdng phap Iai do gffdc bang kit. Du chi phf kha cao, nhuhg thu'c ien xet nghiem fiipt each nhanh chong, chi'nh ayra^co the giai quyet mot Iffdng mau Idn
^ ^ i i c f i gian ngan chinh la ffu diem vffdt trpi
^ u t ^ g phap nay.
ratVinhJ:Ly:irri.t^c dot bien khae, ket qua e6 /8 alen dffdc phat hien dot bien. 03 01 benh han ehi mang mot dot bien Cdl7 A>T du tam ang ia thieu mau nang. Va ket qua dot bien tim
^p nay cung khong phu h ^ vdi ket qua dien di lemoglobin HbAi: 5%, HbAz: 2,4%; HbF:
2.5%. Nhff vay, ngoai dot bien tren gen p- lobin, CO the benh nhan da mang them dot bien rang cum gen Beta va can co mot ky thuat sinh pc phan tff khac duWc ap dung.
Vdi hai ky thuat Iai do bang kit va giai trinh J*, khi tien hanh xae djnh kieu dot bien gen p- ilobin cho 211 benh nhan tffdng ffng vdi 422 len, diung 1»i phat hien co 421 (99,7%) alen lang dot bien vdi 11 itieu. Chi co 01 alen duy ihat khong phat hien dot bien qua hai k9 thuat lay, Trong so eac kieu dot bien, co du 8 kieu dot lien pho bien d khu vffc phi'a bac Viet Nam tim lap tren cae benh nhi khu vffc Dong bang Song :ifU Long vdi ti le rat cao 97,4%: Cd 26 G >A 36,6%), Cd 41/42 -TTCT (22,4%), Cd 17 A > T 20,7%), -28A > G (4,5%), Cd 71/72 +A 4,3%), IVS2.654 C > T (4%), IVSl.l G>T 3,8%), IVS1.5 G > C (0,7%). Dieu nay eho thay ac dot bien gay benh p-Thal phan b5 trai deu rang nff3c Viet Nam.
Ben canh cac dot bien pho bien, nghien cffu on phat hien dot bien dac tnjtig cua ngffdi Viet iam Cd 95 + A (1,7%). Opt bien nay dffdc gap di tan suat cao hdn kieu IVS1.5 G > C (6,7%).
Igoai ra hai dot bien hiem gap khac cung dffdc Ihat hien la Cd 15 G>A (0,7%) va Cd 26 G>T D,2%). Dot bien Cd 15 G>A do sff thay the
nucleotide loai G trong Codon TGG giai ma ra acid amin Tryptophan thanh Codon TAG, mpt loai stop codon. Tffdng tff, Cd 26 G>T cung do thay nucleotid G 6 vi trf thff 1 thanh A lam cho c»don GAG giai ma ra acid Glutamic chuyen thanh TAG - stop codon. Ca hai dot bien gay nen tinh trang tiiieu mau nang cho benh nhan mac benh. Dot bien Cd 26 G>T cung dddc tim gap khi sang loc trffdc sinh cho 498 thai phu vdi ti le 0,1% trong nghien CUXJ eua Nguyen Khac Han Hoan (2013)[2]. Dot bien Cd 15 G>A chu^ tiiay bao cao trong nghien cffu nao d khu vffc phia nam.
Ngoai trff dot bien Cd 26 G>A gay HbE chiem ti Ie cao, thi hai dot bien hay gap nhat la Cd 41/42 -TTCT va Cd 17 A>T. Ket qua nay tffdng tff vdi ket qua nghien cffu cua Svasti,Tran Minh Hieu va epng sff (2002) tren benh nhan p-Tha!
mien nam \fiet Nam va eon nhieu nghien cffu khac nhff Le t h j Hao [1], Filon va cong sff [6].
So vdi cae nffde tiong khu vffc nhff Thailand, Singapore va Nam Trung quoc thi dot bien Cd 41/42 - TTCT, Cd 17 A > T cung la "nhffng dot bien hay gap ngoai sff Iffu hanh cua HbE [4], [5].
Dieu nay mpt lan nife khang dmh sff xuat hien kha pho bien ciia loai dot bien hiem gSp nay tei khu vffc phfa nam va khu vffc d5ng bang Song C ^ Long. Vi vay, nen them dot bien Cd 95 +A trong dian doan xac dinh benh nhanh bang sinh hpc phan tff hay chan doan trffdc sinh benh p-ThaL
Nhff vay, pho dot bien tim gap tren cac benh nhi trong khu vffc tffdng doi rong. Tuy nhien ngoai dot bien gay HbE thi cac dot bien tim gap tren benh nhan phan ldn deu rdi vao 8 loai dot bien pho bien tffdng tff nhff nhieu tac gia da nghien cffu trffdc day. vi vay, chung ta co the sff dung nhieu phffdng phap giup ehan doan nhanh va chi phf thap cho gia dinh va ngffdi nha b§nh nhan nhff ARI4S - PCR, Real time PCR,....Du vay, trong chan doan trffdc sinh, cung can c6 sff phoi hdp nhieu ky thuat khac nhau de tranh bo sot eac dot bien hiem gap, tao od hpi eho cac benh nhi thieu mau nang chao dcfi, tSng ganh ning gia dinh va xa hpi.
Cung chfnh do sff phan bo rong ciia eac dot
bien nen tff 11 kieu ket hdp tiianh 27 kieu di
truyen chia lam 4 dang chfnh (Bang 3.2). Ket
qua nay khac vdi nghien cffu ciia Le Thi Hao
(2001) la 08 kieu dot bien nay ket hdp thanh 16
kieu di truyen. Sff khae nhau la do chung toi sff
/
VIETWAM MEDICAL JOURNAL N'2 - MARCH - 201L
dung 02 ky thuat de tim cac dot dot bien tren cac benh nhan, trong khi tac gia Le Thj Hao chf siJ dung chi mot ky thuat ARI^S - PCR cho 8 kieu dot bien. Co 154/211 ( 7 3 % ) the p-Thal phoi hdp HbE chiem t i le cao nhat trong cac dang phoi hdp. Nghien cull cua Le Thj Hao, Nguyen Khac Han Hoan dang phoi hdp nay luon cf mu'c cao trSn 50% [ l j , [ 2 ] . Ket qua nay cung tir nhu' cac nghien ciJu khac d Bong Nam A, |3-thal/ HbE luon la the b$nh pho b i & nhat [3].
Kieu phoi hdp gen tao the dong hdp td chi tlm__thay d dot bjgn Cd 17 va Cd 41/42 la do sir pho bien cua dot. bien nay trong cong dong. Va sir pho bign nay qon the hien trong t h i di hdp tiJ kep, kieu phoi hdp Cd 17/Cd 41/42 chiSm'ti le cao nhat. Ngoai ra, trong dang phoi hdp vdi dot bien HbE thi sir xuat hien cua Cd41/42/HbE va Cdl7/HbE cung chiem t i le cao nhat i n lu'dt la 29,9%, 2 5 , 1 % . Chinh sir pho blen ciia 3 dot bien nay luon cao nen cd nhieu nghien ciJu trong nirdc xay diTng cac ky thuat chan doan nhanh vdi gia thanh thap nhat de cac benh nhan co the liet kiem nhat trong chan doan tru'dc sinh [ 3 ] . Oay la cd hoi cho cac gia dinh ngheo da co con mac benh p-Thal co the co cd hoi sinh cho minh mot be khoe manh.
V. KET LUiJN
Nghien cu'u xac djnh cac dot bien gen p- gtobin tren 211 benh nhan nhi khu viTc Dong bang Song Cu'u Long cho thay dot bien Cd 95+A pho blen hdn dot bien IVS1.5 G>C. Nhu' vay, ngoai 8 dot bien gay benh pho bien nen thSm dot bien Cd 95+A cho khu vi/c trong chan doan
xac dinh benh nhanh bang sinh hoc phan' chan doan tru'dc sinh benh p-Thal. Ben ca nghien cifu con chi ra p-Thal StripAssay trinh bi la nhiJng ky thuat hieu qua de xe dot blen 99,5%. Tuy nhien, can su'dung tt thuat khac ho t r d trong trirdng hdp char tru'dc sinh tS tranh bo sot cac d6t bien cum gen Beta, dij tan suat gap rat hiem. '
T A I L I E U T H A M K H A O , 1. Lg Thi Hao. Nghien ciOi l^ng dung ky tl
truyen phan tir phat hien dot biefi gen ga' beta-thajassemia tai Viet NaiTl. Bao cao khi 2001.^Tru'cfng Dai hoc Y du'tfc TP Ho Chl Mini
* . Nguyen Khac Han Hoan. Nghien cOU tam ; chan doan benh alpha va beta thalassemia;'. / tieh si, 2013. TnTcIng Dai hoc Y dutJc TP Ho Oil 3. Nguyen Thu T r a n g , Le Thi t h u Ha, Ni
Thuy Ngan, Trieu Tien Sang, Pham Anh Duong, Vo Thi Thuong Lan. Natural SE and Technology, Detection of CommdiS thalassemia Mutations by Reverse Dot Btot Ar
VNU Joumai of Science, 2016, 32,398-403.
4 . Antonio Cao and Renzo Galanello. p-thalas Genetics in Medidne, 2010,12, 61-76.
5. Bobnyawat B, Monsereenusom C, Tra C'MoTe^uiar analysis of beta-globin mutations ^mong Thai beta-thalassemla'chi results from a sirsgle center study. 1 0 researcii.lQU.T, 253-258.
6. D Filon, Ariella Oppenhelm, 3 Rachmilewitz, D. Ba True. Molecular AnalvsH Thalassemia in Vietnam. Artide in Hem^
2000, 24(2), 99-104. '%
7. Svasti S, Hieu TM, Munlcongdee T, V^nldii P, Van Be T, Van Binh T, Fucharoen S. Moi analysis of beta-thalassemia In South Vie American Joumai of Hematology, 2002, 71(2), 8
DAC DIEM DICH TE HOC B E \ H HEN PHE Q U A N TRE EM TU- 6 DEN 1 5 TUOI TAI D A O CAT HAI, HAI PHONG
Nguyen Thi Anh Hyong', Thai Lan Anh^ Nguyen Van K
benh HPQ tir do tim ra giai phap can t h i p l phu'dng phap dieu tra cat ngang, phong v a a j kham benh xac dinh ty le HPQ theo GINA 2 0 i W tren 6 tuoi va tien sir di uYig ciia tre. So'lieu OT tren phan mem SPSS 13.0, ket qua cho' t M HPQ la 8,1%, nam cao hOn nff 1,6 ^ n , n h o r i i a la_9,8%, nhom 10-15 tuoi la 6,2%. Ti 1§ H l ^ Ho gia dinh sir dung nhien li§u (cijl, thani tas) cap 4, nuoi cho meo, khoi thuoc la; tre cp^^ien ifnj ca nhan (di irng thftl tiet, viem mui xoang"!
dl Ung thuoc, d| irng thirc an, may day san ngil^' dmh cd tien sir di iihg.' bo (HPQ, dl irng thdi tleB mui dj utig, may day), me (dl utig thdi tiS), aj em (HPQ), ong ba (HPQ), ho hang (HPQ, di (itij an, dj Unp thdi tiet); tre co can thilp san khoaj Khi de, de non, can nang khi sinh thap; tre cosffl T 6 | V 1 TAT
Hen phe guan (HPg) ngay mpt gia tang theo gia tang phat tnen kinh te-xa hoi. Nghien cuU tien hanh tren toan bp 1663 tre tir 6 den 15 tuoi sinh song tai tat ca cac xa/thj tran, dao Cat Hal, Hai Phong va bS me tre vdi muc tieu khao sat dac diem dich tS hoc
^B$nh vien Ba khoa Cat Ba 'Tnidng Bai hoc Y Dtfdc Hal Phong Chiu trach nhiem chinh; Nguyen Van Khai Email: [email protected] Ngay nhan bai: 23.12.2016 Ngay phan blen khoa hoc: 3.2.2017 Ngay duyet bai: 14.2.2017