THyC TRANG BENH SAN LA GAN LON & NGLPai TAI MOT S6 XA NGOAI THANH HA NOI

TCNCYH Phu tnmng 79 (2) - 2012. THyC TRANG BENH SAN LA GAN LON & NGLPai TAI MOT S6 XA NGOAI THANH HA NOI Vu Hoang Anh\ Pham Duy Turim^ 'Trung tim Yti du phdng Hi N&, ^Tnrimg Bai hpc Y Hi N0i. Nghiin cim nhim dinh gii thuc trang mic binh sin li gan Idn d ngudi tpi tiin xi ngopi thinh thinh phi Hi Npi. Kit qui cho thiy ty id nhiim sin li gan idn duac phit hidn bing kl thuit ELISA ii 1,3%, tf id nhiim sin li gan Idn d nam gidi ii 0,7% vinOgiOi 1,5%. ty id nhiim sin li gan idn ddd tuii dudi 15 ii 1,0%, £ 15 tuii ii 1,3%. Tinh trpng nhiim sin li gan idn tai 4 xS ngoai thinh Hi Ndi li eo sd eho vid giim sit ty id mic binh vi can thiip kip tbOi. Tu khoa: san la gan Idn, Elisa, Ha N$i, ngo^i thinh ddn 60 tudi tpi 4 xa: Tdt Odng, Vpt Lpi, Nam Hdng vd Mai Dinh tir thang 3 - 9/2011. I. DAT VAN o e B0nh sdn Id gan Idn (fasciolasis) d ngudi la benh do ky sinh triing Idy truyin qua dudng thu'c dn do ngudi dn phai cdc loai rau. 2. Phucng phap nghien c i h i 2.1. Thiit ke nghien cuu : Nghidn cuu md. thuy sinh sdng cd chira i u triing sdn Id gan. td eat ngang. Idn [1]. Ty Id m i c benh cao nhit tap trung d. 2.2. Chpn mau : Mdu chgn ed etui dieh tai 4 xa thugc 4 huy^n cd bao eao thdng kd y td bpnh nhan mic sdn la gan Idn. cdc khu vuc Chan nudi ddng vdt ed sirng (ciru. trdu, bo) va khu vuc ngudi ddn cd tap qudn an sdng eae thuc vdt thuy sinh [2]. Nghien ciru benh sdn Id gan Idn d Viet Nam. Cd mdu tinh theo cdng thirc. da phdn bd tpi 100% tinh thanh tren todn qude vd cac ca benh khdng ngirng ngdy cdng. ". •^l-a/2. gdy anh hudng nghiem trpng d i n sire khoe ngudi dan vdi nhti-ng nhO-ng tridu chu-ng todn thdn va tpi gan nhu dau tCrc vung gan. sdt keo ddi. rdi loan tidu hoa. dj irng. vang da, ed t h i dan d i n ung thu gan, dudng mat [4]. Bpnh sdn Id gan Idn ngdy cdng phat tridn, gia tdng vd trd thdnh can bdnh ky sinh triing ciia ngudi ddn, de tim hilu ty Id m i c benh sdn Id gan Idn tai ngopi thanh Hd Ndi d l tdi dugc thuc hidn vdi mgc tieg: Binh gia thpv trang mac benh sin ia gan l&n a nguui tai bin xa ngoai thinh thinh pho Hi /Vdi. II. D 6 I TirCING. VA P H U O N G P H A P. 1. Ddi tup'ng, dja diem va thdi gian nghien cu'u: Ddi tup-ng nghien cii-u tir 10. ,2. d. gia tang [3]. Thue trang benh sdn Id gan Idn Trong d o :. n: ca mlu t l i thilu c i n dgt dugc. p: ty le nhilm san la gan 16'n tu kit qua dilu tra truac (0,11 ty 1$ nhilm san la gan lan a Khanh Hoa nam 2002) [4]. d: dp chinh xac mong muln (lly d = 0,05). Z(i.a/2): he s i tin c$y tuang i>ng h0 s6 tin cgy (^nh truac (Z = 1,96 ). Ca mlu tinh duac va lam tron n = 200 cho m l i xa. Tong s i 4 xa la 800 ngufi'i. 2.3. Ti&u chuan chin doan - Nghien cuu ty le nhiem san la gan lan bang ky thuat ELISA tien hanh tai Labo \^en sit ret - Ky sinh tmng - Con tnJng Tmng Lrang. 37. TCNCYH Phu tnmng 79 (2) -2012 - Elisa duong tinh vdi hieu gia khdng t h i. 3. Xi> ly vd phdn tich s6 li#u: Sd Hdu. 1/3200 Id tidu chuin chin doan xdc djnh. dupe thu thdp. xu- \^ tren Epidata vd phdn. nhilm sdn Id gan Idn [5].. tich bing SPSS 16.0. III. K£T QUA Bdng 1. Ty Ip nhilm sdn la gan Idn tai 4 xa ngoai thanh Hd Npi ELISA. Dja didm nghien ciru. 36 XN. Mai Oinh. %. "sd(+). 202. 2. 0,9. Nam Hdng. 200. 2. 1.0. TdtOdng_. 200. 2. 1.0. Vat Lpi. 200. 4. 2.0. 802. 10. 1,3. Bang 1 cho thiy ty Id nhllm san la gan Idn chung dugc phat hipn bing ky thudt ELISA la 1,3%, xd Vpt Lpi cd ty Id nhllm sdn la gan Idn cao nhit (2,0%), tilp theo Id xa Nam Hdng va Tdt Dpng (1,0%) vd ty l§ thip nhit id xa Mai Oinh (0,9%). Bang 2. Ty Id n h i l m san la gan Idn phan loai theo gidi. XN. S6(+). Mai Dinh. 69. 0. %. XN. 36(+). %. 0. 133. 2. 1,5. Nam Hdng. 65. 0. 0. 135. 2. 1,5. Tdt Odng. 94. 1. 1.1. 106. 1. 0,9. Vdt Lpi. 54. 1. 1.9. 146. 3. 2,1. 0,7. 520. Tdng sd. p < 0.05. Bang 2. chi ra ring ty Id nhilm san Id gan Idn rit khac nhau theo gidi, ty Ip phdt hipn d nu Id 1,5% cao g i p ddi d nam 0,7% (p < 0,05). Tuy nhien khdng phdt hidn trudng hgp nao nhldm san la gan Idn ciia nam gidi tpi Mai Oinh vd Nam Hdng. Bang 3. Ty Id nhilm sdn la gan Idn x i p theo nhdm tudi Nhdm tudi. SdXN. S6(-f). %. <15. 96. 1. 1,0. >15. 706. 9. 1,3. Tdng sd. 802. 10. 1,3. Bang 3 cho thiy ty Id nhilm sdn Id gan Idn d nhdm <15tudi chidm 1,0%. va nhdm >15tudi la 1,3%.. 38. TCNCYH Phu truxyng 79 (2) - 2012 IV. BAN LUAN 1. Ty le n h i l m san la gan lan chung b^ng ky thuat xet nghiem ELISA Co nhilu ky thugt xet nghiem de chin doan benh nhan bj mac san la gan Idn nhu xet nghiem phin ngub"! tim trung san Id gan lan, xet nghiem mau phat hipn huyet thanh mien dich lien kit men, xet nghi0m phSn trau bo, sieu am gan....Tuy nhien vai m l i phuang phap xet nghiem khac nhau se co nhung ty le nhilm benh tuang Cpng. Trong nghien cuu chung toi su dyng xet nghiem mdu theo phuang phap huylt thanh miln djch lien kit men (ELISA), khi chin doan theo phuang phap ELISA thi do nhgy dgt 100%, dp dgc hieu dat 94% [4, 6]. Theo mpt nghien CLPU cua Vien Ve sinh phong djch Quan dpi nam 2009 thuc hien tren 251 quan nhan dong quan tai Mien Trung cho thiy: 5,9% xet nghipm Elisa duang tmh vai F.gigantica. Kit qua nghien cuu cua chung toi tai 4 xa ngogi thanh Ha Npi cho thiy ty le ELtSA(+) la: 1,3%, ty le nay thap han nhilu so vai kit qua cua Dang Thi e l m Thach (92,1%) [7] va Maria nghien cuu a vung Bolovia vao nam 2000 la 53% [8]. Co t h i ly giai kit qua cua chung toi cho thiy muc hieu gia khang the cua benh nhan san la gan lan chu y i u a 1/3200 va duac tiln hanh a cpng ding dan cu vo-i Iua tuoi rpng nen c6 ty le thip han. 2. Ty le n h i l m san la gan lan theo giai va tudi Trong nghien cuu chung toi lay m l u a trong quin dan cu tap trung vao dO tuli tu 10 - 60, ty le nhilm san la gan lan 10-15 tuoi chilm 1,0%, tren 15 tuoi la 1,3%, khong co su khac biet co y nghTa thing ke a 2 nhom tuli (p > 0,05). Theo Nguyen Khac Luc [4] nhom tudi mac san la gan lan cao nhat tu 20 - 49 tuli, tren 10 tuli chilm 99,1%, theo Dang Thi Cam Thach tren 15 tuli chiem. 95,3% [7]. Phai chang Iua tuoi dual 15 it tilp xCic v&\ cac y i u t l phai nhiem nen ty Ip mac thip han. Kit qua cua chung toi con cho thay nQ" CO s i mac cao han nam (1,5% so vd'i 0,7%), k i t qua cua chung toi cOng phu hap vdi quan sdt cua Nguyin Khac Luc nghien cuu tai cpng ding (nu la 6,3% va nam la 2,4%) [4] va Dgng Thj C i m Thgch (nu- la 62,6% va nam la 37,4%) [7], Chua c6 nghien cuu ndo giai thich vi sao nu mac nhilu han nam, tuy nhien chung toi nghT rang nu ca dja y i u han nam se d l nhilm bpnh han, mat khdc nu* hay phai tiep xuc vdi cac yeu t l nguy ca han nhu mim benh trong cdc loai rau trlng vd thuy sinh, phan gia sue V K i r LUAN Thuc trgng nhilm san la gan Idn tai 4 xa ngogi thanh Thanh Pho Ha Npi - Ty Ip nhiem san Id gan Idn chung phdt hien bang kT thugt ELISA la 1,3% - Ty le nhiim sdn la gan Idn d nam gidi la 0,7% va nO-gidi 1,5%. - Ty le nhiim sdn la gan Idn d dp tuoi dudi 15 la 1,0%. > 15 tuli la 1,3% TAI LIEU THAM K H A O 1. Gulssen MT, Savas MC et al., (2006), fascioliasis: a report of five cases preenting with common bile duct obstruction. Neth J Med, 6 4 : 1 7 - 9 . 2. Nguyin Van Kha (2005), nghien cuu thuc trang nhiim sdn Id gan Idn va mpt s i y i u to nguy ca d mpt so diem tai Phu Yen, Khdnh Hoa nam 2005, lu^n van thac sy y hpc, Bp Y Te, Dai hpc Y Ha Npi. 3. Nguyin Van D l , Phan Thi Hu'O'ng Lien, Tru'cng Thi Kim Phu'O'ng (2010), Thuc trang nhilm sdn la gan Idn tren nhom ngudi dupe chin dodn u gan tgi bpnh vien Ha Npi nam 2006-2010. Bap cdo khoa hpc tai. 39. TCNCYH Phu tnmng 79 (2) - 2012 hdi nghj ky sinh triing toan qude 2011, 133-137. 4.. Tpp chi Y hpc thdnh phd Hd Chi Minh, 11, phy ban sd 2: 80 - 88.. Nguyin Khic Lye (2010). Nghidn. 7. D|ing Thj C i m Thpch, 0 6 trung dOng,. ciru mdt sd ddc dilm nhilm sdn Id gan Idn vd hidu qua mdt sd bidn phdp can thidp tpi huydn Dpi Idc-Quang Nam, ludn dn tidn si. Ld Thj Loan (2008). tinh hinh nhilm sdn Id gan Idn d Vidt nam ndm 2007 vd dd xuit bidn phdp phdng chdng. Tpp chi phdng. Y hpc.. chdng bdnh sdt rdt vd cdc bdnh k)? sinh triing.. 5. Engvall E, Perlman P (1971). Enzyme. '''• 31 - 37. - linked Immunosobent assay (ELISA). Quantitative assay of immunoglobulin G. immunoehemistry 8 (9): 871 - 874.. g Maria A. V (2000). Comparative jnfectivity of faseiola hepatica metacercariae ,^o^ isolates of the main and secondary. 6. Nguyin Vdn D l , Ld Thanh Hda vd. reservoir animal host speices in the Bolovian. C^ng sv (2007). Xdc dinh thdnh phin lodi. Altiplano high human endemic region. Folia. sdn Id d Vidt Nam bdng sinh hpc phdn tii'.. Parasltologiea 4 7 : 1 7 - 2 2 .. Summary SITUATION OF HUMAN FASCIOLASIS IN SOME COMMUNES AT THE SUBURBS OF HANOI The study was carried out to assess the status of fascioliasis infection in four communes in the suburbs of Hanoi. Results so that the prevalence of fascioliasis infection by ELISA technique was 1.3%. the rate of fascioliasis in men is 0.7% and 1.5% females, fascioliasis prevalence under the age of 15 is 1.0% and 2 15 years was 1.3%. Concluded that fascioliasis in four suburban communes of Hanoi suburbs is the basis for monitoring the incidence and timely intervention Keywords: fascioliasis, Elisa, Hanoi, suburban. r, DjCH T i HOC S P T XUAT HUYiT VA MOT s 6 YiU TO LIEN QUAN TAI THANH HOA NAM 2008 - 2010 Oao Th\ Minh An', NguySn Danh Phuong ' Tnmng Bai hoc Y Ha Nil 'Trung tam Y ti dw phdng Thanh ph6 Thanh Hoi Nghiin cim nhim md ti mdt si die diim dich ti hpc vi yiu ti tuang quan cua binh sit xuit huyit Dengue (SXHD) tai Thanh hoi trong 3 nim 2008 - 2010. Kit qui nghiin ciru eho thiy tf 1$ mic glCra nam vi na tuang img 54% vi 46%, ca binh tip tmng chu yiu 6 nhdm tU15 din 24 tuSi, ndng din, hpc sinh, sinh viin vi cic bp cdng nhin viin chirc. Cic ca bdnh bit diu xiy ra tir thing 6 vi kit thOc vio thing 11 dinh cao vio thing 8,9,10 hing nam. Huyin TTnh Gra, Thiiu Hda, Hoing Hda, Hiu L0c ti nhO'ng dia phuang cd luu hinh SXHD qua cic nim. Thinh phi Thanh Hda vi mpt si dia bin cd SXHD 40.