than that in the intact hemisphere, blood vessel tone in ischemic hemisphere was higher than that in healthy one and alternating blood flow in ischemic hemisphere is lower than healthy one. There
was a correlation between Crest time parameter and Cholesterol TP/LDL-C in ischemic stroke group.
Key words: Rheoencephalography brain ischemic stroke
NGHIEN CU'U CAC CHi SO LUU HUYET NAO 6* BENH NHAN BAI THAO DUONG TYP 2 TAI BENH VIEN TRUONG DAI HOC Y DUOC HUE Hoang Khanh Hang, H6 Xuan Linh, Nguyin Thj Phuang Anh
Bai hpc Y Diroc Hue Nghien cdu diroc tien hanh tren 40 benh nhan dai thao duong typ 2 tuoi tCr 40 tro len.
Muc tieu cua de tai la xac dinh cac thong so luu huyet nao & benh nhan dai thao duong typ 2. Cac chi so luu huyet nao d benh nhan DTD typ 2 va nguoi binh thudng dupe do bang may Rheoscreen compact-MEDIS (Due). Do tren 2 chuyen dao chinh: chuyen dao tran - chum (F-M) va chuyen dao chum - cham (M - O). Ket qua cho thay dinh sdng dang nhon chiem 22,5%, dinh tu 52,5% va dinh vdm 15%. Song phu xuat hien vdi ty le thap (10%).
Cudng dp ddng mau nao d benh nhan dai thao duong typ 2 thap hon a nguoi binh thuong (p < 0,01). Thdng so danh gia truong luc mach mau nao 6 benh nhan dai thao duong typ 2 cao hon d nguxri binh thuong, bieu hien ro & thdng so thoi gian dinh (p < 0,01). Luu lupng mdu nao (ABF) cua nhom benh thap hon cua nhdm binh thudng (p < 0,01).
Tir khoi: luu huyet nao, dai thao dudrng typ 2 LBATVANOE
Benh dai thao dudng (DTD), trong dd chu yiu la benh dai thao dudng typ 2 chiim ty le ti> 85 - 95% trong tong so benh nhan dai thao dudng. Ty le benh ngay cang cd xu hudng gia tang, dac biet d nu-dc dang phat triin, trong dd cd Viet Nam. Benh tim mach bao gom benh dpng mach vanh va benh mach mau nao la nguyen nhan thudng gap nhat d benh nhan dai thao dudng, chiim hon 65% nguyen nhan tu vong (15% do benh dpng mach nac). Dpi vdi nap, benh nhan dai thao dudng thudng cd xo vi>a ddng mach nao dua din nhung biin chung nhu xuat huyit nao, tic mach nao [1], [4], [5],
Hien nay, viec danh gia muc dp ton thuong mach mau nao tren benh nhan dai thao dudng chu yiu bang sieu am Doppler mach. Tuy nhien, sieu am Doppler mach ddi hdi kinh nghiem cua ngudi lam sieu am, chi phi tuong doi cao, va chi sin cd d mot so trung tam chuyen khoa Idn. Phuong phap do luu huyit nao dap irng nhung yeu cau nay bdi cau true don gian, phan tich kit qua chu yiu dua vao phan mim va dl su dung.
Khao sat cac chi so luu huyet nao nhim di danh gia muc dp tin thuong xo vu-a dpng mach nac thdng qua danh gia luu lupng tuan hoan len nao d nude ta van cdn it du-pc quan tam, dac biet tai Mien Trung
Vietnam Journal of Physiology 14(3), 9/2010 ISSN: 1859 - 2376
noi chung va ThCra Thien Hue noi rieng.
Xuat phat tir ly do tren chung toi tien hanh de tai nay nhlm muc tieu: Xac dinh cac thong so Iwu huyet nao o benh nhan dai thao dwong typ 2.
2. Ofil TLrONG VA PHUONG PHAP NGHIEN CU'U
2.1. Ddi tugng nghien ciiu
- Gom 40 benh nhan da dugc chan doan xac dinh OTO typ 2. Tudi benh nhan tir 40 trd len. Kham va dieu trj tai khoa Ndi - Benh vien Trudng Dai hoc Y Dugc Hue. Thdi gian tCr thang 05/2007 den thang 04/2008.
- Tieu chuan chon benh nhan: cac benh nhan dugc chan doan OTD typ 2 theo tieu chuan chan doan cua TCYTTG nam 1998 va da dugc xac dinh lai nam 2002.
- Tieu chuan loai tru: benh nhan khdng hgp tac, dang trong giai doan cap, cd benh nang phoi hgp.
- Chgn nhdm so sanh: chgn 40 ngudi cd do tuoi tuong dueng nhdm benh, nhCrng ngudi den kiem tra sire khoe tai benh vien Trudng Oai hgc Y - Dugc Hue chua phat hien dugc bat thudng ve lam sang va can lam sang tai thdi diem den kham.
2.2. Phuong phap nghien cuu
- Oo cac chi so luu huyet nao: d benh nhan OTO typ 2 va ngudi binh thudng bing may Rheoscreen compact-MEDIS (Due) tai khoa Tham dd chuc nang, Benh vien trudng Dai hpc Y Dugc Hue. Do tren 2 chuyen dao chinh: chuyen dao tran - chum (F - Wl) (danh gia tuin hoan he dpng mach canh trong) va chuyen dac chum - chim (M - O) (danh gia tuan hcan he dpng mach dct s6ng - than nen).
- Phan tich dudng ghi luu huyet nac + Hinh dang sdng luu huyet nap: Dinh sdng: nhpn, tu, vdm. Sdng phu: cd hay khdng xuat hien, vi tri cua sdng phu (neu cd) so vdi sdng chinh.
+ Cac chi so luu huyet: Cac chi so danh gia cudng dp ddng mau: ty so trd khang, ty so dp d6c. Cac chi so danh gia truong luc mach mau nao gom cd: thdi gian dinh, dp rpng dinh, thdi gian truyen, luu lupng mau thay doi.
2.3. Phuong phap xir ly sd lieu
- So lieu thu dugc su ly theo phuong phap thong ke y hpc.
3. KET QUA VA BAN LUAN 3.1. Hinh dang song luu huyet nao
Ket qua dugc trinh bay trcng bang 1 Bang 1. Phan bp hinh dang sdng luu huyet nap g nhdm nghien cuu
Hinh dang n Ty le (%)
Dinh nhpn 9 22,5
Dinh tii 25 62,5
Dinh vdm 6 15
Sdng phu 4 10
3.2. Cac thong sd danh gia ciro-ng do ddng mau
Bang 2. Cac thong so danh gia cirdng dp ddng mau d chuyen dao chum - tran.
Thdng so Nhdm benh Nhdm binh thirdng P
Ty so trd khang (impedance ratio) (p.m) 0,88 ±0,27 0,96 ±0,26 > 0,05 Ty so dp doc (slop ratic) (p.m/s) 9,62 ±2,97 11,6 ±2,89 < 0,01 Bang 3. Cac theng SP danh gia cirdng dp ddng mau d chuyen dao chum - cham.
Thdng so Nhdm benh Nhdm binh thudng P
Ty so trd khang 0,86 ± 0,28 0,97 ±0,30 > 0,05
Ty so dp doc 9,42 ±3,29 11,58 ±3,53 < 0,01
3.3. Gia trj trung binh cua cac thdng sd danh gia truong luc mach mau nao Bang 4. Cac thdng so danh gia trirong lire mach mau nao
d chuyen dao xuong chiim - tran.
Thdng so Nhdm benh Nhdm binh thirdng P
Thdi gian dinh 201,81 ± 33,73 183,4 ± 36,7 < 0,05
Dp rpng dinh 82,49 ± 15,41 77,85 ±21,95 > 0,05
Thdi gian truyen 122,11 ±47,24 140,2 ± 55,8 > 0,05 Bang 5. Cac thdng SP danh gia trirong lire mach mau nac
d chuyen dao chum - cham
Thdng so Nhdm benh Nhdm binh thirdng P
Thdi gian dinh (ms) 195,39 ±24,13 177,1 ±28,1 < 0,01 Op rpng dinh (ms) 84,48 ± 14,23 77,78 ±20,89 > 0,05 Thdi gian truyen (ms) 110,79 ± 21,45 126,9 ±36,93 < 0,05 3.4. Gia trj trung binh cua luu lugng mau nao (ABF)
Bang 6. Gia tri trung binh ciia liru lirgng mau nao (ABF)
Thdng so Nhdm benh Nhdm binh thirdng P ABF chuyen dao chum - tran (%/min) 20,09 ± 5,40 24,59 ±6,34 < 0,01 ABF chuyen dao chum - cham (%/min) 19,13 ±6,60 24,12 ±8,87 < 0,01
Vietnam Journal of Physiology 14(3), 9/2010 ISSN: 1859-2376
4. BAN LUAN
Ket qua tren bang 1 cho thay ty le benh nhan DTD typ 2 co hinh dang song pho bien la dinh song dang tii chiem 62,5%, tiep den la dinh song dang nhon chiem 22,5%, dinh song dang vdm chiem 15%. Song phu xuat hien It voi ty le 10%. Theo Ronkin va larullin [10], trong cac giai doan cua benh xo vira dpng mach, hinh dang sdng cd dinh liic dau la dang trdn hay phang nhe (tu), sdng phu xuat hien md, ve sau dinh sdng cd dang vdm, cac nguyen, sdng phu rat md hoac khdng xuat hien. Dieu nay bieu hien tang truong lye mach mau nao, tire la giam dp dan hoi ciia thanh mach mau [9]. Hinh dang sdng luru huyet tuy khdng thirong xuyen phan anh chinh xac cac giai doan cua qua trinh xo vCra ddng mach nap nhung khi bi bien doi thirdng ty le thuan theo mire dp xo vira dpng mach nao [3]. Nhir vay vdi ket qua nghien ciru cua chiing tdi tren benh nhan OTO typ 2 cho thay cd bieu hien cua sy giam dan hoi thanh mach.
So lieu d bang 2 cho thay ket qua trung binh cua ty so trd khang ciia benh nhan DTD typ 2 la 0,88 (p.m) thap hon khdng dang ke so d vdi ngirdi binh thu'dng la 0,96 (p.m) (p > 0,05). Ty so dp doc cua benh nhan DTD typ 2 la 9,62 (p.m/s) thap hon ty sc dp doc cua nhdm binh thirdng la 11,6 (p.m/s), sy khac biet nay cd y nghTa thong ke vdi p < 0,01.
Ty so trd khang cua benh nhan DTD typ 2 (bang 3) la 0,86 (p.m), thap hon so vdi ngudi binh thydng la 0,97 (p.m), sy khac biet nay chya cd y nghTa thong ke (p > 0,05). Ty so dp doc cua benh nhan DTD typ 2 la 9,42 (p.m/s) thap hon ty sc dp doc ciia nhdm binh thirdng la 11,58 ± 3,53 (p.m/s), sy khac biet nay cd y nghTa thong
ke vdi p < 0,01. Nhir vay, ket qua ciia hai thdng so nay d hai chuyen dao xirong chum - tran va xirong chum - cham tirong duong nhau va phan anh tinh trang cirdng dp ddng mau nao d benh nhan OTD typ 2 thap hon so vdi d ngirdi binh thu'dng. Nguyin Minh Hai va Vu Dang Nguyen khi nghien ciru tren benh nhan cd thiiu nang tuan hoan nao d dp tuoi 58 nhan thay d benh nhan cd mang xo vua d dpng mach canh cd ty so trd khang la 0,53 ± 0,17 (p.m), ty so dp die la 5,82 ± 2,59 (p.m/s), d benh nhan khdng cd mang xo vira gia trj lan lirpt la 0,65 ±0,10 (p.m) va 11,09 ± 3,78 (p.m/s), cdn d nhdm chirng gia trj lan lirpt la: 0,76 ± 0,10 (p.m) va 11,09 ± 3,78 (p.m/s) [2]. Mot so nghien ciru khac vi benh nhan thiiu nang tuan hoan nao nhir tac gia Doan Van Tiip va cs. d benh nhan cd tuoi trung binh 50,87 ± 9,66 cho kit qua ty so trd khang d chuyen dao xirong chum - tran la 1,48 ± 0,18 (p.m), cdn d chuyin dao xirong chum - cham la 0,91 ± 0,13 (p.m) [7]. Nhir vay khi so sanh vdi kit qua cua cac tac gia khac nhau cho thay kit qua nghien ciru ciia chung tdi ve cac thdng so danh gia cirdng dp ddng mau d benh nhan DTD typ 2 cd gia trj trung gian.
Thdi gian dinh cua benh nhan DTO typ 2 la 201,81 ± 33,73 (ms) Idn hon thoi gian dinh ciia ngirdi binh thirdng la 183,4 ± 36,7 (ms) (p < 0,05) (bang 4). Tirong ty doi vdi thdng so dp rpng dinh, gia trj trung binh cda benh nhan DTD typ 2 la 82,49 ± 15,41 (ms) Idn hon cua ngydi binh thirdng la 77,85 ± 21,95 (ms), nhirng sy khac biet n^y chua cd y nghTa thong ke (p > 0,05). Thdi gian truyen cua benh nhan DTD typ 2 la 122,11 ± 47,24 (ms) thap hon chua cd y nghTa so vdi ngydi binh thudng la 140,2 ± 55,8 (ms) (p > 0,05).
Thdi gian dinh ciia benh nhan DTD typ 2
(bang 5) la 195,39 ± 24,13 (ms) Idn hen thai gian dinh cua ngirdi binh thirdng la 177,1 ± 28,1 (ms) (vdi p < 0,01). Doi vdi thdng so dp rpng dinh, gia tri trung binh cua thdng so nay tren benh nhan DTD typ 2 la 84,48 ± 14,23 (ms) Idn hon khdng dang ke so vdi ngirdi binh thirdng la 77,78 ± 20,89 (ms) (p > 0,05). Thdng so thdi gian truyen cua benh nhan DTD typ 2 la 110,79 ± 21,45 (ms) thap hon so vdi d ngudi binh thirdng la 126,9 ± 36,93 (ms), sir khac biet nay cd y nghia thong ke vdi p < 0,05.
Nhin chung, ket qua cua cac thdng so danh gia trirong lire mach mau nao d benh nhan DTD typ 2 cd sir khac biet so vdi ngirdi binh thu'dng. Trong cac thdng so danh gia trirong lire mach mau nao, chiing tdi nhan thay thdng so thoi gian dinh cd gia tri phan anh trirong lire mach mau hon so vdi hai thdng so cdn lai. Ket qua nghien ciru cua chiing tdi phii hpp vdi ket qua nghien ciru cua Ronkin va larullin, d giai doan ddng mach nac xo vira rd thdi gian dinh keo dai tir 0,2 s den 0,23 s hoac hon nira. Mire dp xo vCra tang len thi dp dan hoi mach mau giam di, dieu nay din den tang trirong lire mach mau nao dirge bieu hien bing tang thoi gian dinh [3], [10]. Bodo va cs. nghien ciru ve lu'u huyet nao tren 546 doi tirgng cd nguy co bj tai bien mach mau nao cao cho thiy cd sir tang thdi gian dinh lam giam dp dan hpi cua dpng mach, gia trj tieu chuin binh thu'dng la 180 ms, thdng so nay la diu hieu sdm cua tinh trang xo vira ddng mach nao va nd phan anh tinh trang xo vira dpng mach nao d giai doan sdm tot hon so voi sieu am Doppler dpng mach canh [8]. Ket qua nghien ciru ciia chiing toi ciing phii hgp vdi mdt SP nghien ciru trong nirdc nhir Dao Phong Tin nghien ciru liru huyet nao tren
ngirdi binh thu'dng cho thay sir thay doi ciia khoang thdi gian nhanh len (thdi gian dinh) la cd y nghTa hon ca, thdng so nay tang len theo sir tang len cua nhdm tuoi va bien doi rd ret nhat g nhdm tudi trung nien va ngudi gia. Gia tri trung binh cua nhdm tuoi 45 - 59 la 0,18 ± 0,03 s (tirong dirong 180 ± 30 ms), nhdm tuoi 60 - 74 la 0,185 ± 0,02 s, tren 75 tuoi la 0,19 ± 0,02 s (190 ± 20 ms). Theo Hing so Sinh hpc ngirdi Viet Nam nam 2003, thdi gian nhanh len chung cho ca hai gidi: lira tuoi 45 - 59 d chuyen dao xirong chum - tran la: 0,18 ± 0,01 s, chuyen dao xirong chum - chim la: 0,19 ± 0,01 s, lira tuoi 60 - 74 va > 75 d ca hai chuyen dao deu la 0,19 ± 0,01 s [6]. Mdt SP nghien ciru khac d benh nhan thieu nang tuin hoan nao, cho gia tri trung binh cua thdi gian dinh la 0,20 ± 0,04 s, theo Doan Van Tiep, Chu Quoc Trirdng d doi tirgng cd tuoi trung binh la 50,8, gia tri nay la 0,22 ± 0,01 s [7].
Nhu> vay, ket qua nghien ciru ciia chiing tdi so vdi cac ket qua nghien ciru cua cac tac gia trong va ngoai nirdc d cac doi tirgng khac nhau kha phii hgp. 6/ benh nhan DTD typ 2 cac thdng so danh gia trirong lire mach mau nao gia tang hon ngirdi binh thudng, phan anh tinh trang kem dan hoi mach mau nao d benh nhan OTO typ 2 so vdi g ngirdi binh thirdng, qua dd phln nao the hien tinh trang xo vira mach mau nac d benh nhan OTO typ 2 cao hon so vdi ngudi binh thudng.
Ket qua gia tri trung binh cua liru lirgng mau (ABF) (bang 6) g chuyen dao xirong chum - tran cua benh nhan OTD typ 2 la 20,09 ± 5,40 (%/min), thip hon cd y nghTa so vdi ngirdi binh thirdng la 24,59 ± 6,34 (%/min), (p < 0,01). Ooi vdi chuyen dao xirong chum - cham, gia tri trung binh ABF
Vietnam Journal of Physiology 14(3), 9/2010 ISSN: 1859 - 2376
a benh nhan DTD typ 2 la 19,13 ± 6,60 (%/min), thap han a ngudi binh thu'dng la 24,12 ± 8,87 (%/min), su- khac biet nay cd y nghia thong ke vdi p < 0,01). Thdng so luu lugng mau nao (ABF) khdng phai la thdng so danh gia liru lugng ddng mau thuc chay trong md nao, ma nd phan anh tuong ddi luu lugng ddng mau thuc, dd la thdng so dugc tdng hgp tu cac thdng so ve cudng do ddng mau nao (ty so tro khang), truong luc mach mau nao (thdi gian dinh) va chu ky tim (hay chu ky sdng luu huyet). Theo nghien
CLFU cua Nguyln Minh Hai va Vu Dang Nguyen nam 2006 tren benh nhan thieu nang tuan hoan nao do tuoi trung binh 58 d benh nhan cd mang xa vua ddng mach canh va ddng mach dot song ABF la: 15,05
± 5,24 (%/min), d benh nhan khdng cd mang xa vCra la: 19,23 ± 4,16 va d nhdm chung la 25,15 ± 6,58 [2]. Nhu vay, ket qua nghien cuu d nhdm chirng cua hai tac gia tren va ciia chung tdi tuong duang nhau, nhin chung ABF d benh nhan DTO typ 2 va nhdm cd nguy co xo vua dong mach deu thap hon so vdi nhdm binh thudng.
Bodo va cs. cho ring luu huyet nao do phan anh su dap irng nhirng bien ddng cua ddng mach nao trong qua trinh ty dieu hoa luu lugng mau nao chinh xac hen so voi dugc xac dinh luu lugng bing Laser Doppler (LDF) va luu lugng ddng mach canh qua sieu am. Cac tac gia cho ring liru huyet nao do cd nhieu thuan Igi irng dung tren lam sang d nhieu ITnh vyc khac nhau va la phuong phap khdng xam nhap [8], [9].
Hien nay vin cdn nhieu tranh cai ve ca sd ciia luu huyet nao va sy chi phoi ciia nhieu tac nhan len dirdng liru huyet nao, dieu dd giai thich sy dao dong ve ket qua nghien ciru cua cac tac gia khac nhau d trong va ngoai
nirdc ve luu huyet nao [1], [4], [5],
Tuy nhien, theo nhan xet cua chung tdi, tuy ket qua nghien ciru ciia cac tac gia cd khac nhau nhung doi vdi tirng nhdm benh nhan thi dirdng ghi luu huyet tuang doi on dinh, do dd nd cd gia trj gdp phln theo ddi qua trinh tien trien ciia benh ly d nhdm benh nhan dd.
5. KET LUAN
- Dinh sdng dang nhgn chiem ty le 22,5%, dinh tii 62,5% va dinh vdm 15%, Sdng phu xuat hien vdi ty le thap 10%.
- Cudng do ddng mau nao d benh nhan dai thao dudng typ 2 thap han so vdi d ngudi binh thudng (p < 0,01).
- Trirong lyc mach mau nao d benh nhan dai thao dudng typ 2 cao hon so vdi d ngudi binh thudng, bieu hien rd d thdng so thdi gian dinh (p < 0,01).
- Lu'u lugng mau nao (ABF) ciia nhdm benh thap han cua nhdm binh thudng (p < 0,01).
TAI LIEU THAM KHAO
1. Ta Van Binh (2006), Nghien ciru theo ddi bien chirng dai thao dirdng d benh nhan den kham lan dau tai benh vien Noi tiet, NXB Y hgc, tr. 15-19, 55-79, 143- 153.
2. Nguyin Minh Hai, Vu Dang Nguyen (2006), Nghien ciru moi lien quan giira sieu am ddng mach canh va dong mach dot song vdi luu huyit nao, dien nao d benh nhan thiiu nang tuan hoan nao, Tap chi Sinh ly hpc, (10), tr. 2-7.
3. Vu Dang Nguyen (1994), Tai lieu liru huyit nao lam sang, Hpc vien Quan Y, Ha Npi, tr. 18-86.
4. Thai Hong Quang (2003), Benh npi tilt, Nha xuat ban Y hpc, Ha Npi, tr. 218-384.
5. D6 Trung Quan (2006),Biln chirng DTD
va dieu tri, NXB Y hoc, tr.9-22.
6. Dao Phong Tin (2003), Hing so sinh hpc ngirdi Viet Nam, NXB Y hpc, tr. 148.
7. Doan Van Tilp, Chu Qudc Tripd-ng, Vu Dang Nguyen (2000), Nghien cuu tac dung ciia phireng phap bim huyet Phong tri tren lam sang va liru huyet nao, dien nao d benh nhan thieu nang tuin hoan nao man tinh, Tap chi Cham ciru Viet Nam, (36), tr. 10-11.
8. Bodo M., Pearce F.J., Baranyi L. et al.
(2005), Changes in the intracranial Rheoencephalogram at lower limit of cerebral blood flow autoregulation, Phisiol Meas, 26(2): S1-17.
9. larullin K (1990), Clinical Rheoencephalography, Medicine Publishing, Moscow, pp. 18-78, 108-162.
SUMMMARY
Parameters of rheoencephalography in diabetes type 2 at hospital of Hue college
of medicine and pharmacology Hoang Khanh Hang, Ho Xuan Linh
Nguyen Thi Phireng Anh Hue College of Medicine and Pharmacy Study on 40 patients with type 2 diatebes at aged over 40 to determine their parameters for cerebral blood flow. We measured the parameters on the patients with type 2 diabetes and the normal people with compact machine Rheoscreen-MEDIS (Germany).
The result showed that the crest pointed wave was 22.5%, the crest obtuse wave was 62.5%, the crest arch wave was 15%, the crest auxiliary wave was 10%. Intensity of cerebral blood flow in patients with type 2 diatebes was less than that in the normal people (p < 0.01). The parameters showed that cerebral blood pressure in type 2 diatebes was higher than that in the normal people (Crest time p < 0.01). ABF of the patients was less than that of the normal people (p < 0.01).
Key words: rheoencephalography, type 2 diabetes
DAC DIEM THIEU MAU CUA BENH NHAN THALASSEMIA NGUOI LOU TM KHOA HUYET HOC - TRUYEN MAU BENH VIEN BACH MAI
Vu Minh Phueng, Phan Thj Phipcrng
Dai hpc Y Ha npi Muc dp thieu mau d benh nhan thalassemia nguoi Ion cd lien quan den the benh
thalassemia. Muc tieu cua nghien cdu nay la: (1) Xac dinh cac the benh thalassemia d ngiroi Ion dupe diiu trj tai khoa Huyet hoc- truyen mau benh vien Bach Mai. (2) Md ta muc do thieu mau d tung the thalassemia. Nghien ciru dupe tien hanh tren 63 benh nhan tu 16 tuoi trd len dieu trj d Khoa Huyet hpc - truyen mau BV Bach Mai dupe chan doan xac djnh thalassemia bang dien di huyet cau to, lam xet nghiem huyet do. Ket qua cho thay: (1) Ty le a- thalassemia la 20,6%, ^-thalassemia tang HbA2 don thuan la 11,1%, ^-thalassemia cd HbF don thuin la 11,1%, p°-thalassemia/HbE la 11,1%, f-thalassemia/HbE la 46%. (2). Ty
