{"id":1358,"date":"2023-04-08T12:54:22","date_gmt":"2023-04-08T05:54:22","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=1358"},"modified":"2023-04-17T10:18:16","modified_gmt":"2023-04-17T03:18:16","slug":"uc-che-sglt2","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/08\/uc-che-sglt2\/","title":{"rendered":"Vai tr\u00f2 b\u1ea3o v\u1ec7 th\u1eadn c\u1ee7a nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2"},"content":{"rendered":"

Nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i thu\u1ed1c m\u1edbi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. Thu\u1ed1c ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n s\u1ef1 h\u1ea5p th\u1ee5 \u0111\u01b0\u1eddng v\u00e0 mu\u1ed1i trong th\u1eadn, gi\u00fap \u0111\u1ea9y ch\u00fang ra n\u01b0\u1edbc ti\u1ec3u. \u0110i\u1ec1u n\u00e0y kh\u00f4ng ch\u1ec9 gi\u00fap gi\u1ea3m m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft m\u00e0 c\u00f2n c\u00f3 th\u1ec3 gi\u00fap b\u1ea3o v\u1ec7 th\u1eadn kh\u1ecfi t\u1ed5n th\u01b0\u01a1ng do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng g\u00e2y ra.<\/strong><\/p>\n

Tuy nhi\u00ean, nh\u00f3m thu\u1ed1c n\u00e0y c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 h\u1ea1n ch\u1ebf trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p n\u00ean vi\u1ec7c hi\u1ec3u v\u1ec1 vai tr\u00f2 c\u0169ng nh\u01b0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5, t\u01b0\u01a1ng t\u00e1c thu\u1ed1c s\u1ebd gi\u00fap ng\u01b0\u1eddi d\u00f9ng c\u00f3 c\u00e1i nh\u00ecn tr\u1ef1c quan h\u01a1n v\u1ec1 nh\u00f3m thu\u1ed1c n\u00e0y.<\/p>\n

1. NH\u00d3M THU\u1ed0C \u1ee8C CH\u1ebe SGLT2 L\u00c0 G\u00cc?<\/strong><\/h2>\n

Thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 (Sodium-Glucose Cotransporter 2 Inhibitor) l\u00e0 m\u1ed9t nh\u00f3m thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng ki\u1ec3u 2. Thu\u1ed1c SGLT2 ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n s\u1ef1 h\u1ea5p th\u1ee5 \u0111\u01b0\u1eddng v\u00e0 mu\u1ed1i trong th\u1eadn, gi\u00fap \u0111\u1ea9y ch\u00fang ra n\u01b0\u1edbc ti\u1ec3u. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 c\u00e2n b\u1eb1ng l\u01b0\u1ee3ng n\u01b0\u1edbc v\u00e0 mu\u1ed1i trong c\u01a1 th\u1ec3.<\/p>\n

SGLT \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n, \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh l\u00e0 SGLT-1, \u0111\u01b0\u1ee3c nh\u00e2n b\u1ea3n t\u1eeb c\u00e1c t\u1ebf b\u00e0o ru\u1ed9t c\u1ee7a ng\u01b0\u1eddi v\u00e0o n\u0103m 1987 v\u00e0 sau \u0111\u00f3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong m\u1ed9t s\u1ed1 m\u00f4 kh\u00e1c bao g\u1ed3m th\u1eadn, tim, kh\u00ed qu\u1ea3n v\u00e0 tuy\u1ebfn ti\u1ec1n li\u1ec7t. SGLT-2, h\u1ea7u nh\u01b0 ch\u1ec9 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong th\u1eadn. SGLT-2 l\u00e0 ch\u1ea5t v\u1eadn chuy\u1ec3n dung l\u01b0\u1ee3ng cao c\u00f3 \u00e1i l\u1ef1c th\u1ea5p n\u1eb1m trong bi\u1ec3u m\u00f4 c\u1ee7a \u0111o\u1ea1n 1 c\u1ee7a \u1ed1ng l\u01b0\u1ee3n g\u1ea7n v\u00e0 ch\u1ecbu tr\u00e1ch nhi\u1ec7m cho kho\u1ea3ng 90% t\u00e1i h\u1ea5p thu glucose \u0111\u00e3 l\u1ecdc. Kho\u1ea3ng 10% t\u1ea3i l\u01b0\u1ee3ng l\u1ecdc c\u00f2n l\u1ea1i \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu b\u1edfi SGLT-1, m\u1ed9t ch\u1ea5t v\u1eadn chuy\u1ec3n c\u00f3 \u00e1i l\u1ef1c cao-n\u0103ng su\u1ea5t th\u1ea5p n\u1eb1m \u1edf \u0111o\u1ea1n 2 c\u1ee7a \u1ed1ng l\u01b0\u1ee3n g\u1ea7n v\u00e0 \u0111o\u1ea1n 3 c\u1ee7a \u1ed1ng l\u01b0\u1ee3n g\u1ea7n. Tuy nhi\u00ean, n\u1ebfu \u1ee9c ch\u1ebf ho\u00e0n to\u00e0n SGLT-2 s\u1ebd ch\u1ec9 d\u1eabn \u0111\u1ebfn b\u00e0i ti\u1ebft t\u1eeb 50-60% glucose \u0111\u00e3 l\u1ecdc do s\u1ef1 \u0111i\u1ec1u ti\u1ebft ng\u01b0\u1ee3c d\u00f2ng c\u1ee7a SGLT-1.<\/p>\n

\"\"
M\u00f4 t\u1ea3 qu\u00e1 tr\u00ecnh sinh l\u00fd \u1edf th\u1ee5 th\u1ec3 SGLT2. Ngu\u1ed3n<\/strong>: SGLT2 inhibitors: mechanisms of cardiovascular benefit beyond glycaemic control by Martin R .Cowie & Miles Fisher. <\/em><\/figcaption><\/figure>\n

2. VAI TR\u00d2 B\u1ea2O V\u1ec6 TH\u1eacN C\u1ee6A NH\u00d3M THU\u1ed0C \u1ee8C CH\u1ebe SGLT2<\/strong><\/h2>\n

C\u00e1c c\u01a1 ch\u1ebf l\u00fd gi\u1ea3i t\u00e1c d\u1ee5ng b\u1ea3o v\u1ec7 th\u1eadn c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5 r\u00e0ng; nhi\u1ec1u c\u01a1 ch\u1ebf \u0111\u01b0\u1ee3c \u0111\u01b0a ra l\u00e0 gi\u1ea3 thuy\u1ebft c\u00f3 li\u00ean quan. T\u00e1c d\u1ee5ng b\u1ea3o v\u1ec7 th\u1eadn c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t ph\u1ea7n gi\u00e1n ti\u1ebfp qua c\u1ea3i thi\u1ec7n c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 nh\u01b0 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft, huy\u1ebft \u00e1p v\u00e0 c\u00e2n n\u1eb7ng. Tuy nhi\u00ean d\u1eef li\u1ec7u t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y r\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 c\u00f3 th\u1ec3 tr\u1ef1c ti\u1ebfp \u0111em l\u1ea1i hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 th\u1eadn.<\/p>\n

V\u00ec k\u00eanh SGLT2 ph\u00e2n b\u1ed1 ch\u1ee7 y\u1ebfu \u1edf \u1ed1ng l\u01b0\u1ee3n g\u1ea7n n\u00ean c\u00f3 v\u1ebb h\u1ee3p l\u00fd khi n\u00f3i r\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 c\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp l\u00ean c\u00e1c t\u1ebf b\u00e0o \u1ed1ng th\u1eadn th\u00f4ng qua vi\u1ec7c c\u1ea3i thi\u1ec7n nhi\u1ec5m \u0111\u1ed9c glucose. C\u00e1c b\u1eb1ng ch\u1ee9ng ti\u1ec1n l\u00e2m s\u00e0ng \u1ee7ng h\u1ed9 gi\u1ea3 thuy\u1ebft n\u00e0y.<\/p>\n

M\u1ed9t ph\u00e2n t\u00edch chuy\u1ec3n h\u00f3a d\u1ef1a tr\u00ean quang ph\u1ed5 kh\u1ed1i cho th\u1ea5y s\u1ef1 t\u00edch t\u1ee5 c\u00e1c ch\u1ea5t trung gian c\u1ee7a chu tr\u00ecnh Krebs nh\u01b0 citrate \u1edf v\u1ecf th\u1eadn c\u1ee7a chu\u1ed9t b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 c\u1ea3i thi\u1ec7n nh\u1eefng thay \u0111\u1ed5i chuy\u1ec3n h\u00f3a c\u00f9ng v\u1edbi qu\u00e1 tr\u00ecnh stress oxy h\u00f3a, gi\u1ea3m albumin ni\u1ec7u v\u00e0 t\u0103ng sinh trung m\u00f4. \u1ee8c ch\u1ebf SGLT2 c\u0169ng l\u00e0m gi\u1ea3m s\u1ef1 thay \u0111\u1ed5i ki\u1ec3u h\u00ecnh c\u1ee7a \u0111\u1ea1i th\u1ef1c b\u00e0o m\u00f4 m\u1ee1, t\u1eeb ki\u1ec3u h\u00ecnh ti\u1ec1n vi\u00eam gi\u1ed1ng M1 \u0111\u1ebfn ki\u1ec3u h\u00ecnh kh\u00e1ng vi\u00eam gi\u1ed1ng M2. T\u00e1c \u0111\u1ed9ng n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan v\u1edbi t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i tr\u00ean ng\u01b0\u1eddi b\u00e9o ph\u00ec c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf SGLT2.<\/p>\n

S\u1ef1 bi\u1ec3u hi\u1ec7n protein SGLT2 v\u00e0 mRNA \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf t\u1ebf b\u00e0o trung m\u00f4 chu\u1ed9t \u0111\u01b0\u1ee3c nu\u00f4i c\u1ea5y. Thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 \u1ee9c ch\u1ebf n\u1ed3ng \u0111\u1ed9 cao glucose, l\u00e0m \u1ee9c ch\u1ebf ho\u1ea1t h\u00f3a protein kinase C v\u00e0 con \u0111\u01b0\u1eddng NADPH-oxidase trong c\u00e1c t\u1ebf b\u00e0o trung m\u00f4, do \u0111\u00f3 thu\u1ed1c n\u00e0y c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng oxy h\u00f3a.<\/p>\n

3. T\u00c1C D\u1ee4NG PH\u1ee4<\/strong><\/h2>\n

Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0:<\/p>\n

    \n
  • H\u1ea1 huy\u1ebft \u00e1p.<\/li>\n
  • Nhi\u1ec5m ceton acid.<\/li>\n
  • Suy th\u1eadn.<\/li>\n
  • Vi\u00eam b\u1ec3 th\u1eadn.<\/li>\n
  • Nhi\u1ec5m khu\u1ea9n ni\u1ec7u.<\/li>\n
  • H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft do t\u0103ng ti\u1ebft insulin.<\/li>\n
  • Nhi\u1ec5m n\u1ea5m sinh d\u1ee5c.<\/li>\n
  • T\u0103ng LDL cholesterol (2,9% \u2013 8,0%).<\/li>\n
  • Dapagliflozin c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn ung th\u01b0 b\u00e0ng quang d\u00f9 ch\u01b0a \u0111\u1ea7y \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng ch\u1ee9ng minh m\u1ed1i li\u00ean h\u1ec7 n\u00e0y.<\/li>\n<\/ul>\n

    4. T\u01af\u01a0NG T\u00c1C THU\u1ed0C<\/strong><\/h2>\n

    N\u1ed3ng \u0111\u1ed9 thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng x\u00e9t nghi\u1ec7m glucose trong n\u01b0\u1edbc ti\u1ec3u v\u00e0 \u0111\u1ecbnh l\u01b0\u1ee3ng 1,5-anhydroglucitol, ngo\u00e0i ra m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t l\u01b0\u1ee3ng \u0111\u01b0\u1eddng trong m\u00e1u.<\/p>\n

    Thu\u1ed1c g\u00e2y c\u1ea3m \u1ee9ng enzym Uridine\u20195 diphospho-glucuronosyl transferase (UGT) (nh\u01b0 rifampin) s\u1ebd l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 d\u1eabn \u0111\u1ebfn gi\u1ea3m hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ee7a c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf SGLT-2 khi d\u00f9ng chung.<\/p>\n

    Canagliflozin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 c\u1ee7a digoxin; do \u0111\u00f3\u00a0 n\u00ean ti\u1ebfn h\u00e0nh theo d\u00f5i ch\u1eb7t ch\u1ebd \u1edf b\u1ec7nh s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi 2 thu\u1ed1c n\u00e0y.<\/p>\n

    Nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 c\u00f3 th\u1ec3 gi\u00fap b\u1ea3o v\u1ec7 th\u1eadn \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng b\u1eb1ng c\u00e1ch gi\u1ea3m \u00e1p l\u1ef1c tr\u00ean c\u00e1c b\u1ed9 ph\u1eadn c\u1ee7a th\u1eadn v\u00e0 gi\u1ea3m s\u1ef1 t\u1ed5n th\u01b0\u01a1ng cho c\u00e1c t\u1ebf b\u00e0o th\u1eadn. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 gi\u00fap ng\u0103n ng\u1eeba c\u00e1c t\u00e1c h\u1ea1i c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00ean th\u1eadn v\u00e0 gi\u1ea3m nguy c\u01a1 suy th\u1eadn v\u00e0 b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh.<\/p>\n

    Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a b\u00e1c s\u0129 v\u00e0 theo ch\u1ec9 \u0111\u1ecbnh ch\u00ednh x\u00e1c c\u1ee7a h\u1ecd \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch duy tr\u00ec th\u00f3i quen \u0103n u\u1ed1ng v\u00e0 l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn th\u1eadn.<\/p>\n

    T\u1ed5ng h\u1ee3p l\u1ea1i, vai tr\u00f2 c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 l\u00e0 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c b\u1ea3o v\u1ec7 th\u1eadn c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129 v\u00e0 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c bi\u1ec7n ph\u00e1p ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe to\u00e0n di\u1ec7n \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n trong \u0111i\u1ec1u tr\u1ecb.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i thu\u1ed1c m\u1edbi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. Thu\u1ed1c ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n s\u1ef1 h\u1ea5p th\u1ee5 \u0111\u01b0\u1eddng v\u00e0 mu\u1ed1i trong th\u1eadn, gi\u00fap \u0111\u1ea9y ch\u00fang ra n\u01b0\u1edbc ti\u1ec3u. \u0110i\u1ec1u n\u00e0y kh\u00f4ng ch\u1ec9 gi\u00fap gi\u1ea3m m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft m\u00e0 c\u00f2n […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"\nVai tr\u00f2 b\u1ea3o v\u1ec7 th\u1eadn c\u1ee7a nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2<\/title>\n<meta name=\"description\" content=\"Nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i thu\u1ed1c m\u1edbi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. 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