{"id":17511,"date":"2023-04-13T17:01:32","date_gmt":"2023-04-13T10:01:32","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=17511"},"modified":"2023-04-14T12:09:32","modified_gmt":"2023-04-14T05:09:32","slug":"dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/","title":{"rendered":"\u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf b\u1ec7nh sinh lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng"},"content":{"rendered":"<p><strong>Lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan\u00a0\u0111\u1ebfn\u00a0h\u1ec7 ti\u00eau ho\u00e1 ph\u1ed5 bi\u1ebfn tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi m\u1ed7i n\u0103m. B\u1ec7nh kh\u00f4ng ph\u00e2n bi\u1ec7t gi\u1edbi t\u00ednh hay \u0111\u1ed9 tu\u1ed5i, nh\u01b0ng th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u1eefng ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh v\u00e0 ng\u01b0\u1eddi gi\u00e0.<\/strong><\/p>\n<figure style=\"width: 600px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/bzy9b0h.png\" alt=\"Minh ho\u1ea1 lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng\" width=\"600\" height=\"370\" \/><figcaption class=\"wp-caption-text\">Minh ho\u1ea1 lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng<\/figcaption><\/figure>\n<h2><strong>1. \u0110\u1ecbnh ngh\u0129a:<\/strong><\/h2>\n<ul>\n<li><strong>Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng<\/strong> l\u00e0 t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng m\u1ea5t ch\u1ea5t s\u00e2u v\u01b0\u1ee3t qu\u00e1 l\u1edbp c\u01a1 ni\u00eam \u1edf d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng.<\/li>\n<li><strong>Lo\u00e9t tr\u01a1 d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng: <\/strong>d &gt; 5mm v\u00e0 kh\u00f4ng l\u00e0nh sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb 8 \u2013 12 tu\u1ea7n b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton.<\/li>\n<li><strong>Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng t\u00e1i ph\u00e1t: <\/strong>l\u00e0 s\u1ef1 t\u00e1i \u0111i t\u00e1i l\u1ea1i nhi\u1ec1u l\u1ea7n c\u00e1c tri\u1ec7u ch\u1ee9ng do nhi\u1ec1u nguy\u00ean nh\u00e2n g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng\u00a0\u00a0lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng m\u1ea1n t\u00ednh<\/li>\n<\/ul>\n<div class=\"mceTemp\"><\/div>\n<figure style=\"width: 640px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/3oAveKW.png\" alt=\"Minh ho\u1ea1 lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng\" width=\"640\" height=\"366\" \/><figcaption class=\"wp-caption-text\">Minh ho\u1ea1 lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng<\/figcaption><\/figure>\n<h2><strong>2. Nguy\u00ean nh\u00e2n g\u00e2y lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng:<\/strong><\/h2>\n<p><strong>&#8211; Th\u01b0\u1eddng g\u1eb7p<\/strong><\/p>\n<ul>\n<li><strong>Nhi\u1ec5m tr\u00f9ng: <\/strong><strong><em>Helicobacter pylori<\/em><\/strong><strong><em>(ch\u1ee7 y\u1ebfu)<\/em><\/strong><strong><em>,<\/em><\/strong> HSV, CMV, helicobacter heilmannii, hi\u1ebfm g\u1eb7p h\u01a1n nh\u01b0 lao, giang mai, mucormycosis.<\/li>\n<li><strong>Thu\u1ed1c:<\/strong> T\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c \u0111\u1ec1u c\u00f3 nguy c\u01a1 sinh lo\u00e9t cao h\u01a1n khi k\u1ebft h\u1ee3p v\u1edbi nh\u00f3m thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00f4ng steroid (NSAID) ho\u1eb7c khi d\u00f9ng \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao:<\/li>\n<li>NSAID, Aspirin k\u1ec3 c\u1ea3 li\u1ec1u th\u1ea5p<\/li>\n<li>Biphosphonate ( khi ph\u1ed1i h\u1ee3p v\u1edbi NSAID)<\/li>\n<li>Clopidogrel ( khi ph\u1ed1i h\u1ee3p v\u1edbi NSAID ho\u1eb7c \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao)<\/li>\n<li>Corticoid ( khi ph\u1ed1i h\u1ee3p v\u1edbi NSAID)<\/li>\n<li>Spironolactone ( khi ph\u1ed1i h\u1ee3p v\u1edbi NSAID)<\/li>\n<li>Thu\u1ed1c b\u1ed5 sung kali<\/li>\n<li><strong>B\u1ec7nh l\u00fd m\u1ea5t b\u00f9 m\u1ea1n t\u00ednh hay suy \u0111a c\u01a1 quan c\u1ea5p t\u00ednh: <\/strong>lo\u00e9t do stress (n\u1eb7ng) \u1edf khoa ch\u0103m s\u00f3c t\u00edch c\u1ef1c, x\u01a1 gan, suy th\u1eadn, COPD, gh\u00e9p t\u1ea1ng.<\/li>\n<\/ul>\n<p>&#8211; <strong>Hi\u1ebfm g\u1eb7p<\/strong><\/p>\n<ul>\n<li><strong>Qua <\/strong><strong>trung gian c\u01a1 ch\u1ebf n\u1ed9i ti\u1ebft:<\/strong>\n<ul>\n<li>U ti\u1ebft gastrin (Gastrinoma g\u00e2y h\u1ed9i ch\u1ee9ng Zollinger-Ellison)<\/li>\n<li>T\u0103ng ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o G v\u00f9ng hang v\u1ecb<\/li>\n<li>T\u0103ng sinh t\u1ebf b\u00e0o mast: m\u1ed9t d\u1ea1ng r\u1ed1i lo\u1ea1n t\u0103ng sinh t\u1ee7y \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 t\u00edch t\u1ee5 c\u1ee7a t\u1ebf b\u00e0o mast \u1edf m\u1ed9t ho\u1eb7c nhi\u1ec1u h\u1ec7 c\u01a1 quan<\/li>\n<li>C\u01b0\u1eddng tuy\u1ebfn c\u1eadn gi\u00e1p: ti\u1ebft ra PTH \u00a0ti\u1ebft Ca2+ (\u0111i\u1ec1u h\u00f3a b\u00e0i ti\u1ebft Ca2+ (Ca2+ c\u00f3 t\u00e1c d\u1ee5ng ki\u1ec1m h\u00f3a m\u00e1u). Do \u0111\u00f3, c\u01a1 th\u1ec3 s\u1ebd huy \u0111\u1ed9ng H<sup>+<\/sup> \u0111\u1ec3 trung h\u00f2a l\u01b0\u1ee3ng Ca2+ \u0111\u00f3. Khi H<sup>+<\/sup> ti\u1ebft ra qu\u00e1 nhi\u1ec1u \u00a0g\u00e2y lo\u00e9t.<\/li>\n<li>B\u1ec7nh l\u00fd t\u0103ng sinh t\u1ee7y c\u00f3 t\u0103ng b\u1ea1ch c\u1ea7u Basophile.<\/li>\n<\/ul>\n<\/li>\n<li><strong>B\u1ec7nh l\u00fd th\u00e2m nhi\u1ec5m: <\/strong>Crohn, sarcoidosis.<\/li>\n<li><strong>Sau <\/strong><strong>ph\u1eabu thu\u1eadt c\u1eaft b\u00e1n ph\u1ea7n d\u1ea1 d\u00e0y, ho\u1eb7c n\u1ed1i t\u1eaft v\u1ecb tr\u00e0ng<\/strong><strong>.<\/strong><\/li>\n<li><strong>X\u1ea1 tr\u1ecb.<\/strong><\/li>\n<li><strong>Lo\u00e9t <\/strong><strong>v\u00f4 c\u0103n ( kh\u00f4ng do H.pylori v\u00e0 kh\u00f4ng do NSAID)<\/strong><strong>.<\/strong><\/li>\n<\/ul>\n<h2><strong>3. C\u01a1 ch\u1ebf b\u1ec7nh sinh<\/strong><\/h2>\n<p>D\u1ea1 d\u00e0y lu\u00f4n ch\u1ecbu t\u00e1c \u0111\u1ed9ng c\u1ee7a <strong>2 nh\u00f3m<\/strong> y\u1ebfu t\u1ed1:<\/p>\n<h3><strong>3.1. C\u00e1c y\u1ebfu t\u1ed1 g\u00e2y lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng: <\/strong><\/h3>\n<p><strong>&#8211; Acid HCL, pepsin:<\/strong><\/p>\n<ul>\n<li>Pepsin \u0111\u01b0\u1ee3c ti\u1ebft ra d\u01b0\u1edbi d\u1ea1ng ti\u1ec1n ch\u1ea5t pepsinnogene d\u01b0\u1edbi t\u00e1c \u0111\u1ed9ng c\u1ee7a acid HCL bi\u1ebfn th\u00e0nh pepsine ho\u1ea1t \u0111\u1ed9ng khi pH &lt;3,5 l\u00e0m ti\u00eau h\u1ee7y ch\u1ea5t nh\u1ea7y v\u00e0 collagen.<\/li>\n<li><em>+ <\/em><em>S\u1ef1 ph\u00e2n t\u00e1n ng\u01b0\u1ee3c c\u1ee7a ion H<sup>+<\/sup>:<\/em> ti\u1ebfn tr\u00ecnh lo\u00e9t \u0111\u01b0\u1ee3c kh\u1edfi ph\u00e1t do t\u0103ng ti\u1ebft HCL do l\u01b0\u1ee3ng t\u1ebf b\u00e0o th\u00e0nh qu\u00e1 nhi\u1ec1u ho\u1eb7c qu\u00e1 ho\u1ea1t \u0111\u1ed9ng, do \u0111\u00f3 l\u01b0\u1ee3ng d\u1ecbch v\u1ecb c\u01a1 b\u1ea3n ho\u1eb7c sau k\u00edch th\u00edch r\u1ea5t gia t\u0103ng, s\u1ef1 ph\u00e2n t\u00e1n ng\u01b0\u1ee3c v\u00e0 s\u1ef1 \u0111i v\u00e0o c\u1ee7a ion H<sup>+<\/sup> l\u00e0m th\u01b0\u01a1ng t\u1ed5n th\u00e0nh d\u1ea1 d\u00e0y v\u00e0 g\u00e2y ra lo\u00e9t; do \u0111\u00f3 l\u00e0m trung h\u00f2a ion H<sup>+<\/sup> \u0111\u00e3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 lo\u00e9t r\u1ea5t nhi\u1ec1u. Nguy c\u01a1 lo\u00e9t c\u00e0ng cao khi s\u1ef1 ti\u1ebft acid c\u00e0ng nhi\u1ec1u.<\/li>\n<\/ul>\n<p><strong>&#8211; C\u00e1c y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i: <\/strong>NSAIDs, Corticoid, R\u01b0\u1ee3u, HP:<\/p>\n<p><strong>+ <\/strong><strong>C\u00e1c thu\u1ed1c kh\u00e1ng vi\u00eam<\/strong><strong>,<\/strong> t\u00e1c \u0111\u1ed9ng l\u00ean d\u1ea1 d\u00e0y theo <strong>2 c\u01a1 ch\u1ebf:<\/strong><\/p>\n<ul>\n<li><strong>T\u00e1c d\u1ee5ng tr\u1ef1c ti\u1ebfp l\u00ean l\u1edbp ni\u00eam m\u1ea1c: <\/strong>l\u00e0m t\u1ed5n th\u01b0\u01a1ng c\u1ea5u tr\u00fac t\u1ebf b\u00e0o v\u00e0 l\u1edbp b\u1ea3o v\u1ec7 ni\u00eam m\u1ea1c b\u1ecb m\u1ecfng \u0111i.<\/li>\n<li><strong>T\u00e1c d\u1ee5ng gi\u00e1n ti\u1ebfp:<\/strong> \u1ee9c ch\u1ebf s\u1ea3n xu\u1ea5t prostaglandin E<sub>2<\/sub> v\u00e0 I<sub>2<\/sub> th\u00f4ng qua \u1ee9c ch\u1ebf COX1 l\u00e0m gi\u1ea3m l\u01b0\u1ee3ng m\u00e1u nu\u00f4i d\u01b0\u1ee1ng t\u1ebf b\u00e0o, gi\u1ea3m b\u00e0i ti\u1ebft ch\u1ea5t nh\u1ea7y v\u00e0 gi\u1ea3m ti\u1ebft Bicarbonat.<\/li>\n<\/ul>\n<p><strong>+ <\/strong><strong>Vi Khu\u1ea9n Helicobacter <\/strong><strong>P<\/strong><strong>ylori (H<\/strong><strong>P<\/strong><strong>):<\/strong><\/p>\n<ul>\n<li>Ng\u00e0y nay, vai tr\u00f2 c\u1ee7a HP trong b\u1ec7nh vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng \u0111\u01b0\u1ee3c xem nh\u01b0 l\u00e0 m\u1ed9t trong nh\u1eefng y\u1ebfu t\u1ed1 b\u1ec7nh nguy\u00ean quan tr\u1ecdng nh\u1ea5t. Nhi\u1ec1u nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y r\u1eb1ng HP l\u00e0 nguy\u00ean nh\u00e2n \u1edf <strong>75-85%<\/strong> tr\u01b0\u1eddng h\u1ee3p lo\u00e9t d\u1ea1 d\u00e0y v\u00e0 tr\u00ean <strong>90%<\/strong> tr\u01b0\u1eddng h\u1ee3p lo\u00e9t t\u00e1 tr\u00e0ng.<\/li>\n<li>HP l\u00e0 m\u1ed9t lo\u1ea1i xo\u1eafn kh\u1ea9n gram \u00e2m \u00e1i kh\u00ed, c\u00f3 k\u00edch th\u01b0\u1edbc ng\u1eafn t\u1eeb 0.2-0.5 micromet, c\u00f3 4-6 chi\u00ean mao. Vi khu\u1ea9n ch\u1ee7 y\u1ebfu s\u1ed1ng trong l\u1edbp ch\u1ea5t nh\u1ea7y c\u1ee7a ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y, m\u1ed9t s\u1ed1 \u00edt b\u00e1m d\u00ednh tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c.<\/li>\n<li>HP g\u00e2y t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng \u0111\u1ed3ng th\u1eddi s\u1ea3n xu\u1ea5t ra amoniac l\u00e0m m\u00f4i tr\u01b0\u1eddng t\u1ea1i ch\u1ed7 b\u1ecb acid \u0111\u1ec3 g\u00e2y ra \u1ed5 lo\u00e9t. HP s\u1ea3n xu\u1ea5t men Urease l\u00e0m t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y; n\u00f3 c\u0169ng s\u1ea3n xu\u1ea5t ra prot\u00eain b\u1ec1 m\u1eb7t, c\u00f3 ho\u00e1 \u1ee9ng \u0111\u1ed9ng (+) v\u1edbi b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh v\u00e0 monocyte. N\u00f3 c\u00f2n ti\u1ebft ra y\u1ebfu t\u1ed1 ho\u1ea1t ho\u00e1 ti\u1ec3u c\u1ea7u, c\u00e1c ch\u1ea5t ti\u1ec1n vi\u00eam, c\u00e1c ch\u1ea5t Superoxyde, interleukin 1 v\u00e0 TNF l\u00e0 nh\u1eefng ch\u1ea5t g\u00e2y vi\u00eam v\u00e0 ho\u1ea1i t\u1eed t\u1ebf b\u00e0o. HP c\u00f2n s\u1ea3n xu\u1ea5t ra c\u00e1c men protease, phospholipase l\u00e0m ph\u00e1 hu\u1ef7 ch\u1ea5t nh\u1ea7y ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y.<\/li>\n<\/ul>\n<p><strong>&#8211; C\u00e1c <\/strong><strong>y\u1ebfu t\u1ed1 b\u00ean trong:<\/strong> D\u1ecbch m\u1eadt, lysolecithin.<\/p>\n<h3><strong>3.2. Nh\u00f3m y\u1ebfu t\u1ed1 b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o:<\/strong><\/h3>\n<p><strong>&#8211; L\u1edbp <\/strong><strong>ch\u1ea5t nh\u1ea7y v\u00e0 bicarbonat bao ph\u1ee7 tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y (<\/strong><strong>\u0111gl<\/strong><strong> h\u00e0ng r\u00e0o b\u1ea3o v\u1ec7 th\u1ee9 nh\u1ea5t):<\/strong> \u0110\u1ec3 <strong><em><u>ch\u1ed1ng l\u1ea1i s\u1ef1 t\u1ea5n c\u00f4ng<\/u><\/em><\/strong> c\u1ee7a ion H<sup>+<\/sup>, y\u1ebfu t\u1ed1 ch\u00ednh l\u00e0 l\u1edbp ni\u00eam d\u1ecbch gi\u00e0u bicarbonate t\u1ea1o b\u1edfi glycoprotein c\u00f3 ch\u1ee9a c\u00e1c phospholipid kh\u00f4ng ph\u00e2n c\u1ef1c, n\u1eb1m tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a l\u1edbp gel n\u00e0y c\u00f3 t\u00ednh nh\u1ea7y \u0111\u00e0n h\u1ed3i. Khi pepsin c\u1eaft chu\u1ed7i peptid ph\u00f3ng th\u00edch c\u00e1c ti\u1ec3u \u0111\u01a1n v\u1ecb glycoprotein; ch\u00fang l\u00e0m m\u1ea5t t\u00ednh ch\u1ea5t nh\u1ea7y \u0111\u00e0n h\u1ed3i n\u00e0y. C\u00e1c ion H<sup>+<\/sup> x\u00e2m nh\u1eadp v\u00e0o l\u1edbp nh\u1ea7y, nh\u01b0ng ch\u00fang b\u1ecb trung h\u00f2a b\u1edfi bicarbonate.<\/p>\n<p>Nh\u01b0ng khi pH&lt;1,7 th\u00ec v\u01b0\u1ee3t qu\u00e1 kh\u1ea3 n\u0103ng trung ho\u00e0 c\u1ee7a n\u00f3 v\u00e0 ion H<sup>+<\/sup> \u0111\u1ebfn \u0111\u01b0\u1ee3c l\u1edbp ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y v\u00e0 g\u00e2y ra lo\u00e9t.<\/p>\n<p><strong>&#8211; L\u1edbp t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 b\u1ec1 m\u1eb7t (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0<\/strong><strong>\u00a0h\u00e0ng r\u00e0o b\u1ea3o v\u1ec7 th\u1ee9 hai):<\/strong> Ti\u1ebft ra glycoprotein, lipid v\u00e0 bicarbonate, ch\u00fang c\u00f3 kh\u1ea3 n\u0103ng <strong><em><u>lo\u1ea1i b\u1ecf s\u1ef1 \u0111i v\u00e0o b\u00e0o t\u01b0\u01a1ng<\/u><\/em><\/strong> c\u1ee7a ion H<sup>+<\/sup> <strong>b\u1eb1ng 2 c\u00e1ch:<\/strong> trung h\u00f2a do bicarbonate v\u00e0 \u0111\u1ea9y ion H<sup>+<\/sup> v\u00e0o kho\u1ea3ng k\u1ebd nh\u1edd b\u01a1m proton H<sup>+<\/sup>&#8211; K<sup>+<\/sup> &#8211; ATPase.<\/p>\n<p><strong>&#8211; D\u00f2ng <\/strong><strong>m\u00e1u t\u01b0\u1edbi cho l\u1edbp ni\u00eam m\u1ea1c c\u1ee7a d\u1ea1 d\u00e0y<\/strong><strong>&#8211;<\/strong><strong>t\u00e1 tr\u00e0ng \u2013 L\u1edbp Limia propria (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0<\/strong><strong>\u00a0h\u00e0ng r\u00e0o b\u1ea3o v\u1ec7 th\u1ee9 ba):<\/strong> ph\u1ee5 tr\u00e1ch <strong><em><u>ch\u1ee9c n\u0103ng \u0111i\u1ec1u h\u00f2a<\/u><\/em><\/strong>. Oxy v\u00e0 bicarbonate \u0111\u01b0\u1ee3c cung c\u1ea5p tr\u1ef1c ti\u1ebfp cho h\u1ea1 ni\u00eam m\u1ea1c b\u1edfi c\u00e1c mao m\u1ea1ch c\u00f3 r\u1ea5t nhi\u1ec1u l\u1ed5 h\u1edf, m\u00e0 c\u00e1c t\u1ebf b\u00e0o n\u00e0y r\u1ea5t nh\u1ea1y c\u1ea3m v\u1edbi toan chuy\u1ec3n h\u00f3a h\u01a1n l\u00e0 s\u1ef1 thi\u1ebfu kh\u00ed. M\u1ed9t l\u01b0\u1ee3ng bicarbonate \u0111\u1ea7y \u0111\u1ee7 ph\u1ea3i \u0111\u01b0\u1ee3c cung c\u1ea5p cho t\u1ebf b\u00e0o ni\u00eam m\u1ea1c \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 acid h\u00f3a trong th\u00e0nh d\u1ea1 d\u00e0y g\u00e2y ra b\u1edfi ion H<sup>+<\/sup> xuy\u00ean qua h\u00e0ng r\u00e0o ni\u00eam m\u1ea1c n\u00e0y.<\/p>\n<p>=&gt; Lo\u00e9t d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng x\u1ea3y ra khi c\u00f3 s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 ph\u00e1 h\u1ee7y ni\u00eam m\u1ea1c v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 b\u1ea3o v\u1ec7 ni\u00eam m\u1ea1c m\u00e0 t\u00ednh tr\u1ed9i thu\u1ed9c v\u1ec1 nh\u00f3m c\u00e1c y\u1ebfu t\u1ed1 t\u1ea5n c\u00f4ng Theo Schwart:<\/p>\n<p>+ Kh\u00f4ng Acid Kh\u00f4ng lo\u00e9t.<\/p>\n<p>+ Kh\u00f4ng Pylori- kh\u00f4ng Acid =&gt; Kh\u00f4ng lo\u00e9t.<\/p>\n<h3><strong>3.3. Y\u1ebfu t\u1ed1 nguy c\u01a1:\u00a0<\/strong><\/h3>\n<ul>\n<li><strong>Di truy\u1ec1n: <\/strong>lo\u00e9t t\u00e1 tr\u00e0ng c\u00f3 t\u00ednh ch\u1ea5t di truy\u1ec1n, t\u1ea7n su\u1ea5t cao \u1edf m\u1ed9t s\u1ed1 gia \u0111\u00ecnh v\u00e0 \u0111\u1ed3ng th\u1eddi x\u1ea3y ra \u1edf c\u1ea3 2 anh (ch\u1ecb) em sinh \u0111\u00f4i c\u00f9ng tr\u1ee9ng h\u01a1n l\u00e0 kh\u00e1c tr\u1ee9ng.<\/li>\n<li><strong>Y\u1ebfu t\u1ed1 t\u00e2m l\u00ed <\/strong><strong>(stress): <\/strong>Nh\u1eefng ng\u01b0\u1eddi hay b\u1ecb c\u0103ng th\u1eb3ng, lo l\u1eafng s\u1ebd c\u00f3 nguy c\u01a1 m\u1eafc b\u1ec7nh <a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/tim-hieu-ve-benh-viem-loet-da-day-ta-trang\/\">lo\u00e9t d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng<\/a>, b\u1edfi c\u00e1c c\u0103ng th\u1eb3ng k\u00e9o d\u00e0i c\u00f3 \u1ea3nh h\u01b0\u1edfng l\u1edbn \u0111\u1ebfn qu\u00e1 tr\u00ecnh b\u00e0i ti\u1ebft acid trong d\u1ea1 d\u00e0y. C\u0103ng th\u1eb3ng th\u1ea7n kinh, sang ch\u1ea5n t\u00e2m l\u00ed, t\u00ecnh c\u1ea3m c\u0169ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb lo\u00e9t d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng.<\/li>\n<li><strong>Y\u1ebfu t\u1ed1 ti\u1ebft th\u1ef1c (li\u00ean quan \u0111\u1ebfn th\u00f3i quen, t\u1eadp t\u1ee5c \u0103n u\u1ed1ng v\u00f9ng mi\u1ec1n): <\/strong>Kh\u00f4ng lo\u1ea1i tr\u1eeb lo\u00e9t ph\u00e2n b\u1ed1 theo \u0111\u1ecba d\u01b0 l\u00e0 c\u00f3 s\u1ef1 \u0111\u00f3ng g\u00f3p c\u1ee7a th\u00f3i quen \u0103n u\u1ed1ng. (B\u1eafc \u1ea4n \u0103n nhi\u1ec1u l\u00faa m\u00ec lo\u00e9t d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng \u00edt h\u01a1n Mi\u1ec1n Nam \u0103n to\u00e0n g\u1ea1o).<\/li>\n<li><strong>H\u00fat thu\u1ed1c l\u00e1 v\u00e0 u\u1ed1ng r\u01b0\u1ee3u bia (c\u00e1c \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n kh\u00e1c): <\/strong>trong kh\u00f3i thu\u1ed1c l\u00e1 c\u00f3 ch\u1ee9a h\u01a1n 200 lo\u1ea1i ch\u1ea5t g\u00e2y h\u1ea1i cho s\u1ee9c kh\u1ecfe c\u1ee7a con ng\u01b0\u1eddi, trong \u0111\u00f3 \u0111\u1eb7c bi\u1ec7t l\u00e0 ch\u1ea5t nicotine. Ch\u1ea5t Nicotine s\u1ebd g\u00e2y k\u00edch th\u00edch c\u01a1 ch\u1ebf \u0111\u1ec3 ti\u1ebft ra nhi\u1ec1u cortisol \u2013 \u0111\u00e2y l\u00e0 t\u00e1c nh\u00e2n ch\u00ednh l\u00e0m t\u0103ng nguy c\u01a1 lo\u00e9t d\u1ea1 d\u00e0y. Thu\u1ed1c l\u00e1 c\u00f2n l\u00e0m ch\u1eadm s\u1ef1 l\u00e0nh s\u1eb9o v\u00e0 g\u00e2y \u0111\u1ec1 kh\u00e1ng v\u1edbi \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li><strong>Th\u00f3i quen \u0103n u\u1ed1ng, sinh ho\u1ea1t kh\u00f4ng \u0111i\u1ec1u \u0111\u1ed9: <\/strong>\u0103n u\u1ed1ng kh\u00f4ng \u0111\u00fang gi\u1edd, \u0111\u00fang b\u1eefa, hay b\u1ecf b\u1eefa nh\u1ea5t l\u00e0 b\u1eefa s\u00e1ng, \u0103n qu\u00e1 khuya, th\u1ee9c khuya, l\u01b0\u1eddi v\u1eadn \u0111\u1ed9ng\u2026<\/li>\n<li><strong>Th\u00f3i quen \u0103n u\u1ed1ng: <\/strong>th\u00edch \u0103n c\u00e1c m\u00f3n chua, cay, n\u00f3ng, l\u1ea1nh, c\u1ee9ng, kh\u00f3 ti\u00eau\u2026<\/li>\n<\/ul>\n<p><strong>Ngu\u1ed3n tham kh\u1ea3o:<\/strong><\/p>\n<ul>\n<li>B\u00e0i gi\u1ea3ng Lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng n\u1ed9i ti\u00eau ho\u00e1 tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc T\u00e2y Nguy\u00ean 2020<\/li>\n<li>S\u00e1ch l\u00e2m s\u00e0ng n\u1ed9i ti\u00eau ho\u00e1 \u0110H Y Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan\u00a0\u0111\u1ebfn\u00a0h\u1ec7 ti\u00eau ho\u00e1 ph\u1ed5 bi\u1ebfn tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi m\u1ed7i n\u0103m. B\u1ec7nh kh\u00f4ng ph\u00e2n bi\u1ec7t gi\u1edbi t\u00ednh hay \u0111\u1ed9 tu\u1ed5i, nh\u01b0ng th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u1eefng ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh v\u00e0 ng\u01b0\u1eddi gi\u00e0. 1. \u0110\u1ecbnh ngh\u0129a: Lo\u00e9t d\u1ea1 d\u00e0y [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf b\u1ec7nh sinh lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng<\/title>\n<meta name=\"description\" content=\"Lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan\u00a0\u0111\u1ebfn\u00a0h\u1ec7 ti\u00eau ho\u00e1 ph\u1ed5 bi\u1ebfn tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi m\u1ed7i n\u0103m.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf b\u1ec7nh sinh lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng\" \/>\n<meta property=\"og:description\" content=\"Lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan\u00a0\u0111\u1ebfn\u00a0h\u1ec7 ti\u00eau ho\u00e1 ph\u1ed5 bi\u1ebfn tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi m\u1ed7i n\u0103m.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-13T10:01:32+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-14T05:09:32+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/i.imgur.com\/bzy9b0h.png\" \/>\n<meta name=\"author\" content=\"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/\",\"name\":\"\u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf b\u1ec7nh sinh lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-13T10:01:32+00:00\",\"dateModified\":\"2023-04-14T05:09:32+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/93244bcbae85b37711d0dde67f41b5f6\"},\"description\":\"Lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan\u00a0\u0111\u1ebfn\u00a0h\u1ec7 ti\u00eau ho\u00e1 ph\u1ed5 bi\u1ebfn tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi m\u1ed7i n\u0103m.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/dinh-nghia-nguyen-nhan-co-che-benh-sinh-loet-da-day-ta-trang\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"\u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf b\u1ec7nh sinh lo\u00e9t d\u1ea1 d\u00e0y &#8211; 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