{"id":18248,"date":"2023-04-11T07:43:00","date_gmt":"2023-04-11T00:43:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18248"},"modified":"2023-05-02T17:07:12","modified_gmt":"2023-05-02T10:07:12","slug":"lao-nha-va-benh-ly-toan-than-tong-quan-nghien-cuu","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/11\/lao-nha-va-benh-ly-toan-than-tong-quan-nghien-cuu\/","title":{"rendered":"L\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n – T\u1ed5ng quan nghi\u00ean c\u1ee9u."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p cho \u0111\u1ed1i t\u01b0\u1ee3ng Nha s\u0129 c\u00e1i nh\u00ecn s\u00e2u s\u1eafc v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa nh\u00f3m b\u1ec7nh l\u00fd v\u1ec1 l\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n d\u1ef1a tr\u00ean c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng t\u1ea1i nhi\u1ec1u n\u01b0\u1edbc. \u0110\u1ed3ng th\u1eddi v\u1edbi \u0111\u00f3, Nha s\u0129 c\u1ea7n \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n khi \u0111\u1ee9ng tr\u01b0\u1edbc m\u1ed9t b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb r\u0103ng mi\u1ec7ng, c\u00f3 m\u1eafc c\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n.<\/strong><\/p>\n

\"benh-ly-lao-nha-va-toan-than\"
B\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n – T\u1ed5ng quan nghi\u00ean c\u1ee9u<\/figcaption><\/figure>\n

1. M\u1ed1i li\u00ean quan gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – v\u00f9ng quanh r\u0103ng v\u00e0 b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/h2>\n

\u1ea2nh h\u01b0\u1edfng c\u1ee7a \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u1ebfn m\u00f4 quanh r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c nhi\u1ec1u t\u00e1c gi\u1ea3 tr\u00ean th\u1ebf gi\u1edbi ch\u00fa \u00fd nghi\u00ean c\u1ee9u. Ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng th\u01b0\u1eddng c\u00f3 s\u01b0ng n\u1ec1 l\u1ee3i ti\u1ebfn tri\u1ec3n trong \u0111\u00e1p \u1ee9ng v\u1edbi m\u1ea3ng b\u00e1m vi khu\u1ea9n. \u0110\u00e1p \u1ee9ng n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u, v\u1edbi nh\u1eefng c\u1ea3 th\u1ec3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t c\u00f3 m\u1ed9t m\u1ee9c \u0111\u1ed9 vi\u00eam l\u1ee3i gi\u1ed1ng nh\u01b0 \u1edf nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 nh\u1eefng c\u00e1 th\u1ec3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t k\u00e9m c\u00f3 s\u1ef1 vi\u00eam s\u01b0ng l\u1ee3i gia t\u0103ng m\u1ed9t c\u00e1ch \u0111\u00e1ng k\u1ec3.<\/p>\n

S\u1ef1 ph\u1ed5 bi\u1ebfn c\u1ee7a b\u1ec7nh l\u00fd l\u00e3o nha – vi\u00eam quanh r\u0103ng \u1edf thanh thi\u1ebfu ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 nhi\u1ec1u h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u1edf c\u00f9ng \u0111\u1ed9 tu\u1ed5i. Trong m\u1ed9t ph\u00e2n t\u00edch t\u1ed5ng qu\u00e1t, Papanou \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng \u0111a s\u1ed1 c\u00e1c nghi\u00ean c\u1ee9u \u0111\u1ec1u cho th\u1ea5y t\u00ecnh tr\u1ea1ng quanh r\u0103ng c\u1ee7a nh\u1eefng b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng n\u1eb7ng h\u01a1n so v\u1edbi nh\u00f3m ch\u1ee9ng kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n

Trong m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf bang Arizona v\u1edbi t\u1ed9c ng\u01b0\u1eddi Pima Indian, n\u01a1i c\u00f3 t\u1ef7 l\u1ec7 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng cao nh\u1ea5t th\u1ebf gi\u1edbi, ng\u01b0\u1eddi ta \u0111\u00e3 th\u1ea5y r\u1eb1ng s\u1ef1 ph\u1ed5 bi\u1ebfn c\u1ee7a m\u1ea5t b\u00e1m d\u00ednh v\u00e0 ti\u00eau x\u01b0\u01a1ng \u1ed5 r\u0103ng \u1edf ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 l\u1edbn h\u01a1n \u1edf nh\u00f3m ch\u1ee9ng kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u1edbi c\u00f9ng \u0111\u1ed9 tu\u1ed5i. Trong m\u1ed9t ph\u00e2n t\u00edch \u0111a bi\u1ebfn th\u1ec3 nguy c\u01a1, ng\u01b0\u1eddi ta \u0111\u00e3 th\u1ea5y r\u1eb1ng nh\u1eefng ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nguy c\u01a1 m\u1eafc vi\u00eam quanh r\u0103ng l\u1edbn h\u01a1n 2,8\u2013 3,4 l\u1ea7n so v\u1edbi ng\u01b0\u1eddi kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng sau khi \u0111\u00e3 \u0111i\u1ec1u ch\u1ec9nh v\u1ec1 tu\u1ed5i, gi\u1edbi v\u00e0 t\u00ecnh tr\u1ea1ng v\u1ec7 sinh r\u0103ng mi\u1ec7ng.<\/p>\n

C\u0169ng trong m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean 3.524 ng\u01b0\u1eddi t\u1eeb 18 tu\u1ed5i tr\u1edf l\u00ean, ng\u01b0\u1eddi ta \u0111\u00e3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c r\u1eb1ng c\u00f3 s\u1ef1 li\u00ean quan \u0111\u00e1ng k\u1ec3 gi\u1eefa vi\u00eam quanh r\u0103ng v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 th\u1ec3 kh\u00f4ng ch\u1ec9 \u1ea3nh h\u01b0\u1edfng t\u1edbi s\u1ef1 ph\u1ed5 bi\u1ebfn, m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a vi\u00eam quanh r\u0103ng m\u00e0 c\u00f2n t\u1edbi s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh. Nguy c\u01a1 ti\u00eau x\u01b0\u01a1ng ti\u1ebfn tri\u1ec3n \u1edf ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u1edbn h\u01a1n 4,2 l\u1ea7n so v\u1edbi ng\u01b0\u1eddi kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 \u0111\u1eb7c bi\u1ec7t nguy c\u01a1 n\u00e0y l\u1edbn nh\u1ea5t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n d\u01b0\u1edbi 34 tu\u1ed5i. Tuy nhi\u00ean, s\u1ef1 li\u00ean quan gi\u1eefa ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 c\u1ee7a \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 b\u1ec7nh quanh r\u0103ng c\u0169ng kh\u00f4ng th\u1eadt r\u00f5 r\u00e0ng. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u k\u00e9m ph\u00e1t tri\u1ec3n ph\u00e1 hu\u1ef7 quanh r\u1eb1ng n\u1eb7ng, trong khi nh\u1eefng ng\u01b0\u1eddi kh\u00e1c l\u1ea1i kh\u00f4ng.<\/p>\n

Ng\u01b0\u1ee3c l\u1ea1i, nhi\u1ec1u b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t c\u00f3 s\u1ee9c kho\u1ebb quanh r\u0103ng tuy\u1ec7t v\u1eddi nh\u01b0ng s\u1ed1 kh\u00e1c l\u1ea1i ph\u00e1t tri\u1ec3n vi\u00eam quanh r\u0103ng. Nhi\u1ec1u nghi\u00ean c\u1ee9u tr\u00ean l\u00e2m s\u00e0ng \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc b\u1ec7nh l\u00e2u ng\u00e0y \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t k\u00e9m c\u00f3 xu h\u01b0\u1edbng ph\u00e1 hu\u1ef7 quanh r\u0103ng n\u1eb7ng h\u01a1n nh\u1eefng ng\u01b0\u1eddi ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 t\u1ed1t. Seppala v\u00e0 \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng nh\u1eefng ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ki\u1ec3m so\u00e1t k\u00e9m c\u00f3 t\u1ef7 l\u1ec7 m\u1ea5t b\u00e1m d\u00ednh v\u00e0 ti\u00eau x\u01b0\u01a1ng t\u0103ng \u0111\u00e1ng k\u1ec3 so v\u1edbi nh\u00f3m ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 t\u1ed1t.<\/p>\n

Tervonen v\u00e0 Oliver ch\u1ec9 ra r\u1eb1ng nh\u1eefng ng\u01b0\u1eddi ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 k\u00e9m qua ti\u1ebfn tr\u00ecnh 2\u20135 n\u0103m c\u00f3 t\u1ef7 l\u1ec7 t\u00fai quanh r\u0103ng s\u00e2u v\u00e0 m\u1ea5t b\u00e1m d\u00ednh l\u1edbn h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi nh\u00f3m ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u t\u1ed1t. Nghi\u00ean c\u1ee9u c\u1ee7a Taylor v\u00e0 \u0111\u1ed3ng nghi\u1ec7p c\u0169ng cho k\u1ebft qu\u1ea3 t\u01b0\u01a1ng t\u1ef1.<\/p>\n

C\u00e1c c\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u v\u1ec1 \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh quanh r\u0103ng tr\u00ean b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u0169ng \u0111\u01b0\u1ee3c nhi\u1ec1u t\u00e1c gi\u1ea3 ti\u1ebfn h\u00e0nh v\u00e0 b\u00e1o c\u00e1o. Trong nghi\u00ean c\u1ee9u c\u1ee7a m\u00ecnh, Christgau v\u00e0 \u0111\u1ed3ng nghi\u1ec7p th\u1ea5y r\u1eb1ng nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t, c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh quanh r\u0103ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p n\u1ea1o kh\u00f4ng ph\u1eabu thu\u1eadt v\u00e0 l\u00e0m nh\u1eb5n ch\u00e2n r\u0103ng gi\u1ed1ng nh\u01b0 \u1edf \u0111\u1ed1i t\u01b0\u1ee3ng kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng sau 4 th\u00e1ng \u0111i\u1ec1u tr\u1ecb. Westfelt v\u00e0 \u0111\u1ed3ng nghi\u1ec7p c\u0169ng th\u1ef1c hi\u1ec7n m\u1ed9t nghi\u00ean c\u1ee9u d\u1ecdc, g\u1ed3m nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 nh\u00f3m ch\u1ee9ng kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u1edbi b\u1ec7nh vi\u00eam quanh r\u0103ng. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u01b0\u1ee3c l\u1ea5y cao r\u0103ng v\u00e0 l\u00e0m nh\u1eb5n ch\u00e2n r\u0103ng, ph\u1eabu thu\u1eadt v\u1ea1t Widman c\u1ea3i ti\u1ebfn v\u00e0 cung c\u1ea5p c\u00e1c li\u1ec7u ph\u00e1p quanh r\u0103ng m\u1ed7i 3 th\u00e1ng. Sau 5 n\u0103m, t\u00e1c gi\u1ea3 th\u1ea5y c\u00f3 t\u1ef7 l\u1ec7 gi\u1ed1ng nhau v\u1ec1 ph\u01b0\u01a1ng di\u1ec7n \u0111\u1ea1t v\u00e0 m\u1ea5t b\u00e1m d\u00ednh v\u00e0 t\u1ef7 l\u1ec7 gi\u1ed1ng nhau v\u1ec1 ph\u01b0\u01a1ng di\u1ec7n \u1ed5n \u0111\u1ecbnh m\u1ee9c b\u00e1m d\u00ednh, khi so s\u00e1nh gi\u1eefa nh\u00f3m \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u1edbi nh\u00f3m ch\u1ee9ng. H\u1ea7u h\u1ebft nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng trong nghi\u00ean c\u1ee9u n\u00e0y \u0111\u1ec1u \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u t\u1ed1t v\u00e0 trung b\u00ecnh.<\/p>\n

Trong khi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn m\u00f4 quanh r\u0103ng, th\u00ec c\u0169ng c\u00f3 nh\u1eefng b\u1eb1ng ch\u1ee9ng g\u1ee3i \u00fd r\u1eb1ng nhi\u1ec5m tr\u00f9ng quanh r\u0103ng c\u00f3 kh\u1ea3 n\u0103ng t\u00e1c \u0111\u1ed9ng ng\u01b0\u1ee3c t\u1edbi vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Taylor v\u00e0 \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 ti\u1ebfn h\u00e0nh m\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 \u0111\u1ec3 t\u00ecm hi\u1ec3u r\u1eb1ng li\u1ec7u vi\u00eam quanh r\u0103ng n\u1eb7ng c\u00f3 l\u00e0m t\u0103ng nguy c\u01a1 \u0111\u1ed1i v\u1edbi vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u hay kh\u00f4ng. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y, vi\u00eam quanh r\u0103ng n\u1eb7ng l\u00e0m gia t\u0103ng nguy c\u01a1 v\u1edbi ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u g\u1ea5p 6 l\u1ea7n. Trong m\u1ed9t nghi\u00ean c\u1ee9u b\u1ec7nh ch\u1ee9ng nh\u1eefng ng\u01b0\u1eddi l\u1edbn \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 vi\u00eam l\u1ee3i ho\u1eb7c vi\u00eam quanh r\u0103ng nh\u1eb9 so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam quanh r\u0103ng n\u1eb7ng, sau 1 \u0111\u1ebfn 11 n\u0103m theo d\u00f5i, ng\u01b0\u1eddi ta th\u1ea5y \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh vi\u00eam quanh r\u0103ng n\u1eb7ng c\u00f3 s\u1ef1 ph\u1ed5 bi\u1ebfn h\u01a1n \u0111\u00e1ng k\u1ec3 c\u00e1c bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch v\u00e0 th\u1eadn so v\u1edbi nh\u00f3m c\u00f3 b\u1ec7nh quanh r\u0103ng t\u1ed1i thi\u1ec3u.<\/p>\n

N\u1ebfu nh\u01b0 nhi\u1ec5m tr\u00f9ng quanh r\u0103ng c\u00f3 \u1ea3nh h\u01b0\u1edfng t\u1edbi vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u, th\u00ec m\u1ed9t c\u00e2u h\u1ecfi c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u1eb7t ra l\u00e0: Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh r\u0103ng b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 gi\u1ea3m s\u01b0ng n\u1ec1 c\u00f3 th\u1ec3 c\u00f3 \u1ea3nh h\u01b0\u1edfng t\u00edch c\u1ef1c t\u1edbi vi\u1ec7c ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u hay kh\u00f4ng? Trong m\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 1 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t k\u00e9m c\u00f3 b\u1ec7nh vi\u00eam quanh r\u0103ng, Miller v\u00e0 \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 \u0111\u00e1nh gi\u00e1 t\u00e1c d\u1ee5ng c\u1ee7a vi\u1ec7c l\u1ea5y cao r\u0103ng v\u00e0 l\u00e0m nh\u1eb5n ch\u00e2n r\u0103ng k\u1ebft h\u1ee3p v\u1edbi d\u00f9ng thu\u1ed1c kh\u00e1ng sinh doxycycline \u0111\u01b0\u1eddng to\u00e0n th\u00e2n 14 ng\u00e0y. Nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng vi\u1ec7c t\u0103ng c\u01b0\u1eddng s\u1ee9c kh\u1ecfe quanh r\u0103ng c\u00f3 t\u00e1c d\u1ee5ng t\u00edch c\u1ef1c v\u1edbi vi\u1ec7c ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 \u1edf ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, \u0111\u1ed3ng th\u1eddi c\u0169ng ch\u1ec9 ra l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam quanh r\u0103ng \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 k\u00e9m. Grossi v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 nghi\u00ean c\u1ee9u m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng l\u1edbn ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1 k\u00e9m c\u00f3 vi\u00eam quanh r\u0103ng n\u1eb7ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ea1o d\u01b0\u1edbi l\u1ee3i k\u1ebft h\u1ee3p v\u1edbi d\u00f9ng doxycycline \u0111\u01b0\u1eddng to\u00e0n th\u00e2n (100mg\/ng\u00e0y) ho\u1eb7c d\u00f9ng gi\u1ea3 d\u01b0\u1ee3c trong 14 ng\u00e0y. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y s\u1ef1 k\u1ebft h\u1ee3p \u0111i\u1ec1u tr\u1ecb n\u1ea1o d\u01b0\u1edbi l\u1ee3i v\u00e0 doxycycline to\u00e0n th\u00e2n cho k\u1ebft qu\u1ea3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 c\u00e1c th\u00f4ng s\u1ed1 c\u1ee7a ki\u1ec3m so\u00e1t chuy\u1ec3n ho\u00e1.<\/p>\n

Ng\u00e0y c\u00e0ng c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u v\u1ec1 m\u1ed1i li\u00ean quan, s\u1ef1 t\u00e1c \u0111\u1ed9ng qua l\u1ea1i gi\u1eefa vi\u00eam quanh r\u0103ng v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh, c\u01a1 ch\u1ebf c\u1ee7a s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u0169ng d\u1eabn \u0111\u01b0\u1ee3c l\u00e0m s\u00e1ng t\u1ecf. Nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y gi\u00fap ch\u00fang ta c\u00f3 \u0111\u01b0\u1ee3c hi\u1ec3u bi\u1ebft \u0111\u1ea7y \u0111\u1ee7, kh\u00e1ch quan v\u00e0 khoa h\u1ecdc h\u01a1n v\u1ec1 b\u1ec7nh quanh r\u0103ng c\u0169ng nh\u01b0 v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1, \u0111\u1ed3ng th\u1eddi m\u1edf ra m\u1ed9t h\u01b0\u1edbng m\u1edbi trong vi\u1ec7c ph\u00f2ng v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh quanh r\u0103ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh quanh r\u0103ng tr\u00ean b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n

2. M\u1ed1i li\u00ean quan gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – v\u00f9ng quanh r\u0103ng v\u00e0 b\u1ec7nh tim m\u1ea1ch \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/h2>\n

2.1. M\u1ed1i li\u00ean quan gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – nhi\u1ec5m tr\u00f9ng quanh r\u0103ng v\u1edbi b\u1ec7nh m\u1ea1ch v\u00e0nh v\u00e0 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch<\/h3>\n

\u1ede h\u1ea7u h\u1ebft c\u00e1c qu\u1ed1c gia, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 m\u1ed9t trong c\u00e1c nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong m\u00e0 c\u01a1 s\u1edf sinh l\u00fd b\u1ec7nh ch\u00ednh l\u00e0 x\u01a1 c\u1ee9ng \u0111\u1ed9ng m\u1ea1ch. Th\u1ed1ng k\u00ea c\u1ee7a T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi cho th\u1ea5y b\u1ec7nh tim m\u1ea1ch l\u00e0 nguy\u00ean nh\u00e2n c\u1ee7a 20% t\u1eed vong. \u1ede c\u00e1c n\u01b0\u1edbc ph\u01b0\u01a1ng T\u00e2y b\u1ec7nh tim m\u1ea1ch g\u00e2y n\u00ean t\u1ef7 l\u1ec7 t\u1eed vong 50%.
\nSau 7 n\u0103m nghi\u00ean c\u1ee9u v\u00e0 theo d\u00f5i 214 b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd m\u1ea1ch v\u00e0nh v\u00e0 c\u00f3 kh\u00e1m r\u0103ng mi\u1ec7ng, \u0111\u00e1nh gi\u00e1 nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1 b\u1ec7nh l\u00fd tim m\u1ea1ch 1995 Mattila \u0111\u00e3 nghi\u00ean c\u1ee9u v\u00e0 ch\u1ee9ng minh m\u1ed1i li\u00ean quan c\u00f3 \u00fd ngh\u0129a v\u00e0 b\u1ec1n v\u1eefng gi\u1eefa nhi\u1ec5m tr\u00f9ng r\u0103ng t\u1eeb b\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd m\u1ea1ch v\u00e0nh.<\/p>\n

Joshipura v\u00e0 c\u1ed9ng s\u1ef1 sau khi nghi\u00ean c\u1ee9u 44119 nam gi\u1edbi s\u1ee9c kho\u1ebb b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u1ec1 b\u1ec7nh l\u00fd m\u1ea1ch v\u00e0nh l\u00fac b\u1eaft \u0111\u1ea7u nghi\u00ean c\u1ee9u trong 6 n\u0103m \u0111\u00e3 ch\u1ee9ng minh m\u1ed1i li\u00ean quan gi\u1eefa t\u00ecnh tr\u1ea1ng m\u1ea5t r\u0103ng v\u00e0 t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh m\u1ea1ch v\u00e0nh nh\u01b0ng m\u1ed1i li\u00ean quan n\u00e0y ch\u1ec9 gi\u1edbi h\u1ea1n \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh s\u1eed ti\u00eau x\u01b0\u01a1ng do vi\u00eam quanh r\u0103ng c\u1ee7a b\u1ec7nh l\u00fd l\u00e3o nha.<\/p>\n

Genco v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e1nh gi\u00e1 m\u1ee9c ti\u00eau x\u01b0\u01a1ng v\u00e0 gi\u00e1m s\u00e1t t\u00ecnh tr\u1ea1ng tim m\u1ea1ch \u1edf ng\u01b0\u1eddi M\u1ef9 khu v\u1ef1c s\u00f4ng Gila c\u0169ng ch\u1ee9ng minh m\u1ee9c \u0111\u1ed9 ti\u00eau x\u01b0\u01a1ng do b\u1ec7nh vi\u00eam quanh r\u0103ng l\u00e0 y\u1ebfu t\u1ed1 d\u1ef1 \u0111o\u00e1n v\u1ec1 b\u1ec7nh l\u00fd tim m\u1ea1ch cho nh\u00f3m tu\u1ed5i 60 hay tr\u1ebb h\u01a1n v\u1edbi \u0111\u1ed9 ch\u00eanh l\u00e0 2,68.<\/p>\n

Nghi\u00ean c\u1ee9u 50 b\u1ec7nh nh\u00e2n vi\u00eam quanh r\u0103ng Bublin K \u0111\u00e3 ph\u00e1t hi\u1ec7n trong m\u00e1u c\u1ee7a nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y t\u1ef7 l\u1ec7 lipoprotein t\u1ef7 tr\u1ecdng cao (HDL) gi\u1ea3m m\u1ea1nh. M\u00e0 theo c\u01a1 ch\u1ebf sinh l\u00fd b\u1ec7nh lipoprotein t\u1ef7 tr\u1ecdng cao (HDL) c\u00f3 t\u00e1c d\u1ee5ng b\u1ea3o v\u1ec7 v\u00e0 tr\u1ee3 gi\u00fap vi\u1ec7c huy \u0111\u1ed9ng lipoprotein t\u1ef7 tr\u1ecdng th\u1ea5p (LDL) l\u00e0m gi\u1ea3m qu\u00e1 tr\u00ecnh x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch. V\u00ec ch\u00ednh lipoprotein t\u1ef7 tr\u1ecdng th\u1ea5p l\u00e0 lipid sinh x\u01a1 v\u1eefa ch\u1ee7 y\u1ebfu.<\/p>\n

Beck v\u00e0 c\u1ed9ng s\u1ef1 c\u0169ng nghi\u00ean c\u1ee9u v\u1ec1 nguy c\u01a1 g\u00e2y x\u01a1 c\u1ee9ng \u0111\u1ed9ng m\u1ea1ch do b\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 \u0111\u01b0a ra s\u1ed1 li\u1ec7u s\u01a1 b\u1ed9 v\u1ec1 m\u1ed1i li\u00ean quan b\u1ec7nh vi\u00eam quanh r\u0103ng v\u1edbi \u0111\u1ed9 d\u00e0y m\u00e0ng trong \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, ph\u01b0\u01a1ng ph\u00e1p c\u1eadn l\u00e2m s\u00e0ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u01a1 c\u1ee9ng \u0111\u1ed9ng m\u1ea1ch.<\/p>\n

C\u01a1 s\u1edf sinh l\u00fd gi\u1ea3i th\u00edch cho gi\u1ea3 thuy\u1ebft v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa nh\u00f3m b\u1ec7nh l\u00fd l\u00e3o nha – vi\u00eam quanh r\u0103ng v\u00e0 b\u1ec7nh tim m\u1ea1ch \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u s\u00e2u h\u01a1n. C\u00f3 nhi\u1ec1u c\u01a1 ch\u1ebf c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch m\u1ed7i li\u00ean quan gi\u1eefa b\u1ec7nh tim m\u1ea1ch v\u00e0 b\u1ec7nh vi\u00eam quanh r\u0103ng. B\u1ec7nh vi\u00eam quanh r\u0103ng l\u00e0 m\u1ed9t ph\u1ea3n \u1ee9ng vi\u00eam m\u1ea1n t\u00ednh c\u1ee7a m\u00f4 quanh r\u0103ng \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng do vi khu\u1ea9n Gram \u00e2m k\u1ef5 kh\u00ed. C\u00e1c vi khu\u1ea9n n\u00e0y v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m c\u1ee7a ch\u00fang nh\u01b0 lipopolysaccharide d\u1ec5 d\u00e0ng v\u00e0o m\u1ea1ch m\u00e1u b\u00ean d\u01b0\u1edbi nh\u1edd v\u00e0o b\u1ec1 m\u1eb7t r\u1ed9ng c\u1ee7a t\u00fai vi\u00eam quanh r\u0103ng.<\/p>\n

Gi\u1ea3 thuy\u1ebft v\u1ec1 ngh\u1ebdn m\u1ea1ch do vi khu\u1ea9n v\u00e0 m\u1ed9t c\u01a1 ch\u1ebf trong \u0111\u00f3 x\u1ea3y ra t\u00e1c \u0111\u1ed9ng t\u01b0\u01a1ng h\u1ed7 gi\u1eefa s\u1ea3n ph\u1ea9m c\u1ee7a vi khu\u1ea9n v\u00e0 h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u nh\u01b0 \u0111\u00e3 n\u00eau tr\u00ean, nhi\u1ec5m tr\u00f9ng d\u01b0\u01a1ng nh\u01b0 l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh tim m\u1ea1ch v\u00e0 x\u01a1 c\u1ee9ng \u0111\u1ed9ng m\u1ea1ch. B\u1ec7nh nh\u00e2n vi\u00eam quanh r\u0103ng c\u00f3 s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u v\u00e0 n\u1ed3ng \u0111\u1ed9 fibrinogen trong huy\u1ebft t\u01b0\u01a1ng cao. S\u1ef1 gia t\u0103ng v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u v\u00e0 fibrinogen nh\u01b0 v\u1eady c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t qu\u00e1 tr\u00ecnh x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch v\u00e0 ngh\u1ebdn m\u1ea1ch d\u1eabn \u0111\u1ebfn b\u1ec7nh tim m\u1ea1ch. S\u1ef1 k\u1ebft c\u1ee5m ti\u1ec3u c\u1ea7u do collagen, Thrombin v\u00e0 m\u1ed9t s\u1ed1 vi khu\u1ea9n nh\u01b0 Streptococcus Sanguis v\u00e0 Porphyromonas Gingivalis. C\u00e1c vi khu\u1ea9n n\u1ea3y g\u00e2y ra s\u1ef1 k\u1ebft c\u1ee5m ti\u1ec3u c\u1ea7u nh\u1edd k\u1ebft n\u1ed1i v\u1edbi m\u1ed9t protein b\u1ec1 m\u1eb7t \u0111\u1eb7c hi\u1ec7u, protein n\u00e0y c\u00f3 t\u00ednh t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi v\u00f9ng collagen ho\u1ea1t ho\u00e1 ti\u1ec3u c\u1ea7u. Ngo\u00e0i ra, P. Gingivalis v\u00e0 P. Intermedia c\u0169ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong c\u00e1c m\u00f4 \u0111\u1ed9ng m\u1ea1ch v\u00e0 c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp v\u00e0o t\u1ebf b\u00e0o n\u1ed9i m\u00f4. Lipopolysaccharide hay n\u1ed9i \u0111\u1ed9c t\u1ed1 khi xu\u1ea5t hi\u1ec7n s\u1ebd l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c \u0111\u1ed1i v\u1edbi c\u01a1 th\u1ec3, c\u00f3 th\u1ec3 k\u00edch th\u00edch s\u1ef1 th\u00e2m nh\u1eadp t\u1ebf b\u00e0o vi\u00eam v\u00e0o c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn, l\u00e0m t\u0103ng sinh c\u00e1c c\u01a1 tr\u01a1n th\u00e0nh m\u1ea1ch, g\u00e2y tho\u00e1i ho\u00e1 m\u1ee1 \u1edf m\u1ea1ch m\u00e1u v\u00e0 l\u00e0m \u0111\u00f4ng \u0111\u1eb7c n\u1ed9i m\u1ea1ch. T\u00f3m l\u1ea1i, nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y g\u1ee3i \u00fd r\u1eb1ng vi khu\u1ea9n \u1edf mi\u1ec7ng hi\u1ec7n di\u1ec7n trong m\u1ea1ch m\u00e1u l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 kh\u1edfi ph\u00e1t s\u1ef1 huy\u1ebft t\u1eafc v\u00e0 gia t\u0103ng nguy c\u01a1 g\u00e2y tim m\u1ea1ch. Nh\u1eefng b\u1eb1ng ch\u1ee9ng m\u1ea1nh m\u1ebd t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng nhi\u1ec5m tr\u00f9ng v\u00e0 vi\u00eam l\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh c\u0103n c\u1ee7a b\u1ec7nh tim m\u1ea1ch v\u00e0 x\u01a1 c\u1ee9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0 nhi\u1ec1u nghi\u00ean c\u1ee9u c\u0169ng \u0111\u00e3 ch\u1ec9 ra vai tr\u00f2 tr\u1ef1c ti\u1ebfp h\u01a1n c\u1ee7a nhi\u1ec5m tr\u00f9ng r\u0103ng mi\u1ec7ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 do vi\u00eam quanh r\u0103ng. Tinh ch\u1ea5t m\u1ea1n t\u00ednh c\u1ee7a b\u1ec7nh vi\u00eam quanh r\u0103ng ch\u00ednh l\u00e0 ngu\u1ed3n cung c\u1ea5p d\u1ed3i d\u00e0o vi khu\u1ea9n d\u01b0\u1edbi l\u1ee3i v\u00e0 t\u1ea1o ra c\u00e1c s\u1ea3n ph\u1ea9m do \u0111\u00e1p \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 v\u00e0 g\u00e2y hi\u1ec7u qu\u1ea3 trong m\u1ed9t th\u1eddi gian d\u00e0i.<\/p>\n

2.2. M\u1ed1i li\u00ean quan gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – nhi\u1ec5m tr\u00f9ng quanh r\u0103ng v\u1edbi b\u1ec7nh \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o<\/h3>\n

Beck v\u00e0 c\u1ed9ng s\u1ef1 d\u1ef1a v\u00e0o s\u1ed1 li\u1ec7u k\u1ebft h\u1ee3p t\u1eeb nghi\u00ean c\u1ee9u v\u1ec1 l\u00e3o ho\u00e1 v\u00e0 nghi\u00ean c\u1ee9u d\u1ecdc v\u1ec1 r\u0103ng \u0111o ch\u1ec9 s\u1ed1 m\u1ea5t x\u01b0\u01a1ng trung b\u00ecnh \u0111\u01b0a ra k\u1ebft lu\u1eadn. T\u1ef7 l\u1ec7 m\u1ea5t x\u01b0\u01a1ng \u1edf r\u0103ng t\u1ea1i nh\u00f3m b\u1ec7nh l\u00fd l\u00e3o nha n\u00e2ng cao t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh tim, t\u1eed vong do b\u1ec7nh tim v\u00e0 \u0111\u1ed9t qu\u1ef5 c\u00e0ng cao, nghi\u00ean c\u1ee9u r\u1ed9ng r\u00e3i li\u00ean quan \u0111\u1ed9t qu\u1ef5 v\u1edbi b\u1ec7nh vi\u00eam quanh r\u0103ng \u0111\u01b0\u1ee3c Wu. T v\u00e0 c\u1ed9ng s\u1ef1 c\u00f4ng b\u1ed1. H\u1ecd \u0111\u00e3 nghi\u00ean c\u1ee9u t\u01b0 li\u1ec7u c\u01a1 b\u1ea3n c\u1ee7a NHANES tr\u00ean 9962 ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh theo d\u00f5i trong 18 n\u0103m. N\u1ed9i dung b\u1ec7nh to\u00e0n th\u00e2n l\u00e0 b\u1ec7nh m\u1ea1ch m\u00e1u n\u00e3o bao g\u1ed3m \u0111\u1ed9t qu\u1ef5 do ch\u1ea3y m\u00e1u v\u00e0 kh\u00f4ng ch\u1ea3y m\u00e1u, thi\u1ebfu m\u00e1u n\u00e3o tho\u00e1ng qua. C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh lo\u1ea1i b\u1ecb vi\u00eam quanh r\u0103ng, vi\u00eam l\u1ee3i hay m\u00f4 quanh r\u0103ng l\u00e0nh m\u1ea1nh tr\u00ean c\u01a1 s\u1edf ch\u1ec9 s\u1ed1 quanh r\u0103ng Russell. H\u1ecd th\u1ea5y r\u1eb1ng vi\u00eam quanh r\u0103ng kh\u00e1m l\u1ea7n \u0111\u1ea7u \u0111\u00e3 k\u1ebft h\u1ee3p v\u1edbi \u0111\u1ed9t qu\u1ef5 kh\u00f4ng ch\u1ea3y m\u00e1u (thi\u1ebfu m\u00e1u) v\u1edbi nguy c\u01a1 t\u01b0\u01a1ng quan 2:1 (95% CI: 1,3\u20133,4). T\u1ea7m quan tr\u1ecdng \u0111\u00e1ng k\u1ec3 nh\u1eadn th\u1ea5y trong c\u00f9ng nh\u00f3m n\u00e0y l\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a vi\u00eam quanh r\u0103ng v\u1edbi \u0111\u1ed9t qu\u1ef5 ch\u1ea3y m\u00e1u m\u00e0 n\u00f3 k\u1ebft h\u1ee3p v\u1edbi m\u1ea1ch m\u00e1u b\u1ecb ch\u1ea3y, cung c\u1ea5p ch\u1ee9ng c\u1edb th\u00eam n\u1eefa \u0111\u1ed1i v\u1edbi vai tr\u00f2 nhi\u1ec5m tr\u00f9ng trong qu\u00e1 tr\u00ecnh x\u01a1 v\u1eefa. Nguy c\u01a1 t\u0103ng l\u00ean \u0111\u1ed1i v\u1edbi \u0111\u1ed9t qu\u1ef5 kh\u00f4ng ch\u1ea3y m\u00e1u \u0111\u01b0\u1ee3c th\u1ea5y \u1edf nam v\u00e0 n\u1eef ch\u00e2u Phi, M\u1ef9 v\u00e0 ch\u00e2u u (ng\u01b0\u1eddi da tr\u1eafng). B\u1ec7nh m\u00f4 quanh r\u0103ng kh\u1edfi \u0111\u1ea7u \u0111\u01b0\u1ee3c t\u00ednh l\u00e0 19% c\u1ee7a nh\u00f3m c\u00f3 th\u1ec3 tham gia v\u00e0o nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 kh\u00f4ng ch\u1ea3y m\u00e1u c\u00f3 t\u1ea7m quan tr\u1ecdng v\u1ec1 s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng. C\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u n\u00e0y l\u00e0 quan tr\u1ecdng b\u1edfi v\u00ec c\u00f3 m\u1ed9t s\u1ef1 ki\u1ec3m tra n\u1ed9i khoa ngh\u0129a l\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 li\u00ean quan gi\u1eefa b\u1ec7nh vi\u00eam quanh r\u0103ng trong c\u00f9ng m\u1ed9t nh\u00f3m v\u1edbi \u0111\u1ed9t qu\u1ef5 ch\u1ea3y m\u00e1u.<\/p>\n

Nh\u1eefng nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y ch\u1ec9 ra s\u1ef1 li\u00ean quan x\u00e1c th\u1ef1c c\u1ee7a \u0111\u1ed9t qu\u1ef5 hay ch\u1ee9ng thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 \u1edf m\u1ea1ch m\u00e1u n\u00e3o v\u1edbi nhi\u1ec5m tr\u00f9ng r\u0103ng mi\u1ec7ng (t\u1ef7 su\u1ea5t ch\u00eanh l\u00e0 2,6). Ngo\u00e0i ra, nghi\u00ean c\u1ee9u n\u00e3o ho\u00e1 ch\u1ea9n v\u00e0 nghi\u00ean c\u1ee9u s\u1ecdc nha khoa c\u1ee7a h\u1ed9i \u0111\u1ed3ng c\u1ed1 v\u1ea5n th\u1ea5y r\u1eb1ng t\u1ef7 su\u1ea5t ch\u00eanh hi\u1ec7n h\u00e0nh \u0111\u1ed1i v\u1edbi m\u1ea5t x\u01b0\u01a1ng v\u00e0 b\u1ec7nh tim m\u1ea1ch to\u00e0n b\u1ed9, b\u1ec7nh tim m\u1ea1ch g\u00e2y t\u1eed vong v\u00e0 \u0111\u1ed9t qu\u1ef5 t\u01b0\u01a1ng \u1ee9ng l\u00e0 1,5; 2,2 v\u00e0 2,8.<\/p>\n

2.3. M\u1ed1i li\u00ean quan gi\u1eefa nhi\u1ec5m tr\u00f9ng quanh r\u0103ng v\u1edbi vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c do vi khu\u1ea9n<\/h3>\n

Hi\u1ec7n nay nhi\u1ec5m tr\u00f9ng huy\u1ebft c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb mi\u1ec7ng, g\u00e2y nhi\u1ec5m tr\u00f9ng c\u00e1c van tim \u0111\u00e3 h\u01b0 l\u00e0 m\u1ed1i quan h\u1ec7 r\u00f5 r\u00e0ng nh\u1ea5t gi\u1eefa m\u1ea3ng b\u00e1m vi khu\u1ea9n\/vi\u00eam quanh r\u0103ng c\u1ee7a b\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 b\u1ec7nh to\u00e0n th\u00e2n. Ng\u01b0\u1eddi ta ch\u1ea5p nh\u1eadn r\u1eb1ng c\u00e1c th\u1ee7 thu\u1eadt r\u0103ng mi\u1ec7ng v\u00e0 c\u00e1c th\u1ee7 thu\u1eadt kh\u00e1c l\u00e0m cho nh\u1eefng b\u1ec7nh nh\u00e2n nh\u1ea1y c\u1ea3m d\u1ec5 b\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c do nhi\u1ec5m tr\u00f9ng hay nhi\u1ec5m tr\u00f9ng \u1edf th\u00e0nh n\u1ed9i t\u00e2m m\u1ea1c. Vi khu\u1ea9n vi\u00eam quanh r\u0103ng c\u1ee7a b\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m ph\u1ee5 c\u1ee7a ch\u00fang c\u0169ng c\u00f3 th\u1ec3 \u0111i v\u00e0o h\u1ec7 tu\u1ea7n ho\u00e0n b\u1eb1ng c\u00e1ch x\u00e2m nh\u1eadp tr\u1ef1c ti\u1ebfp qua m\u00f4 quanh r\u0103ng. Nhi\u1ec5m khu\u1ea9n huy\u1ebft c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb mi\u1ec7ng d\u01b0\u1eddng nh\u01b0 li\u00ean quan tr\u1ef1c ti\u1ebfp v\u1edbi s\u1ef1 tr\u1ea7m tr\u1ecdng c\u1ee7a vi\u00eam nhi\u1ec5m \u1edf m\u00f4 quanh r\u0103ng.<\/p>\n

C\u00f3 hai d\u1ea1ng vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng c\u1ea5p v\u00e0 b\u00e1n c\u1ea5p. Nh\u1eefng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u00e0 h\u1ec7 vi khu\u1ea9n li\u00ean quan th\u01b0\u1eddng kh\u00e1c nhau. Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng c\u1ea5p bi\u1ec3u hi\u1ec7n b\u1eb1ng s\u1ef1 b\u1ed9t ph\u00e1t c\u01a1n s\u1ed1t, \u0111\u1ed1m huy\u1ebft \u1edf da, mi\u1ec7ng v\u00e0 ho\u1ea1i t\u1eed da t\u1eadp trung. C\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch, l\u00e0m t\u0103ng nguy c\u01a1 ngh\u1ebdn m\u1ea1ch v\u00e0 nhi\u1ec5m tr\u00f9ng lan t\u1edbi b\u1ea5t k\u1ef3 c\u01a1 quan n\u00e0o c\u1ee7a c\u01a1 th\u1ec3. N\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh, c\u00f3 th\u1ec3 \u0111\u01b0a \u0111\u1ebfn t\u1eed vong. Ng\u01b0\u1eddi ta \u0111\u00e3 ly tr\u00edch \u0111\u01b0\u1ee3c Streptococci \u1edf mi\u1ec7ng, \u0111\u00f3 l\u00e0 Streptococcus viridans v\u00e0 S. sanguis t\u1eeb nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng b\u00e1n c\u1ea5p. C\u00e1c d\u00f2ng vi khu\u1ea9n S. sanguis b\u00e1m v\u00e0o v\u1ebft s\u00f9i tr\u00ean van tim v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 th\u00e0nh l\u1eadp huy\u1ebft kh\u1ed1i. Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng c\u0169ng c\u00f3 th\u1ec3 do nh\u1eefng vi khu\u1ea9n g\u00e2y b\u1ec7nh vi\u00eam quanh r\u0103ng kh\u00e1c: nh\u1eefng lo\u00e0i Haemophilus, Actinobacillus<\/p>\n

Actinomycetemcomitans, Eikenella corrodens, nh\u1eefng lo\u00e0i Capnocytophaga v\u00e0 Fusobacterium nucleatum. Do \u0111\u00f3, \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng tr\u01b0\u1edbc h\u1ebft n\u00ean nh\u1eb1m v\u00e0o vi\u1ec7c gi\u1ea3m thi\u1ec3u t\u1ed1i \u0111a nhi\u1ec5m tr\u00f9ng l\u1ee3i \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1. Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh van tim, thay th\u1ebf van tim, hay c\u00f3 ti\u1ec1n s\u1eed vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng c\u00f3 nguy c\u01a1 cao b\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng, b\u1ec7nh tim sung huy\u1ebft, hay ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp tim. C\u00e1c b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh r\u0103ng n\u00ean b\u00e0n b\u1ea1c v\u1edbi b\u00e1c s\u0129 tim m\u1ea1ch. Vi\u1ec7c c\u00e1c nh\u00e2n vi\u00ean nha khoa khuy\u00ean th\u1ea7y thu\u1ed1c ch\u00fa \u00fd \u0111\u1ebfn t\u00ecnh tr\u1ea1ng vi\u00eam quanh r\u0103ng\/r\u0103ng mi\u1ec7ng l\u00e0 quan tr\u1ecdng ngang nhau.<\/p>\n

Ng\u00e0y c\u00e0ng c\u00f3 nhi\u1ec1u b\u1eb1ng ch\u1ee9ng cho r\u1eb1ng b\u1ec7nh vi\u00eam quanh r\u0103ng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh tim m\u1ea1ch, tuy nhi\u00ean c\u1ea7n c\u00f3 nhi\u1ec1u d\u1eef li\u1ec7u thuy\u1ebft ph\u1ee5c h\u01a1n trong c\u00e1c nghi\u00ean c\u1ee9u s\u00e2u h\u01a1n, c\u0169ng nh\u01b0 nh\u1eefng nghi\u00ean c\u1ee9u can thi\u1ec7p \u0111\u01b0\u1ee3c ki\u1ec3m ch\u1ee9ng t\u1ed1t \u0111\u1ec3 ch\u1ee9ng minh m\u1ed1i li\u00ean quan nh\u00e2n qu\u1ea3 n\u1ea3y. N\u1ebfu nh\u01b0 nh\u1eefng nghi\u00ean c\u1ee9u trong t\u01b0\u01a1ng lai ch\u1ee9ng minh \u0111\u01b0\u1ee3c b\u1ec7nh vi\u00eam quanh r\u0103ng l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 th\u1eadt s\u1ef1 c\u1ee7a b\u1ec7nh tim m\u1ea1ch, v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh r\u0103ng l\u00e0m gi\u1ea3m \u0111\u01b0\u1ee3c nguy c\u01a1 m\u1eafc m\u1ed9t s\u1ed1 b\u1ec7nh to\u00e0n th\u00e2n, \u0111i\u1ec1u n\u00e0y c\u00f3 \u00fd ngh\u0129a \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi h\u00e0nh ngh\u1ec1 Nha khoa c\u0169ng nh\u01b0 t\u00e1c \u0111\u1ed9ng t\u1edbi s\u1ef1 hi\u1ec3u bi\u1ebft v\u00e0 \u0111\u1ed9ng l\u1ef1c th\u00fac \u0111\u1ea9y gi\u1eef g\u00ecn s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng c\u1ee7a b\u1ec7nh nh\u00e2n. Do v\u1eady, t\u1ea7m quan tr\u1ecdng c\u1ee7a b\u1ec7nh l\u00fd vi\u00eam quanh r\u0103ng trong s\u1ee9c kho\u1ebb c\u1ed9ng \u0111\u1ed3ng s\u1ebd c\u00e0ng tr\u1edf n\u00ean c\u00f3 \u00fd ngh\u0129a h\u01a1n v\u00e0 s\u1ebd xu\u1ea5t hi\u1ec7n nh\u1eefng ti\u00eau chu\u1ea9n v\u1ec1 ch\u0103m s\u00f3c \u0111\u1ed1i v\u1edbi b\u00e1c s\u0129 v\u00e0 ng\u00e0nh B\u1ea3o hi\u1ec3m.<\/p>\n

Nha s\u0129 ph\u1ea3i quan t\u00e2m nhi\u1ec1u h\u01a1n \u0111\u1ebfn nhu c\u1ea7u c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 m\u1eafc b\u1ec7nh tim m\u1ea1ch cho b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao nh\u01b0 c\u00f3 van tim gi\u1ea3, c\u00f3 ti\u1ec1n s\u1eed vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c, ph\u00ec \u0111\u1ea1i c\u01a1 tim b\u1ea9m sinh. Ng\u00e0y c\u00e0ng c\u00f3 nhi\u1ec1u b\u1eb1ng ch\u1ee9ng cho r\u1eb1ng b\u1ec7nh vi\u00eam quanh r\u0103ng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 b\u1ec7nh tim m\u1ea1ch.<\/p>\n

3. M\u1ed1i li\u00ean quan gi\u1eefa s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/h2>\n

M\u1ed1i li\u00ean quan gi\u1eefa c\u00e1c b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p v\u00e0 s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng trong c\u1ed9ng \u0111\u1ed3ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u b\u1eb1ng d\u1eef li\u1ec7u c\u1ee7a NHANES I. D\u1eef li\u1ec7u g\u1ed3m th\u00f4ng tin v\u1ec1 s\u1ee9c kh\u1ecfe t\u1ed5ng qu\u00e1t c\u1ee7a 23808 ng\u01b0\u1eddi. Trong \u0111\u00f3, 365 ng\u01b0\u1eddi b\u1ecb c\u00e1c b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh (vi\u00eam ph\u1ebf qu\u1ea3n m\u1ea1n t\u00ednh hay khi ph\u1ebf th\u0169ng) ho\u1eb7c b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p c\u1ea5p t\u1ec9nh (c\u00fam, vi\u00eam ph\u1ed5i, vi\u00eam ph\u1ebf qu\u1ea3n c\u1ea5p t\u00ednh). Sau khi ki\u1ec3m so\u00e1t c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 gi\u1edbi t\u00ednh, tu\u1ed5i v\u00e0 ch\u1ee7ng t\u1ed9c, th\u1ea5y c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng m\u1eafc b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh c\u00f3 ch\u1ec9 s\u1ed1 v\u1ec7 sinh r\u0103ng mi\u1ec7ng cao h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng kh\u00f4ng b\u1ecb b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p. H\u01a1n n\u1eefa, nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng m\u1eafc b\u1ec7nh c\u1ea5p t\u00ednh c\u00f3 xu h\u01b0\u1edbng c\u00f3 nhi\u1ec1u r\u0103ng s\u00e2u h\u01a1n nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng kh\u00f4ng m\u1eafc b\u1ec7nh. Kh\u00f4ng c\u00f3 m\u1ed1i li\u00ean quan c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea gi\u1eefa b\u1ea5t c\u1ee9 c\u00e1c chi s\u1ed1 s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng n\u00e0o v\u00e0 b\u1ec7nh h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh. Ngo\u00e0i ra, kh\u00f4ng c\u00f3 m\u1ed1i li\u00ean h\u1ec7 n\u00e0o gi\u1eefa ch\u1ec9 s\u1ed1 quanh r\u0103ng v\u00e0 c\u00e1c b\u1ec7nh c\u1ea5p t\u00ednh hay m\u1ea1n t\u00ednh.
\nM\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c cho th\u1ea5y b\u1ec7nh quanh r\u0103ng, \u0111o b\u1eb1ng m\u1ee9c \u0111\u1ed9 ti\u00eau x\u01b0\u01a1ng \u1ed5 r\u0103ng tr\u00ean phim tia X, l\u00fac kh\u1edfi \u0111\u1ea7u v\u00e0 sau \u0111\u00f3 l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed9c l\u1eadp cho b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh.<\/p>\n

Nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y \u0111\u01b0\u1ee3c \u1ee7ng h\u1ed9 b\u1edfi m\u1ed9t nghi\u00ean c\u1ee9u sau \u0111\u00f3 v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa t\u00ecnh tr\u1ea1ng r\u0103ng mi\u1ec7ng k\u00e9m v\u00e0 b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh (c\u00f3 ki\u1ec3m so\u00e1t c\u00e1c bi\u1ebfn s\u1ed1 g\u00e2y nhi\u1ec5u). D\u1eef li\u1ec7u t\u1eed NHANES III, ph\u00e2n t\u00edch t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe t\u1ed5ng qu\u00e1t v\u00e0 t\u00ecnh tr\u1ea1ng dinh d\u01b0\u1ee1ng tr\u00ean ng\u01b0\u1eddi d\u00e2n Hoa K\u1ef3 l\u1ef1a ch\u1ecdn ng\u1eabu nhi\u00ean t\u1eeb n\u0103m 1988 \u0111\u1ebfn n\u0103m 1994. Nghi\u00ean c\u1ee9u c\u1eaft ngang, h\u1ed3i c\u1ee9u c\u00e1c d\u1eef li\u1ec7u c\u1ee7a NHANES III tr\u00ean d\u00e2n s\u1ed1 g\u1ed3m 13792 \u0111\u1ed1i t\u01b0\u1ee3ng \u2265 20 tu\u1ed5i c\u00f3 \u00edt nh\u1ea5t 6 r\u0103ng th\u1eadt. Ti\u1ec1n s\u1eed vi\u00eam ph\u1ebf qu\u00e2n v\u00e0\/ho\u1eb7c kh\u00ed ph\u1ebf th\u0169ng ghi nh\u1eadn \u0111\u01b0\u1ee3c t\u1eeb b\u1ea3ng c\u00e2u h\u1ecfi. Ch\u1ee9c n\u0103ng ph\u1ed5i \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 d\u1ef1a v\u00e0o t\u1ef7 l\u1ec7 th\u1ec3 t\u00edch khi th\u1edf ra trong m\u1ed9t gi\u00e2y \u0111\u1ea7u ti\u00ean\/th\u1ec3 t\u00edch s\u1ed1ng g\u1eafng s\u1ee9c. T\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 d\u1ef1a v\u00e0o ch\u1ec9 s\u1ed1 s\u00e2u m\u1ea5t tr\u00e1m, ch\u1ea3y m\u00e1u l\u1ee3i, t\u1ee5t l\u1ee3i, \u0111\u1ed9 s\u00e2u t\u00fai l\u1ee3i v\u00e0 m\u1ea5t b\u00e1m d\u00ednh. Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh c\u00f3 m\u1ee9c m\u1ea5t b\u00e1m d\u00ednh l\u00e2m s\u00e0ng (CAL trung b\u00ecnh: 1,48 \u00b1 1,35) t\u1ed1t h\u01a1n so v\u1edbi nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng kh\u00f4ng m\u1eafc b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (CAL trung b\u00ecnh: 1,17 \u00b1 1,09). \u0110\u1ec3 ki\u1ec3m so\u00e1t \u0111\u1ed3ng th\u1eddi c\u00e1c bi\u1ebfn s\u1ed1 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1ed1ng k\u00ea ph\u00e2n t\u00edch, c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 gi\u1edbi t\u00ednh, tu\u1ed5i t\u00e1c, ch\u1ee7ng t\u1ed9c, h\u1ecdc v\u1ea5n, thu nh\u1eadp, ti\u1ec1n s\u1eed \u0111i\u1ec1u tr\u1ecb nha khoa, ti\u00eau th\u1ee5 r\u01b0\u1ee3u, t\u00ecnh tr\u1ea1ng b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 t\u00ecnh tr\u1ea1ng h\u00fat thu\u1ed1c l\u00e1 \u0111\u00e3 \u0111\u01b0\u1ee3c xem x\u00e9t trong ph\u00e2n t\u00edch h\u1ed3i quy v\u1edbi ti\u1ec1n s\u1eed b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh. Nguy c\u01a1 m\u1eafc b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh cao h\u01a1n \u0111\u00e1ng k\u1ec3 khi m\u1ee9c m\u1ea5t b\u00e1m d\u00ednh l\u00e2m s\u00e0ng (MAL) tr\u1ea7m tr\u1ecdng h\u01a1n (MAL \u2265 2,0mm) so v\u1edbi t\u00ecnh tr\u1ea1ng quanh r\u0103ng kh\u1ecfe m\u1ea1nh (< 2,0mm MAL; t\u1ef7 s\u1ed1 nguy c\u01a1 t\u01b0\u01a1ng \u0111\u1ed1i l\u00e0 1,35, 95% CI: 1,07\u20131,71). H\u01a1n n\u1eefa, t\u1ef7 s\u1ed1 nguy c\u01a1 t\u01b0\u01a1ng \u0111\u1ed1i l\u00e0 1,45 (95% CI: 1,02\u20132,05) \u1edf nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 MAL 2 3,0mm. M\u1ed9t xu h\u01b0\u1edbng \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 ch\u1ee9c n\u0103ng ph\u1ed5i c\u00e0ng gi\u1ea3m th\u00ec m\u1ee9c \u0111\u1ed9 m\u1ea5t b\u00e1m d\u00ednh c\u1ea3ng t\u0103ng. Kh\u00f4ng ghi nh\u1eadn xu h\u01b0\u1edbng nh\u01b0 v\u1eady \u0111\u1ed1i v\u1edbi ch\u1ea3y m\u00e1u l\u1ee3i. Kh\u00f4ng ghi nh\u1eadn \u0111\u01b0\u1ee3c m\u1ed1i li\u00ean h\u1ec7 c\u00f3 \u00fd ngh\u0129a gi\u1eefa b\u1ea5t k\u1ef3 m\u1ee9c \u0111\u1ed9 s\u1ee9c kh\u1ecfe r\u0103ng mi\u1ec7ng v\u00e0 c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh, nh\u01b0 c\u00fam ho\u1eb7c vi\u00eam ph\u1ed5i.<\/p>\n

M\u1ea3ng b\u00e1m r\u0103ng c\u00f3 th\u1ec3 l\u00e0 ngu\u1ed3n ch\u1ee9a c\u00e1c m\u1ea7m b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p \u1edf c\u00e1c b\u1ec7nh nh\u00e2n b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh n\u1eb1m vi\u1ec7n. S\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt lai DNA ki\u1ec3u b\u1ea3n c\u1edd \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh 8 t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p v\u00e0 8 t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh r\u0103ng mi\u1ec7ng, c\u00e1c lo\u00e0i vi khu\u1ea9n nh\u01b0 S. aures, P. aeruginosa, Acinetobacter baumannii v\u00e0 Enterobacter clacca \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong m\u1ea3ng b\u00e1m t\u1eeb 29 \u0111\u1ebfn 34 (85,3%) b\u1ec7nh nh\u00e2n n\u1eb1m vi\u1ec7n, trong khi chi ph\u00e1t hi\u1ec7n \u1edf 12 trong s\u1ed1 31 (38,7%) b\u1ec7nh nh\u00e2n kh\u00f4ng n\u1eb1m vi\u1ec7n. Nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y ch\u1ec9 ra r\u1eb1ng m\u1ea3ng b\u00e1m r\u0103ng l\u00e0 m\u1ed9t ngu\u1ed3n nhi\u1ec5m khu\u1ea9n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh n\u1eb1m vi\u1ec7n.<\/p>\n

4. M\u1ed1i li\u00ean quan gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – v\u00f9ng quanh r\u0103ng v\u00e0 b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/h2>\n

B\u00e1o c\u00e1o c\u1ee7a Sachs n\u0103m 1926, m\u1ed9t trong nh\u1eefng b\u00e1o c\u00e1o s\u1edbm nh\u1ea5t \u0111\u1ec1 c\u1eadp t\u1edbi m\u1ed1i li\u00ean quan n\u00e0y. H\u01a1n 30 n\u0103m qua, c\u00f3 nhi\u1ec1u b\u00e0i vi\u1ebft ho\u00e0i nghi v\u1ec1 m\u1ed1i li\u00ean h\u1ec7 n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c xu\u1ea5t b\u1ea3n. V\u00ed d\u1ee5: Nghi\u00ean c\u1ee9u quan s\u00e1t tr\u00ean nh\u00f3m ng\u01b0\u1eddi Nam Phi cho th\u1ea5y b\u1ec7nh kh\u1edbp n\u1eb7ng kh\u00f4ng l\u00e0m t\u0103ng c\u00e1c b\u1ec7nh l\u00fd l\u00e3o nha li\u00ean quan \u0111\u1ebfn r\u0103ng mi\u1ec7ng, trong \u0111\u00f3 c\u00f3 b\u1ec7nh quanh r\u0103ng. Nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p ng\u01b0\u1eddi Nh\u1eadt c\u0169ng kh\u00f4ng th\u1ea5y c\u00f3 s\u1ef1 t\u0103ng n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh quanh r\u0103ng. Nghi\u00ean c\u1ee9u c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng v\u00e0 mi\u1ec5n d\u1ecbch c\u1ee7a vi\u00eam quanh r\u0103ng c\u0169ng cho th\u1ea5y c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p kh\u00f4ng ph\u1ea3i l\u00e0 nh\u00f3m nguy c\u01a1. Nghi\u00ean c\u1ee9u b\u1ec7nh ch\u1ee9ng tr\u00ean nh\u00f3m ng\u01b0\u1eddi Scandinavian (204 \u1edf nh\u00f3m b\u1ec7nh v\u00e0 204 \u1edf nh\u00f3m ch\u1ee9ng) cho th\u1ea5y t\u00ecnh tr\u1ea1ng quanh r\u0103ng \u1edf nh\u00f3m vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 xu h\u01b0\u1edbng t\u1ed1t h\u01a1n so v\u1edbi nh\u00f3m ch\u1ee9ng. Ngo\u00e0i ra, nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c b\u1ec7nh nh\u00e2n NaUy b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p \u1edf \u0111\u1ed9 tu\u1ed5i 40.56 cho th\u1ea5y kh\u00f4ng c\u00f3 m\u1ed1i li\u00ean quan gi\u1eefa t\u00ecnh tr\u1ea1ng m\u1ea5t r\u0103ng c\u1ee7a nh\u00f3m b\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p. M\u1ed9t nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng c\u00e1c d\u1eef li\u1ec7u d\u1ecbch t\u1ec5 h\u1ecdc c\u1ee7a NHANES c\u0169ng kh\u00f4ng cho th\u1ea5y m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p t\u1ef1 khai v\u00e0 s\u1ed1 r\u0103ng m\u1ea5t. Tr\u00e1i v\u1edbi nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean, nhi\u1ec1u nghi\u00ean c\u1ee9u l\u1ea1i \u1ee7ng h\u1ed9 m\u1ed1i li\u00ean h\u1ec7 n\u00e0y. Tuy c\u00f3 gi\u00e1 tr\u1ecb ch\u1ee9ng c\u1ee9 th\u1ea5p nh\u01b0ng m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u th\u0103m d\u00f2 \u0111\u01a1n gi\u1ea3n ph\u00e2n t\u00edch nh\u1eefng d\u1eef li\u1ec7u do b\u1ec7nh nh\u00e2n t\u1ef1 khai \u0111\u00e3 cho th\u1ea5y b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam quanh r\u0103ng c\u00f3 t\u1ef7 l\u1ec7 vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p cao h\u01a1n. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u b\u1ec7nh ch\u1ee9ng \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n. T\u1ea5t c\u1ea3 \u0111\u1ec1u cho th\u1ea5y b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 t\u1ef7 l\u1ec7 b\u1ec7nh vi\u00eam quanh r\u0103ng cao h\u01a1n. Trong nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y t\u00ecnh tr\u1ea1ng quanh r\u0103ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng nhi\u1ec1u th\u00f4ng s\u1ed1 nh\u01b0 s\u1ed1 r\u0103ng m\u1ea5t, ch\u1ea3y m\u00e1u l\u1ee3i, m\u1ea5t b\u00e1m d\u00ednh, chi\u1ec1u s\u00e2u t\u00fai v\u00e0 m\u1ea5t x\u01b0\u01a1ng tr\u00ean phim tia X.<\/p>\n

Ti\u1ebfp theo nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 ti\u1ebfn h\u00e0nh kh\u1ea3o s\u00e1t c\u00e1c th\u00f4ng s\u1ed1 l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – vi\u00eam quanh r\u0103ng v\u00e0 vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p. Trong \u0111\u00f3 c\u00f3 c\u00e1c kh\u1ea3o s\u00e1t v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m cytokine, c\u00e1c ch\u1ea5t trung gian vi\u00eam, kh\u00e1ng nguy\u00ean HLA\u2013DR v\u00e0 c\u00e1c hormone. T\u1ea5t c\u1ea3 c\u00e1c nghi\u00ean c\u1ee9u n\u00e0y \u0111\u1ec1u cho th\u1ea5y s\u1ef1 t\u01b0\u01a1ng quan gi\u1eefa hai b\u1ec7nh v\u00e0 nhi\u1ec1u t\u00e1c gi\u1ea3 \u0111\u00e3 k\u1ebft lu\u1eadn r\u1eb1ng t\u00ecnh tr\u1ea1ng vi\u00eam (v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n c\u1ee7a n\u00f3) l\u00e0 c\u1ea7u n\u1ed1i ch\u00ednh gi\u1eefa b\u1ec7nh quanh r\u0103ng c\u1ee7a nh\u00f3m b\u1ec7nh l\u00fd l\u00e3o nha v\u00e0 b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p.
\nT\u1eeb n\u0103m 1985, m\u1ed9t b\u00e1o c\u00e1o \u0111\u00e3 cho th\u1ea5y sau khi \u0111i\u1ec1u tr\u1ecb b\u1ec7nh quanh r\u0103ng, t\u00ecnh tr\u1ea1ng vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 thuy\u00ean gi\u1ea3m. M\u1eb7c d\u00f9, c\u00e1c nghi\u00ean c\u1ee9u n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean m\u1eabu t\u01b0\u01a1ng \u0111\u1ed1i nh\u1ecf nh\u01b0ng \u0111\u00e3 nh\u1ea5n m\u1ea1nh tr\u00ean \u1ee9ng d\u1ee5ng l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 c\u00f3 c\u1ee7a m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa vi\u00eam quanh r\u0103ng v\u00e0 b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p.
\nM\u1ed1i li\u00ean h\u1ec7 gi\u1eefa b\u1ec7nh l\u00fd l\u00e3o nha – vi\u00eam quanh r\u0103ng v\u00e0 b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f2n \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c nghi\u00ean c\u1ee9u tr\u00ean m\u00f4 h\u00ecnh \u0111\u1ed9ng v\u1eadt. Vi\u1ec7c ti\u00eam c\u00e1c t\u00e1 d\u01b0\u1ee3c g\u00e2y vi\u00eam kh\u1edbp v\u00e0o chu\u1ed9t cho th\u1ea5y c\u00f3 t\u00ecnh tr\u1ea1ng ph\u00e1 hu\u1ef7 m\u00f4 quanh r\u0103ng, b\u1eb1ng ch\u1ee9ng l\u00e0 s\u1ef1 ti\u00eau x\u01b0\u01a1ng v\u00e0 t\u0103ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a men metalloproteinase ch\u1ea5t n\u1ec1n \u1edf m\u00f4 l\u1ee3i.
\n\u0110\u00e1nh gi\u00e1 k\u1ef9 c\u00e1c nghi\u00ean c\u1ee9u n\u00e0y ch\u00fang ta th\u1ea5y \u0111\u01b0\u1ee3c m\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng. Th\u1ee9 nh\u1ea5t, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u1ee7ng h\u1ed9 quan \u0111i\u1ec3m b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 t\u00ecnh tr\u1ea1ng v\u1ec7 sinh r\u0103ng mi\u1ec7ng k\u00e9m v\u00ec h\u1ecd b\u1ecb khuy\u1ebft t\u1eadt. C\u00e1c b\u00e1o c\u00e1o cho th\u1ea5y t\u00ecnh tr\u1ea1ng v\u1ec7 sinh r\u0103ng mi\u1ec7ng kh\u00f4ng kh\u00e1c bi\u1ec7t gi\u1eefa b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p v\u00e0 b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p. M\u1ed9t v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng kh\u00e1c l\u00e0 nh\u1eefng ng\u01b0\u1eddi b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p tr\u1ea7m tr\u1ecdng th\u01b0\u1eddng d\u1ec5 m\u1eafc b\u1ec7nh quanh r\u0103ng h\u01a1n v\u00e0 ng\u01b0\u1ee3c l\u1ea1i. Tuy nhi\u00ean, c\u00f3 v\u1ebb nh\u01b0 l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p t\u00e1c \u0111\u1ed9ng l\u00ean vi\u00eam quanh r\u0103ng h\u01a1n l\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n

C\u1ea7n c\u00f3 th\u00eam c\u00e1c nghi\u00ean c\u1ee9u theo chi\u1ec1u d\u1ecdc \u0111\u1ec3 ti\u1ebfp t\u1ee5c \u0111\u00e1nh gi\u00e1 tr\u00ecnh t\u1ef1 th\u1eddi gian c\u1ee7a m\u1ed1i li\u00ean h\u1ec7 n\u00e0y. Ngo\u00e0i ra c\u0169ng n\u00ean ch\u00fa \u00fd t\u1edbi \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p tr\u00ean t\u00ecnh tr\u1ea1ng quanh r\u0103ng. Nhi\u1ec1u thu\u1ed1c kh\u00e1ng vi\u00eam d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam \u1edf m\u00f4 quanh r\u0103ng v\u00e0 \u1ea3nh h\u01b0\u1edfng l\u00ean s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a vi\u00eam quanh r\u0103ng. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng vi\u00eam v\u1eabn c\u00f3 th\u1ec3 c\u00f3 s\u1ef1 ph\u00e1 hu\u1ef7 m\u00f4 quanh r\u0103ng \u0111\u00e1ng k\u1ec3.<\/p>\n

V\u00ec v\u1eady, ng\u01b0\u1eddi ta \u0111\u00e3 cho r\u1eb1ng tr\u01b0\u1edbc khi b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p, vi\u00eam quanh r\u0103ng \u0111\u00e3 ph\u00e1t tri\u1ec3n nh\u01b0ng ch\u01b0a \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n. Do \u0111\u00f3, khi ph\u00e2n t\u00edch m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa hai b\u1ec7nh, th\u1eddi gian m\u1eafc b\u1ec7nh (\u0111\u1ed1i v\u1edbi t\u1eebng b\u1ec7nh) l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t. Cho n\u00ean c\u00e1c nghi\u00ean c\u1ee9u trong t\u01b0\u01a1ng lai n\u00ean x\u00e9t t\u1edbi th\u1eddi gian m\u1eafc b\u1ec7nh v\u00e0 m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a c\u1ea3 hai b\u1ec7nh.<\/p>\n

Ngu\u1ed3n: L\u00e3o nha – NXB Gi\u00e1o d\u1ee5c Vi\u1ec7t Nam<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p cho \u0111\u1ed1i t\u01b0\u1ee3ng Nha s\u0129 c\u00e1i nh\u00ecn s\u00e2u s\u1eafc v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa nh\u00f3m b\u1ec7nh l\u00fd v\u1ec1 l\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n d\u1ef1a tr\u00ean c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng t\u1ea1i nhi\u1ec1u n\u01b0\u1edbc. \u0110\u1ed3ng th\u1eddi v\u1edbi \u0111\u00f3, Nha s\u0129 c\u1ea7n \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n khi \u0111\u1ee9ng tr\u01b0\u1edbc m\u1ed9t […]<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[28,33],"tags":[3],"yoast_head":"\nL\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n - T\u1ed5ng quan nghi\u00ean c\u1ee9u.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft cung c\u1ea5p cho Nha s\u0129 c\u00e1i nh\u00ecn s\u00e2u s\u1eafc gi\u1eefa nh\u00f3m b\u1ec7nh l\u00fd v\u1ec1 l\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n d\u1ef1a tr\u00ean c\u00e1c nghi\u00ean c\u1ee9u t\u1ea1i nhi\u1ec1u n\u01b0\u1edbc.\" \/>\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=\"L\u00e3o nha v\u00e0 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n - 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