{"id":19254,"date":"2023-04-13T16:17:24","date_gmt":"2023-04-13T09:17:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19254"},"modified":"2023-05-02T16:39:15","modified_gmt":"2023-05-02T09:39:15","slug":"doi-mau-rang-nguyen-nhan-va-co-che-hoa-sinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/doi-mau-rang-nguyen-nhan-va-co-che-hoa-sinh\/","title":{"rendered":"\u0110\u1ed5i m\u00e0u r\u0103ng – Nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf h\u00f3a sinh."},"content":{"rendered":"

Vi\u1ec7c hi\u1ec3u r\u00f5 c\u01a1 ch\u1ebf v\u1ec1 s\u1ef1 \u0111\u1ed5i m\u00e0u r\u0103ng g\u00f3p ph\u1ea7n s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p t\u1ea9y tr\u1eafng c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean l\u00e2m s\u00e0ng. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c c\u01a1 ch\u1ebf li\u00ean quan \u0111\u1ebfn s\u1ef1 \u0111\u1ed5i m\u00e0u s\u1eafc \u1edf r\u0103ng, c\u0169ng nh\u01b0 ph\u00e2n lo\u1ea1i c\u00e1c c\u01a1 ch\u1ebf tr\u00ean l\u00e2m s\u00e0ng. Ng\u01b0\u1eddi ta chia \u0111\u1ed5i m\u00e0u (nhi\u1ec5m s\u1eafc) r\u0103ng th\u00e0nh 2 nh\u00f3m ch\u00ednh: \u0110\u1ed5i m\u00e0u r\u0103ng do nguy\u00ean nh\u00e2n ngo\u1ea1i sinh v\u00e0 \u0111\u1ed5i m\u00e0u r\u0103ng do nguy\u00ean nh\u00e2n n\u1ed9i sinh.<\/strong><\/p>\n

1. C\u01a1 ch\u1ebf ho\u00e1 h\u1ecdc c\u1ee7a \u0111\u1ed5i m\u00e0u r\u0103ng do nhi\u1ec5m s\u1eafc ngo\u1ea1i sinh<\/h2>\n
\"doi-mau-rang-1\"
\u0110\u1ed5i m\u00e0u r\u0103ng do nguy\u00ean nh\u00e2n ngo\u1ea1i sinh<\/figcaption><\/figure>\n

S\u1ee9c h\u00fat c\u1ee7a v\u1eadt li\u1ec7u \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quan tr\u1ecdng trong s\u1ef1 l\u1eafng \u0111\u1ecdng ch\u1ea5t m\u00e0u ngo\u1ea1i lai. C\u00e1c lo\u1ea1i l\u1ef1c h\u00fat g\u1ed3m nh\u1eefng l\u1ef1c t\u01b0\u01a1ng t\u00e1c y\u1ebfu nh\u01b0 l\u1ef1c Van der Waals v\u00e0 l\u1ef1c t\u0129nh \u0111i\u1ec7n. Nh\u1eefng l\u1ef1c t\u01b0\u01a1ng t\u00e1c m\u1ea1nh nh\u01b0 l\u1ef1c hydrat ho\u00e1, l\u1ef1c t\u01b0\u01a1ng t\u00e1c k\u1ef5 n\u01b0\u1edbc, l\u1ef1c l\u01b0\u1ee1ng c\u1ef1c v\u00e0 c\u00e1c m\u1ed1i n\u1ed1i hydrogen. Nh\u1eefng l\u1ef1c n\u00e0y gi\u00fap t\u1ea1o m\u00e0u ho\u1eb7c ch\u1ea5t ti\u1ec1n t\u1ea1o m\u00e0u \u00e1p tr\u00ean b\u1ec1 m\u1eb7t men. S\u1ef1 b\u00e1m d\u00ednh ch\u1ea5t t\u1ea1o m\u00e0u tu\u1ef3 thu\u1ed9c v\u00e0o v\u1eadt li\u1ec7u v\u00e0 c\u01a1 ch\u1ebf x\u00e1c \u0111\u1ecbnh l\u1ef1c g\u1eafn d\u00ednh.<\/p>\n

1.1. Nhi\u1ec5m s\u1eafc lo\u1ea1i N1<\/h3>\n

S\u1ef1 nhi\u1ec5m s\u1eafc c\u00f3 m\u00e0u \u0111\u1ed3ng \u0111\u1ec1u v\u00e0 m\u1ed9t s\u1ed1 ch\u1ea5t g\u00e2y ra s\u1ef1 nhi\u1ec5m s\u1eafc thu\u1ed9c c\u01a1 ch\u1ebf nhi\u1ec5m s\u1eafc lo\u1ea1i N1. Kh\u1ea3 n\u0103ng t\u1ea1o m\u00e0u n\u00e0y t\u00f9y thu\u1ed9c v\u00e0o s\u1ef1 h\u1ea5p thu nh\u1eefng th\u00e0nh ph\u1ea7n n\u01b0\u1edbc b\u1ecdt v\u00e0o men r\u0103ng v\u00e0 s\u1ef1 k\u1ebft h\u1ee3p nh\u1eefng l\u1ef1c h\u00fat m\u1ea1nh ho\u1eb7c y\u1ebfu. L\u1ef1c t\u0129nh \u0111i\u1ec7n chi\u1ebfm \u01b0u th\u1ebf v\u00ec men r\u0103ng c\u00f3 \u0111i\u1ec7n t\u00edch \u00e2m, n\u00ean c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ef1 k\u1ebft d\u00ednh protein c\u00f3 ch\u1ecdn l\u1ecdc. L\u1ef1c k\u1ebft d\u00ednh n\u00e0y x\u1ea3y ra qua c\u1ea7u calcium. Th\u1ee9c \u0103n v\u00e0 n\u01b0\u1edbc u\u1ed1ng nh\u01b0 ch\u00e8, c\u00e0 ph\u00ea, r\u01b0\u1ee3u vang c\u0169ng c\u00f3 th\u1ec3 t\u1ea1o ra nhi\u1ec5m s\u1eafc tr\u00ean r\u0103ng b\u1edfi s\u1ef1 l\u1eafng \u0111\u1ecdng ch\u1ea5t t\u1ea1o m\u00e0u tr\u1ef1c ti\u1ebfp tr\u00ean r\u0103ng.<\/p>\n

1.2. Nhi\u1ec5m s\u1eafc lo\u1ea1i N2<\/h3>\n

Nh\u1eefng ch\u1ea5t m\u00e0u \u0111\u1ea7u ti\u00ean g\u1eafn v\u00e0o m\u00e0ng n\u01b0\u1edbc b\u1ecdt ho\u1eb7c tr\u00ean b\u1ec1 m\u1eb7t r\u0103ng, sau \u0111\u00f3 \u0111\u1ed5i m\u00e0u h\u01a1i v\u00e0ng \u1edf \u0111\u01b0\u1eddng vi\u1ec1n l\u1ee3i, nh\u00fa l\u1ee3i, v\u00f9ng m\u1eb7t b\u00ean c\u1ee7a r\u0103ng v\u00e0 chuy\u1ec3n th\u00e0nh m\u00e0u n\u00e2u theo tu\u1ed5i. S\u1ef1 thay \u0111\u1ed5i m\u00e0u s\u1eafc n\u00e0y x\u1ea3y ra l\u00e0 do s\u1ef1 t\u00edch t\u1ee5 ng\u00e0y m\u1ed9t nhi\u1ec1u h\u01a1n ho\u1eb7c do s\u1ef1 thay \u0111\u1ed5i ho\u00e1 h\u1ecdc c\u1ee7a c\u00e1c protein tr\u00ean l\u1edbp m\u00e0ng n\u01b0\u1edbc b\u1ecdt. Nh\u1eefng v\u1ebft m\u00e0u th\u1ee9c \u0103n c\u0169ng g\u00e2y ra nhi\u1ec5m s\u1eafc lo\u1ea1i N2, v\u00e0 m\u00e0u \u0111\u1eadm d\u1ea7n theo th\u1eddi gian. Nhi\u1ec5m s\u1eafc lo\u1ea1i N2 c\u0169ng r\u1ea5t kh\u00f3 lo\u1ea1i b\u1ecf b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p th\u00f4ng th\u01b0\u1eddng. Tuy nhi\u00ean, s\u1ef1 thay \u0111\u1ed5i m\u00e0u lo\u1ea1i n\u00e0y c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra theo c\u01a1 ch\u1ebf c\u1ea7u kim lo\u1ea1i bao g\u1ed3m nh\u1eefng nh\u00f3m hydroxyl t\u1ef1 do c\u1ee7a polyphenol v\u00e0 cation kim lo\u1ea1i.<\/p>\n

1.3. Nhi\u1ec5m s\u1eafc r\u0103ng lo\u1ea1i N3<\/h3>\n

Nh\u1eefng ch\u1ea5t kh\u00f4ng m\u00e0u g\u1eafn v\u00e0o r\u0103ng ch\u1ecbu nh\u1eefng ph\u1ea3n \u1ee9ng ho\u00e1 h\u1ecdc v\u00e0 bi\u1ebfn \u0111\u1ed5i \u0111\u1ec3 t\u1ea1o th\u00e0nh nh\u1eefng ch\u1ea5t c\u00f3 m\u00e0u g\u00e2y ra nhi\u1ec5m s\u1eafc lo\u1ea1i N3. Nh\u1eefng ch\u1ea5t ti\u1ec1n t\u1ea1o m\u00e0u ho\u1eb7c nh\u1eefng ch\u1ea5t kh\u00f4ng m\u00e0u c\u00f3 th\u1ec3 t\u1ea1o ra nhi\u1ec5m s\u1eafc r\u0103ng b\u1edfi m\u1ed9t s\u1ed1 t\u01b0\u01a1ng t\u00e1c v\u1eadt l\u00fd k\u1ebft h\u1ee3p.<\/p>\n

2. \u0110\u1ed5i m\u00e0u r\u0103ng do nguy\u00ean nh\u00e2n n\u1ed9i sinh<\/h2>\n
\"doi-mau-rang-noi-sinh\"
\u0110\u1ed5i m\u00e0u r\u0103ng do nguy\u00ean nh\u00e2n n\u1ed9i sinh<\/figcaption><\/figure>\n

Lo\u1ea1i nhi\u1ec5m s\u1eafc n\u00e0y chia l\u00e0m hai nh\u00f3m:<\/strong><\/p>\n

– Nh\u00f3m nhi\u1ec5m s\u1eafc tr\u01b0\u1edbc khi m\u1ecdc r\u0103ng. <\/em><\/p>\n

– Nh\u00f3m nhi\u1ec5m s\u1eafc sau khi m\u1ecdc r\u0103ng.<\/em><\/p>\n

Trong giai \u0111o\u1ea1n ph\u00f4i thai h\u00ecnh th\u00e0nh m\u1ea7m r\u0103ng, giai \u0111o\u1ea1n n\u00e0y h\u00ecnh th\u00e0nh ra c\u00e1c khung h\u1eefu c\u01a1 r\u1eb1ng. N\u1ebfu \u1edf giai \u0111o\u1ea1n n\u00e0y nhi\u1ec5m ion kim lo\u1ea1i ho\u1eb7c t\u1ed5 h\u1ee3p m\u00e0u s\u1ebd k\u1ebft h\u1ee3p v\u1edbi c\u00e1c khung h\u1eefu c\u01a1 t\u1ea1o ra ph\u1ee9c h\u1ee3p m\u00e0u.<\/p>\n

Khung h\u1eefu c\u01a1 ti\u1ebfp t\u1ee5c kho\u00e1ng ho\u00e1 ti\u1ebfp x\u00fac v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 vi l\u01b0\u1ee3ng nh\u01b0 magie, fluor, carbonate… c\u00f3 th\u1ec3 g\u00e2y ra \u0111\u1ed5i m\u00e0u r\u0103ng.<\/p>\n

\u1ede giai \u0111o\u1ea1n ho\u00e0n thi\u1ec7n tr\u01b0\u1edbc khi m\u1ecdc r\u0103ng c\u00f3 s\u1ef1 trao \u0111\u1ed5i m\u1ea1nh m\u1ebd v\u1edbi m\u00e1u, v\u00e0 v\u1eady c\u00f3 th\u1ec3 nhi\u1ec5m m\u00e0u v\u1edbi c\u00e1c th\u00e0nh ph\u1ea7n ph\u00e2n hu\u1ef7 trong m\u00e1u.<\/p>\n

Nh\u01b0 v\u1eady, c\u00e1c ch\u1ea5t \u0111\u1ed5i m\u00e0u c\u00f3 th\u1ec3 n\u1eb1m trong ng\u00e0 r\u0103ng, gi\u1eefa men v\u00e0 ng\u00e0. Ph\u1ea7n gi\u1eefa men v\u00e0 ng\u00e0 r\u0103ng l\u00e0 c\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng \u0111\u01b0\u1ee3c.<\/p>\n

C\u01a1 ch\u1ebf \u0111\u1ed5i m\u00e0u do nhi\u1ec5m tetracycline: c\u00e1c ph\u00e2n t\u1eed tetracycline k\u1ebft h\u1ee3p v\u1edbi c\u00e1c khung h\u1eefu c\u01a1 t\u1ea1o ra m\u1ed9t ph\u1ee9c h\u1ee3p kh\u00f4ng ho\u00e0 tan v\u00e0 \u1ed5n \u0111\u1ecbnh v\u00ec v\u1eady, \u0111\u1ed5i m\u00e0u c\u1ea3 c\u1ea5u tr\u00fac ng\u00e0 v\u00e0 \u1edf c\u1ea5u tr\u00fac men v\u00e0 ng\u00e0.<\/p>\n

Nhi\u1ec5m fluor: Fluor l\u00e0m r\u1ed1i lo\u1ea1n th\u00ec ho\u00e0n thi\u1ec7n men r\u0103ng, t\u1ea1o ra ph\u1ee9c h\u1ee3p m\u00e0u, v\u00ec v\u1eady g\u00e2y thay \u0111\u1ed5i m\u00e0u s\u1eafc v\u00e0 \u0111\u1eb7c t\u00ednh l\u00fd ho\u00e1 c\u1ee7a men r\u0103ng.<\/p>\n

Ngo\u00e0i ra, nhi\u1ec5m s\u1eafc tr\u01b0\u1edbc khi m\u1ecdc r\u0103ng c\u0169ng th\u1ea5y \u1edf m\u00f4 r\u0103ng d\u1ecb d\u1ea1ng do di truy\u1ec1n, g\u1eb7p trong tr\u01b0\u1eddng h\u1ee3p r\u1ed1i lo\u1ea1n huy\u1ebft h\u1ecdc nh\u01b0 b\u1ec7nh crythoblastosise, thalasemia. Thi\u1ebfu m\u00e1u t\u1ebf b\u00e0o h\u00ecnh li\u1ec1m c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec5m s\u1eafc r\u0103ng b\u1edfi v\u00ec h\u1ec7 th\u1ed1ng \u0111\u00f4ng m\u00e1u v\u00e0 s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a m\u00e1u trong \u1ed1ng ng\u00e0.<\/p>\n

R\u0103ng b\u1ecb nhi\u1ec5m s\u1eafc n\u1ed9i t\u1ea1i sau khi m\u1ecdc r\u0103ng c\u0169ng x\u1ea3y ra t\u01b0\u01a1ng t\u1ef1, v\u00ed d\u1ee5 nh\u01b0: sau khi r\u0103ng b\u1ecb ch\u1ea5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 ch\u1ea3y m\u00e1u tu\u1ef7 v\u00e0 ng\u1ea5m v\u00e0o trong \u1ed1ng ng\u00e0. Trong qu\u00e1 tr\u00ecnh gi\u00e0 b\u00ecnh th\u01b0\u1eddng c\u0169ng g\u00e2y nhi\u1ec5m s\u1eafc do s\u1ef1 l\u1eafng \u0111\u1ecdng ng\u00e0 th\u1ee9 ph\u00e1t, v\u00f4i ho\u00e1 tu\u1ef7. S\u1ef1 ph\u00f3ng th\u00edch kim lo\u1ea1i t\u1eeb mi\u1ebfng h\u00e0n amalgam ho\u1eb7c vi\u1ec7c h\u00e0n bu\u1ed3ng t\u1ee7y trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.
\nR\u0103ng ch\u1ebft t\u1ee7y b\u1ecb \u0111\u1ed5i m\u00e0u: Fish v\u00e0 Wainwright l\u00e0m nh\u1eefng th\u1eed nghi\u1ec7m kh\u00e1c nhau th\u1ea5y r\u1eb1ng, c\u1ea5u tr\u00fac r\u0103ng c\u00f3 th\u1ec3 th\u1ea9m th\u1ea5u \u0111\u01b0\u1ee3c. Nh\u1eefng r\u0103ng kh\u00f4ng c\u00f2n t\u1ee7y th\u00ec kh\u00f4 v\u00e0 kh\u00f4ng c\u00f3 h\u1ec7 b\u1ea1ch huy\u1ebft ho\u1eb7c d\u1ecbch trong r\u0103ng v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng th\u1ea9m th\u1ea5u t\u1ed1t h\u01a1n l\u00e0 nh\u1eefng r\u0103ng s\u1ed1ng v\u00e0 c\u00f3 khuynh h\u01b0\u1edbng th\u1ea9m th\u1ea5u m\u00e0u t\u1eeb ngu\u1ed3n ngo\u1ea1i sinh c\u0169ng nh\u01b0 l\u00e0 nh\u1eefng mu\u1ed1i s\u1eaft t\u1eeb s\u1ef1 ph\u00e2n hu\u1ef7 hemoglobin trong bu\u1ed3ng t\u1ee7y.<\/p>\n

S\u1ef1 ph\u00e2n hu\u1ef7 m\u00f4 tu\u1ef7 hemoglobin (ch\u1ee9a s\u1eaft) k\u1ebft h\u1ee3p v\u1edbi:<\/em><\/p>\n

\u2212 NH3 (t\u1eeb s\u1ef1 ph\u00e2n hu\u1ef7 c\u1ee7a vi khu\u1ea9n) v\u00e0 n\u01b0\u1edbc t\u1ea1o ra h\u1ee3p ch\u1ea5t ferric hydroxide c\u00f3 m\u00e0u n\u00e2u \u0111\u1ecf.<\/p>\n

\u2013 H2S, cho ra h\u1ee3p ch\u1ea5t iron sulfide c\u00f3 m\u00e0u \u0111en.<\/p>\n

\u0110\u1ed9 s\u00e2u v\u00e0 n\u1ed3ng \u0111\u1ed9 c\u1ee7a nh\u1eefng v\u1ebft m\u00e0u ng\u1ea5m v\u00e0o c\u00e1c \u1ed1ng ng\u00e0 s\u1ebd x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 v\u00e0 lo\u1ea1i \u0111\u1ed5i m\u00e0u.
\nH\u1ea1n ch\u1ebf s\u1ef1 \u0111\u1ed5i m\u00e0u b\u1eb1ng c\u00e1ch ng\u0103n c\u1ea3n s\u1ef1 xu\u1ea5t huy\u1ebft trong khi l\u1ea5y t\u1ee7y ho\u1eb7c th\u01b0\u1eddng xuy\u00ean b\u01a1m r\u1eeda \u0111\u1ec3 l\u1ea5y m\u00e1u, nh\u1eefng m\u1ea3nh v\u1ee5n ra kh\u1ecfi \u1ed1ng t\u1ee7y v\u00e0 d\u00f9ng cement \u0111\u1ec3 h\u00e0n \u1ed1ng tu\u1ef7 kh\u00f4ng b\u1ea1c, d\u00f9ng eugenol kh\u00f4ng m\u00e0u, c\u00f2n m\u1edbi \u0111\u1ec3 tr\u1ed9n ch\u1ea5t tr\u00e1m v\u00e0 l\u1ea5y \u0111i t\u1ea5t c\u1ea3 nh\u1eefng v\u1eadt li\u1ec7u tr\u00e1m \u1ed1ng t\u1ee7y d\u01b0 \u1edf ph\u1ea7n th\u00e2n r\u0103ng.<\/p>\n

Ngu\u1ed3n: Ch\u1eefa r\u0103ng v\u00e0 n\u1ed9i nha T\u1eadp 2 – NXB Gi\u00e1o d\u1ee5c Vi\u1ec7t Nam<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u1ec7c hi\u1ec3u r\u00f5 c\u01a1 ch\u1ebf v\u1ec1 s\u1ef1 \u0111\u1ed5i m\u00e0u r\u0103ng g\u00f3p ph\u1ea7n s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p t\u1ea9y tr\u1eafng c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean l\u00e2m s\u00e0ng. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c c\u01a1 ch\u1ebf li\u00ean quan \u0111\u1ebfn s\u1ef1 \u0111\u1ed5i m\u00e0u s\u1eafc \u1edf r\u0103ng, c\u0169ng nh\u01b0 ph\u00e2n lo\u1ea1i c\u00e1c c\u01a1 ch\u1ebf tr\u00ean l\u00e2m s\u00e0ng. Ng\u01b0\u1eddi […]<\/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":"\n\u0110\u1ed5i m\u00e0u r\u0103ng - Nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf h\u00f3a sinh. - Vinmec<\/title>\n<meta name=\"description\" content=\"Ng\u01b0\u1eddi ta chia \u0111\u1ed5i m\u00e0u (nhi\u1ec5m s\u1eafc) r\u0103ng th\u00e0nh 2 nh\u00f3m ch\u00ednh: \u0110\u1ed5i m\u00e0u r\u0103ng do ngo\u1ea1i sinh v\u00e0 do n\u1ed9i sinh. 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