{"id":20149,"date":"2023-04-13T17:46:36","date_gmt":"2023-04-13T10:46:36","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20149"},"modified":"2023-04-14T12:30:20","modified_gmt":"2023-04-14T05:30:20","slug":"cac-dau-an-sinh-hoc-cua-nhoi-mau-co-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/cac-dau-an-sinh-hoc-cua-nhoi-mau-co-tim\/","title":{"rendered":"C\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc c\u1ee7a nh\u1ed3i m\u00e1u c\u01a1 tim"},"content":{"rendered":"<p><strong>\u0110au ng\u1ef1c l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u th\u01b0\u1eddng g\u1eb7p. Trong c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111au ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim l\u00e0 m\u1ed9t trong c\u00e1c l\u00fd do ch\u00ednh \u1edf n\u01b0\u1edbc ta. Nh\u1ed3i m\u00e1u c\u01a1 tim hay g\u1eb7p nh\u1ea5t l\u00e0 do bi\u1ebfn ch\u1ee9ng c\u1ee7a x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch, \u00a0x\u1ea3y ra khi c\u00e1c m\u1ea3ng b\u00e1m tr\u00ean th\u00e0nh \u0111\u1ed9ng m\u1ea1ch d\u1ea7n ph\u00e1t tri\u1ec3n v\u00e0 \u0111\u1ebfn m\u1ed9t th\u1eddi \u0111i\u1ec3m m\u1ea3ng x\u01a1 v\u1eefa n\u00e0y bong ra th\u00fac \u0111\u1ea9y h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng l\u00e0m b\u00edt t\u1eafc l\u00f2ng m\u1ea1ch m\u00e1u. D\u1eabn \u0111\u1ebfn v\u00f9ng c\u01a1 tim ph\u00eda sau kh\u00f4ng \u0111\u01b0\u1ee3c m\u00e1u \u0111\u1ebfn nu\u00f4i, g\u00e2y ho\u1ea1i t\u1eed v\u00e0 ch\u1ebft v\u00f9ng c\u01a1 tim \u0111\u00f3 g\u00e2y n\u00ean nh\u1ed3i m\u00e1u c\u01a1 tim.<\/strong><\/p>\n<p>C\u00e1c thay \u0111\u1ed5i tr\u00ean \u0111i\u1ec7n tim \u0111\u1ed3 c\u1ee7a nh\u1ed3i m\u00e1u c\u01a1 tim kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng r\u00f5 r\u00e0ng, c\u00f3 th\u1ec3 b\u1ecb che l\u1ea5p b\u1edfi c\u00e1c b\u1ec7nh kh\u00e1c. V\u00ec v\u1eady c\u1ea7n l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n, ph\u00e2n bi\u1ec7t, theo d\u00f5i v\u00e0 ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh.<\/p>\n<h1>1.Creatin kinase (CK), CK-MB<\/h1>\n<p>Creatin kinase l\u00e0 enzym \u0111\u1eb7c hi\u1ec7u cho c\u01a1, kh\u00f4ng ch\u1ec9 c\u01a1 tim CK c\u00f3 t\u00e1c d\u1ee5ng x\u00fac t\u00e1c cho ph\u1ea3n \u1ee9ng chuy\u1ec3n h\u00f3a phosphocreatine k\u1ebft h\u1ee3p v\u1edbi ADP \u0111\u1ec3 t\u1ea1o ra ATP cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng cho m\u00f4. C\u00f3 3 loa\u1ecb isoenzym c\u1ee7a CK: CK-MM, CK-MB, CK-BB. CK-MM c\u00f3 nhi\u1ec1u trong c\u01a1 x\u01b0\u01a1ng, CK-BB nhi\u1ec1u trong n\u00e3o. C\u00f2n trong c\u01a1 tim CK-MB chi\u1ebfm 80%, CK-MM chi\u1ebfm 20%.<\/p>\n<p>X\u00e9t nghi\u1ec7m CK trong m\u00e1u \u0111\u00e1nh gi\u00e1 s\u1ee9c kh\u1ecfe c\u1ee7a tim v\u00e0 t\u00ecnh tr\u1ea1ng c\u01a1 b\u1eafp. Khi k\u1ebft qu\u1ea3 c\u00f3 t\u0103ng ho\u1ea1t \u0111\u1ed9 CK cho th\u1ea5y c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u0111\u1ebfn tim, c\u01a1 x\u01b0\u01a1ng ho\u1eb7c c\u01a1 b\u1eafp, b\u1ec7nh nh\u00e2n th\u01b0\u1eddng s\u1ebd \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n x\u00e9t nghi\u1ec7m CK-MB \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u1ee5 th\u1ec3 h\u01a1n.<\/p>\n<p>CK b\u1eaft \u0111\u1ea7u t\u0103ng sau c\u01a1n nh\u1ed3i m\u00e1u c\u01a1 tim 6-8 gi\u1edd, \u0111\u1ea1t \u0111\u1ec9nh ho\u1ea1t \u0111\u1ed9 t\u1ed1i \u0111a sau 24-38 gi\u1edd v\u00e0 gi\u1ea3m v\u1ec1 b\u00ecnh th\u01b0\u1eddng sau 2-4 ng\u00e0y. C\u00f2n CK-MB t\u0103ng sau kho\u1ea3ng 4-6 gi\u1edd v\u00e0 \u0111\u1ea1t \u0111\u1ec9nh sau 18-20 gi\u1edd, tr\u1edf l\u1ea1i tr\u1ecb s\u1ed1 b\u00ecnh th\u01b0\u1eddng sau 2-3 ng\u00e0y. N\u1ebfu s\u1ef1 t\u0103ng ho\u1ea1t \u0111\u1ed9 k\u00e9o d\u00e0i nhi\u1ec1u th\u00e1ng s\u1ebd th\u01b0\u1eddng c\u00f3 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u.<\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter\" src=\"https:\/\/suckhoe123.vn\/uploads\/suc-khoe\/2021_05\/20200612_085119_946809_nhoi-mau-co-tim.max-1800x1800.jpg\" alt=\"nh\u1ed3i m\u00e1u c\u01a1 tim\" width=\"355\" height=\"286\" \/><\/p>\n<h2>2. LDH trong nh\u1ed3i m\u00e1u c\u01a1 tim<\/h2>\n<p>LDH l\u00e0 enzym x\u00fac t\u00e1c chuy\u1ec3n acid pyruvic th\u00e0nh acid lactic, ph\u1ea3n \u1ee9ng cu\u1ed1i c\u00f9ng c\u1ee7a \u0111\u01b0\u1eddng ph\u00e2n y\u1ebfm kh\u00ed khi t\u1ebf b\u00e0o thi\u1ebfu oxy. LDH c\u00f3 trong b\u00e0o t\u01b0\u01a1ng m\u1ecdi t\u1ebf b\u00e0o, \u0111\u1eb7c bi\u1ec7t nhi\u1ec1u trong gan, tim v\u00e0 c\u01a1 x\u01b0\u01a1ng.<\/p>\n<p>LDH d\u1ec5 d\u00e0ng gi\u1ea3i ph\u00f3ng ra huy\u1ebft thanh khi c\u01a1 tim b\u1ecb t\u1ed5n th\u01b0\u01a1ng, t\u0103ng sau 12-24 gi\u1edd v\u00e0 \u0111\u1ea1t \u0111\u1ec9nh ho\u1ea1t \u0111\u1ed9 sau 48-72 gi\u1edd. Trong khi ho\u1ea1t \u0111\u1ed9 c\u00e1c enzym kh\u00e1c \u0111\u00e3 tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng th\u00ec ho\u1ea1t \u0111\u1ed9 LDH s\u1ebd t\u0103ng k\u00e9o d\u00e0i tr\u00ean 1 tu\u1ea7n, th\u01b0\u1eddng l\u00e0 8-10 ng\u00e0y. X\u00e9t nghi\u1ec7m LDH to\u00e0n ph\u1ea7n r\u1ea5t c\u00f3 \u00fd ngh\u0129a khi b\u1ec7nh nh\u00e2n v\u00e0o vi\u1ec7n mu\u1ed9n.<img decoding=\"async\" loading=\"lazy\" class=\"aligncenter\" src=\"https:\/\/vinmec-prod.s3.amazonaws.com\/images\/20191222_034954_513751_xet-nghiem-ldh-la-gi.max-800x800.jpg\" alt=\"X\u00e9t nghi\u1ec7m \u0111\u1ecbnh l\u01b0\u1ee3ng LDH l\u00e0 g\u00ec v\u00e0 khi n\u00e0o c\u1ea7n th\u1ef1c hi\u1ec7n? | Vinmec\" width=\"419\" height=\"279\" \/><\/p>\n<h3>3. Troponin T (TnT)<\/h3>\n<p>Troponin \u0111i\u1ec1u h\u00f2a h\u1ec7 th\u1ed1ng co du\u1ed7i c\u1ee7a c\u01a1 v\u00e2n. Troponin g\u1ed3m 3 ti\u1ec3u ph\u1ea7n, troponin T, troponin I, troponin C. Trong \u0111\u00f3 TnT c\u1ee7a c\u01a1\u00a0 tim\u00a0 l\u00e0 m\u1ed9t d\u1ea5u \u1ea5n c\u00f3 t\u00ednh \u0111\u1eb7c hi\u1ec7u, \u0111\u1ed9 nh\u1ea1y cao cho t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim. B\u00ecnh th\u01b0\u1eddn TnT d\u01b0\u1edbi 0,04 ng\/ml. Khi c\u00f3 nh\u1ed3i m\u00e1u, TnT t\u0103ng cao g\u1ea5p h\u00e0ng tr\u0103m l\u1ea7n so, k\u00e9o d\u00e0i v\u00e0 b\u1ec1n v\u1eefng l\u00e2u h\u01a1n so v\u1edbi CK, CK-MB , LDH.<\/p>\n<p>TnT l\u00e0 m\u1ed9t x\u00e9t nghi\u1ec7m r\u1ea5t c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n NMCT , ti\u00ean l\u01b0\u1ee3ng \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng b\u1ec7nh trong th\u1eddi gian g\u1ea7n v\u00e0 trung b\u00ecnh, th\u1eadm ch\u00ed th\u1eddi gian d\u00e0i v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p.<\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter\" src=\"https:\/\/vinmec-prod.s3.amazonaws.com\/images\/20200227_151146_215893_12_troponin.max-1800x1800.jpg\" alt=\" nh\u1ed3i m\u00e1u c\u01a1 tim \" width=\"481\" height=\"247\" \/><\/p>\n<div data-canvas-width=\"145.0536710315294\"><\/div>\n<p>Nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a th\u01b0\u1eddng g\u1eb7p nh\u1ea5t nh\u1ed3i m\u00e1u c\u01a1 tim bao g\u1ed3m:<\/p>\n<ul>\n<li>\u0111au th\u1eaft, kh\u00f3 ch\u1ecbu trong ng\u1ef1c.<\/li>\n<li>kh\u00f3 th\u1edf.<\/li>\n<li>nh\u1ecbp tim nhanh.<\/li>\n<li>m\u1ec7t m\u1ecfi, hoa m\u1eaft ch\u00f3ng m\u1eb7t.<\/li>\n<li>t\u0103ng ho\u1eb7c t\u1ee5t huy\u1ebft \u00e1p.<\/li>\n<\/ul>\n<p>N\u1ebfu b\u1ea1n nghi ng\u1edd m\u00ecnh c\u00f3 m\u1ed9t trong nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00e0y, b\u1ea1n n\u00ean \u0111\u1ebfn b\u1ec7nh vi\u1ec7n VINMEC \u0111\u1ec3 g\u1eb7p b\u00e1c s\u0129 \u0111\u1ec3 \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 t\u01b0 v\u1ea5n. D\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 ki\u1ec3m tra l\u00e2m s\u00e0ng, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 c\u00e1c x\u00e9t nghi\u00eam, d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u1eb7c hi\u1ec7u, b\u00e1c s\u0129 s\u1ebd x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ea1n v\u00e0 \u0111\u01b0a ra ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t.<\/p>\n<p class=\"\">\u0110\u1ec3 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ea1i vi\u1ec7n, qu\u00fd kh\u00e1ch vui l\u00f2ng li\u00ean h\u1ec7 <strong>HOTLINE<\/strong>\u00a0 ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp <a class=\"appointment-button link-in-body\" href=\"https:\/\/myvinmec.page.link\/download\"><b class=\"link-in-body\">T\u1ea0I \u0110\u00c2Y<\/b><\/a>. T\u1ea3i v\u00e0 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ef1 \u0111\u1ed9ng tr\u00ean\u00a0<a class=\"link-in-body\" href=\"https:\/\/www.vinmec.com\/myvinmec\/\" target=\"_blank\" rel=\"noopener\">\u1ee9ng d\u1ee5ng MyVinmec<\/a>\u00a0\u0111\u1ec3 qu\u1ea3n l\u00fd, theo d\u00f5i l\u1ecbch v\u00e0 \u0111\u1eb7t h\u1eb9n m\u1ecdi l\u00fac m\u1ecdi n\u01a1i ngay tr\u00ean \u1ee9ng d\u1ee5ng.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110au ng\u1ef1c l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u th\u01b0\u1eddng g\u1eb7p. Trong c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111au ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim l\u00e0 m\u1ed9t trong c\u00e1c l\u00fd do ch\u00ednh \u1edf n\u01b0\u1edbc ta. Nh\u1ed3i m\u00e1u c\u01a1 tim hay g\u1eb7p nh\u1ea5t l\u00e0 do bi\u1ebfn ch\u1ee9ng c\u1ee7a x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch, \u00a0x\u1ea3y ra khi c\u00e1c m\u1ea3ng b\u00e1m tr\u00ean th\u00e0nh \u0111\u1ed9ng m\u1ea1ch [&hellip;]<\/p>\n","protected":false},"author":36,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc c\u1ee7a nh\u1ed3i m\u00e1u c\u01a1 tim - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110au ng\u1ef1c l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u th\u01b0\u1eddng g\u1eb7p. Trong c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111au ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim l\u00e0 m\u1ed9t trong c\u00e1c l\u00fd do ch\u00ednh \u1edf n\u01b0\u1edbc ta. 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