{"id":20522,"date":"2023-04-17T04:59:59","date_gmt":"2023-04-16T21:59:59","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20522"},"modified":"2023-04-17T11:08:25","modified_gmt":"2023-04-17T04:08:25","slug":"chan-doan-lupus-ban-do-he-thong-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/chan-doan-lupus-ban-do-he-thong-theo-bo-y-te\/","title":{"rendered":"Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng: ch\u1ea9n \u0111o\u00e1n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y T\u1ebf"},"content":{"rendered":"

B\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng – (Systemic lupus erythematosus- SLE) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd vi\u00eam m\u00e3n t\u00ednh\u00a0khi h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch t\u1ea5n c\u00f4ng c\u00e1c t\u1ebf b\u00e0o v\u00e0 m\u00f4 trong c\u01a1 th\u1ec3. B\u1ec7nh n\u00e0y l\u00e0 b\u1ec7nh kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0ng c\u0169ng kh\u00f4ng hi\u1ebfm g\u1eb7p. 70-90% th\u01b0\u1eddng m\u1eafc \u1edf ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh s\u1ea3n, tuy nhi\u00ean, n\u00f3 c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1ecdi \u0111\u1ed9 tu\u1ed5i v\u00e0 gi\u1edbi t\u00ednh.<\/strong><\/p>\n

1. B\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng l\u00e0 b\u1ec7nh g\u00ec?<\/h2>\n

Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng l\u00e0 b\u1ec7nh l\u00fd c\u1ee7a m\u00f4 li\u00ean k\u1ebft c\u00f3 t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u c\u01a1 quan do h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 b\u1ecb r\u1ed1i lo\u1ea1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a kh\u00e1ng th\u1ec3 kh\u00e1ng nh\u00e2n v\u00e0 nhi\u1ec1u t\u1ef1 kh\u00e1ng th\u1ec3 kh\u00e1c. C\u00e1c c\u01a1 quan th\u01b0\u1eddng b\u1ecb t\u1ed5n th\u01b0\u01a1ng bao g\u1ed3m kh\u1edbp, da, th\u1eadn, t\u1ebf b\u00e0o m\u00e1u, tim, ph\u1ed5i, th\u1ea7n kinh\u2026<\/p>\n

2. Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng<\/h2>\n

Cho \u0111\u1ebfn nay, nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 c\u01a1 ch\u1ebf b\u1ec7nh sinh ch\u00ednh x\u00e1c c\u1ee7a lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft r\u00f5. C\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a b\u1ec7nh l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh ph\u1ee9c t\u1ea1p v\u1edbi s\u1ef1 tham gia c\u1ee7a nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0 di truy\u1ec1n, mi\u1ec5n d\u1ecbch th\u1ec3 d\u1ecbch, mi\u1ec5n d\u1ecbch t\u1ebf b\u00e0o v\u00e0 y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng. M\u1ed9t s\u1ed1 gen quy \u0111\u1ecbnh ph\u1ee9c h\u1ee3p kh\u00e1ng nguy\u00ean ph\u00f9 h\u1ee3p t\u1ed5 ch\u1ee9c nh\u01b0 HLA-DR2,3,8, c\u00e1c gen m\u00e3 h\u00f3a b\u1ed5 th\u1ec3 C1q, C2, C4 v\u00e0 m\u1ed9t s\u1ed1 cytokin c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh cao.<\/p>\n

3. Y\u1ebfu t\u1ed1 nguy c\u01a1 m\u1eafc b\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng<\/h2>\n

Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng c\u00f3 th\u1ec3 b\u1ecb kh\u1edfi ph\u00e1t b\u1edfi m\u1ed9t t\u00e1c nh\u00e2n m\u00f4i tr\u01b0\u1eddng ch\u01b0a bi\u1ebft, t\u00e1c nh\u00e2n n\u00e0y g\u00e2y ra ph\u1ea3n \u1ee9ng t\u1ef1 mi\u1ec5n \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 y\u1ebfu t\u1ed1 gen li\u00ean quan \u0111\u1ebfn b\u1ec7nh.\u00a0 N\u1ebfu trong gia \u0111\u00ecnh c\u1ee7a b\u1ea1n c\u00f3 ng\u01b0\u1eddi m\u1eafc lupus ban \u0111\u1ecf, th\u00ec b\u1ea1n c\u00f3 nguy c\u01a1 cao h\u01a1n \u0111\u1ec3 ph\u00e1t tri\u1ec3n b\u1ec7nh n\u00e0y.
\nC\u00e1c y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n v\u00e0o vi\u1ec7c k\u00edch ho\u1ea1t h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch v\u00e0 g\u00e2y ra b\u1ec7nh lupus ban \u0111\u1ecf, bao g\u1ed3m:<\/p>\n

Ti\u1ebfp x\u00fac v\u1edbi \u00e1nh n\u1eafng m\u1eb7t tr\u1eddi qu\u00e1 nhi\u1ec1u: \u00c1nh n\u1eafng m\u1eb7t tr\u1eddi c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch v\u00e0 g\u00f3p ph\u1ea7n g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a lupus ban \u0111\u1ecf.
\nC\u00e1c lo\u1ea1i thu\u1ed1c: M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y ra ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch v\u00e0 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng cho c\u01a1 th\u1ec3 (v\u00ed d\u1ee5, hydralazine, procainamide, isoniazid, thu\u1ed1c kh\u00e1ng y\u1ebfu t\u1ed1 ho\u1ea1i t\u1eed u TNF) g\u00e2y ra h\u1ed9i ch\u1ee9ng lupus c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c \u0111\u01b0\u1ee3c sau khi d\u1eebng thu\u1ed1c.
\nC\u00e1c ch\u1ea5t g\u00e2y \u0111\u1ed9c h\u1ea1i: Ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t g\u00e2y \u0111\u1ed9c h\u1ea1i trong m\u00f4i tr\u01b0\u1eddng l\u00e0m vi\u1ec7c ho\u1eb7c trong th\u1ef1c ph\u1ea9m c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n k\u00edch ho\u1ea1t h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch.
\nC\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng: M\u1ed9t s\u1ed1 b\u1ec7nh nhi\u1ec5m tr\u00f9ng, nhi\u1ec5m virus c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 k\u00edch ho\u1ea1t c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch v\u00e0 g\u00f3p ph\u1ea7n v\u00e0o vi\u1ec7c ph\u00e1t tri\u1ec3n lupus ban \u0111\u1ecf.
\nNgo\u00e0i ra, d\u1eady th\u00ec, sinh con ho\u1eb7c m\u00e3n kinh c\u0169ng c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t t\u00ecnh tr\u1ea1ng b\u1ec7nh.<\/p>\n

3. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng<\/h2>\n

3.1. L\u00e2m s\u00e0ng:<\/h3>\n

Ch\u1ee7 y\u1ebfu g\u1eb7p th\u1ec3 b\u00e1n c\u1ea5p<\/p>\n

\u2212 T\u1ec9 l\u1ec7 m\u1eafc b\u1ec7nh n\u1eef: nam= 9:1, ch\u1ee7 y\u1ebfu \u1edf \u0111\u1ed9 tu\u1ed5i 20-30.
\n\u2212 Kh\u1edfi ph\u00e1t: \u0110a s\u1ed1 b\u1eaft \u0111\u1ea7u t\u1eeb t\u1eeb, t\u0103ng d\u1ea7n v\u1edbi s\u1ed1t dai d\u1eb3ng kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, \u0111au kh\u1edbp ho\u1eb7c vi\u00eam kh\u1edbp v\u1edbi bi\u1ec3u hi\u1ec7n t\u01b0\u01a1ng t\u1ef1 trong b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p. M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 thu\u1eadn l\u1ee3i kh\u1edfi ph\u00e1t b\u1ec7nh: nhi\u1ec5m tr\u00f9ng, ch\u1ea5n th\u01b0\u01a1ng, stress, thu\u1ed1c\u2026
\n\u2212 To\u00e0n ph\u00e1t: t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u c\u01a1 quan:
\n+ To\u00e0n th\u00e2n: s\u1ed1t dai d\u1eb3ng k\u00e9o d\u00e0i, m\u1ec7t m\u1ecfi, g\u1ea7y s\u00fat.
\n+ C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0111au ho\u1eb7c vi\u00eam c\u00e1c kh\u1edbp v\u1edbi bi\u1ec3u hi\u1ec7n t\u01b0\u01a1ng t\u1ef1 trong b\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p song hi\u1ebfm khi bi\u1ebfn d\u1ea1ng kh\u1edbp; \u0111au c\u01a1. M\u1ed9t s\u1ed1 hi\u1ebfm tr\u01b0\u1eddng h\u1ee3p c\u00f3 ho\u1ea1i t\u1eed x\u01b0\u01a1ng (th\u01b0\u1eddng g\u1eb7p ho\u1ea1i t\u1eed v\u00f4 m\u1ea1ch \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng \u0111\u00f9i).
\n+ Da ni\u00eam m\u1ea1c: ban \u0111\u1ecf h\u00ecnh c\u00e1nh b\u01b0\u1edbm \u1edf m\u1eb7t (r\u1ea5t th\u01b0\u1eddng g\u1eb7p), ban d\u1ea1ng \u0111\u0129a (g\u1eb7p trong th\u1ec3 m\u1ea1n t\u00ednh), nh\u1ea1y c\u1ea3m v\u1edbi \u00e1nh s\u00e1ng (ch\u00e1y, b\u1ecfng, x\u1ea1m da sau khi ti\u1ebfp x\u00fac v\u1edbi \u00e1nh n\u1eafng), lo\u00e9t ni\u00eam m\u1ea1c mi\u1ec7ng, ni\u00eam m\u1ea1c m\u0169i, r\u1ee5ng t\u00f3c, vi\u00eam mao m\u1ea1ch d\u01b0\u1edbi da..
\n+ M\u00e1u v\u00e0 c\u01a1 quan t\u1ea1o m\u00e1u: thi\u1ebfu m\u00e1u do vi\u00eam, thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n, ch\u1ea3y m\u00e1u d\u01b0\u1edbi da (do gi\u1ea3m ti\u1ec3u c\u1ea7u), l\u00e1ch to, h\u1ea1ch to.
\n+ Th\u1ea7n kinh t\u00e2m th\u1ea7n: r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n, \u0111\u1ed9ng kinh…
\n+ Tu\u1ea7n ho\u00e0n, h\u00f4 h\u1ea5p: th\u01b0\u1eddng g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng tr\u00e0n d\u1ecbch m\u00e0ng tim, m\u00e0ng ph\u1ed5i, t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, vi\u00eam ph\u1ed5i k\u1ebd. C\u00e1c tri\u1ec7u ch\u1ee9ng hi\u1ebfm g\u1eb7p: vi\u00eam c\u01a1 tim, vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c , h\u1ed9i ch\u1ee9ng Raynaud, vi\u00eam t\u1eafc \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch…
\n+ Th\u1eadn: r\u1ea5t th\u01b0\u1eddng g\u1eb7p: protein ni\u1ec7u, t\u1ebf b\u00e0o tr\u1ee5 ni\u1ec7u, h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0, vi\u00eam c\u1ea7u th\u1eadn…
\n+ Gan: c\u1ed5 tr\u01b0\u1edbng, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan (hi\u1ebfm g\u1eb7p).
\n+ M\u1eaft: gi\u1ea3m ti\u1ebft n\u01b0\u1edbc m\u1eaft (H\u1ed9i ch\u1ee9ng Sjogren), vi\u00eam gi\u00e1c m\u1ea1c, vi\u00eam k\u1ebft m\u1ea1c, vi\u00eam v\u00f5ng m\u1ea1c.<\/p>\n

\"\"
Tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng<\/figcaption><\/figure>\n

3.2. C\u1eadn l\u00e2m s\u00e0ng<\/h2>\n

\u2212 C\u00e1c x\u00e9t nghi\u1ec7m kh\u00f4ng \u0111\u1eb7c hi\u1ec7u: t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi (gi\u1ea3m h\u1ed3ng c\u1ea7u, gi\u1ea3m b\u1ea1ch c\u1ea7u, gi\u1ea3m ti\u1ec3u c\u1ea7u), t\u1ed1c \u0111\u1ed9 l\u1eafng m\u00e1u t\u0103ng, \u0111i\u1ec7n di huy\u1ebft thanh (\u03b3 globulin t\u0103ng), t\u00ecm th\u1ea5y ph\u1ee9c h\u1ee3p mi\u1ec5n d\u1ecbch trong m\u00e1u, ph\u1ea3n \u1ee9ng BW (+) gi\u1ea3\u2026
\n\u2212 C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1eb7c hi\u1ec7u: kh\u00e1ng th\u1ec3 kh\u00e1ng nh\u00e2n (ANA), kh\u00e1ng th\u1ec3 kh\u00e1ng Ds\u0002DNA, kh\u00e1ng th\u1ec3 ch\u1ed1ng c\u00e1c kh\u00e1ng nguy\u00ean h\u00f2a tan, kh\u00e1ng th\u1ec3 kh\u00e1ng h\u1ed3ng c\u1ea7u, kh\u00e1ng lympho b\u00e0o, kh\u00e1ng ti\u1ec3u c\u1ea7u\u2026, gi\u1ea3m b\u1ed5 th\u1ec3, gi\u1ea3m t\u1ec9 l\u1ec7 lympho b\u00e0o so v\u1edbi t\u1ebf b\u00e0o B.
\n\u2212 Sinh thi\u1ebft c\u00e1c c\u01a1 quan t\u1ed5n th\u01b0\u01a1ng:
\n+ Sinh thi\u1ebft da: l\u1eafng \u0111\u1ecdng globulin mi\u1ec5n d\u1ecbch IgM, IgG v\u00e0 b\u1ed5 th\u1ec3 th\u00e0nh m\u1ed9t l\u1edbp th\u01b0\u1ee3ng b\u00ec v\u00e0 trung b\u00ec c\u1ee7a da (+70%).
\n+ Th\u1eadn: vi\u00eam c\u1ea7u th\u1eadn, d\u00e0y m\u00e0ng \u0111\u00e1y do l\u1eafng \u0111\u1ecdng IgG, IgM v\u00e0 b\u1ed5 th\u1ec3.
\n+ M\u00e0ng ho\u1ea1t d\u1ecbch kh\u1edbp: t\u1ed5n th\u01b0\u01a1ng g\u1ea7n t\u01b0\u01a1ng t\u1ef1 vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p.<\/p>\n

3.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/h3>\n

\u00c1p d\u1ee5ng ti\u00eau chu\u1ea9n c\u1ee7a H\u1ed9i Th\u1ea5p h\u1ecdc M\u1ef9 ACR 1982 (b\u1ed5 sung v\u00e0 \u0111i\u1ec1u ch\u1ec9nh n\u0103m 1997), g\u1ed3m 11 y\u1ebfu t\u1ed1:
\n\u2212 Ban \u0111\u1ecf h\u00ecnh c\u00e1nh b\u01b0\u1edbm \u1edf m\u1eb7t.<\/p>\n

\u2212 Ban \u0111\u1ecf d\u1ea1ng \u0111\u0129a \u1edf m\u1eb7t v\u00e0 than.<\/p>\n

\u2212 Nh\u1ea1y c\u1ea3m v\u1edbi \u00e1nh sang.<\/p>\n

\u2212 Lo\u00e9t mi\u1ec7ng ho\u1eb7c m\u0169i h\u1ecdng.<\/p>\n

\u2212 Vi\u00eam kh\u1edbp v\u00e0 \u0111au kh\u1edbp kh\u00f4ng c\u00f3 ph\u00e1 h\u1ee7y kh\u1edbp.<\/p>\n

\u2212 Vi\u00eam \u0111a m\u00e0ng: m\u00e0ng ph\u1ed5i, m\u00e0ng tim.<\/p>\n

\u2212 T\u1ed5n th\u01b0\u01a1ng th\u1eadn: protein ni\u1ec7u > 500mg\/24 gi\u1edd ho\u1eb7c 3+ (10 th\u00f4ng s\u1ed1 n\u01b0\u1edbc ti\u1ec3u) ho\u1eb7c c\u00f3 tr\u1ee5 t\u1ebf b\u00e0o (h\u1ed3ng c\u1ea7u, hemoglobin, tr\u1ee5 h\u1ea1t, t\u1ebf b\u00e0o \u1ed1ng th\u1eadn ho\u1eb7c h\u1ed7n h\u1ee3p).<\/p>\n

\u2212 T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: co gi\u1eadt ho\u1eb7c c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n kh\u00f4ng do thu\u1ed1c v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nh\u01b0 r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, t\u0103ng ur\u00ea m\u00e1u, nhi\u1ec5m toan ceton\u2026<\/p>\n

\u2212 R\u1ed1i lo\u1ea1n v\u1ec1 m\u00e1u: (a) Thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n c\u00f3 t\u0103ng h\u1ed3ng c\u1ea7u l\u01b0\u1edbi, ho\u1eb7c (b) Gi\u1ea3m b\u1ea1ch c\u1ea7u < 4.000\/mm3, ho\u1eb7c (c) Gi\u1ea3m b\u1ea1ch c\u1ea7u lympho < 1.500\/mm3, ho\u1eb7c (d) Gi\u1ea3m ti\u1ec3u c\u1ea7u < 100.000\/mm3 kh\u00f4ng do thu\u1ed1c.<\/p>\n

\u2212 R\u1ed1i lo\u1ea1n v\u1ec1 mi\u1ec5n d\u1ecbch:
\n+ Kh\u00e1ng th\u1ec3 kh\u00e1ng Ds-DNA (+), ho\u1eb7c
\n+ Kh\u00e1ng th\u1ec3 kh\u00e1ng Sm (+), ho\u1eb7c
\n+ Kh\u00e1ng th\u1ec3 kh\u00e1ng phospholipids (+) c\u0103n c\u1ee9 v\u00e0o: t\u0103ng kh\u00e1ng th\u1ec3 kh\u00e1ng cardiolipin lo\u1ea1i IgM ho\u1eb7c IgG, lupus anticoagulant (+), test huy\u1ebft thanh giang mai d\u01b0\u01a1ng t\u00ednh gi\u1ea3 > 6 th\u00e1ng c\u00f3 ki\u1ec3m ch\u1ee9ng test c\u1ed1 \u0111\u1ecbnh Treponema Pallidum.<\/p>\n

\u2212 Kh\u00e1ng th\u1ec3 kh\u00e1ng nh\u00e2n: hi\u1ec7u gi\u00e1 cao theo ti\u00eau chu\u1ea9n c\u1ee7a ph\u00f2ng x\u00e9t nghi\u1ec7m v\u00e0 kh\u00f4ng do s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c trong danh m\u1ee5c g\u00e2y ra h\u1ed9i ch\u1ee9ng gi\u1ea3 Lupus. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi c\u00f3 t\u1eeb 4 y\u1ebfu t\u1ed1 tr\u1edf l\u00ean.<\/p>\n

G\u1ea7n \u0111\u00e2y, n\u0103m 2012, nh\u1eefng trung t\u00e2m c\u1ed9ng t\u00e1c qu\u1ed1c t\u1ebf v\u1ec1 lupus h\u1ec7 th\u1ed1ng n\u0103m (Systemic International Collaborating Clinics – SLICC 2012) \u0111\u00e3 \u0111\u01b0a ra ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng g\u1ed3m:
\n1. Ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng 2. Ti\u00eau chu\u1ea9n mi\u1ec5n d\u1ecbch
\n1. Lupus da c\u1ea5p 1. ANA
\n2. Lupus da m\u1ea1n 2. Anti-DNA
\n3. Lo\u00e9t mi\u1ec7ng hay m\u0169i 3. Anti-Sm
\n4. R\u1ee5ng t\u00f3c kh\u00f4ng s\u1eb9o 4. KT Antiphospholipid
\n5. Vi\u00eam kh\u1edbp 5. Gi\u1ea3m b\u1ed5 th\u1ec3 (C3, C4)
\n6. Vi\u00eam thanh m\u1ea1c 6. Test Coombs tr\u1ef1c ti\u1ebfp
\n7. Th\u1eadn (Kh\u00f4ng \u0111\u01b0\u1ee3c t\u00ednh khi c\u00f3
\n8. Th\u1ea7n kinh s\u1ef1 t\u1ed3n t\u1ea1i c\u1ee7a thi\u1ebfu m\u00e1u
\n9. Thi\u1ebfu m\u00e1u tan huy\u1ebft tan huy\u1ebft)
\n10. Gi\u1ea3m b\u1ea1ch c\u1ea7u
\n11. Gi\u1ea3m ti\u1ec3u c\u1ea7u (<100.000\/mm3)
\nCh\u1ea9n \u0111o\u00e1n lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng khi c\u00f3 \u2265 4 ti\u00eau chu\u1ea9n (c\u00f3 \u00edt nh\u1ea5t m\u1ed9t ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng v\u00e0 m\u1ed9t ti\u00eau chu\u1ea9n c\u1eadn l\u00e2m s\u00e0ng) ho\u1eb7c b\u1ec7nh th\u1eadn lupus \u0111\u01b0\u1ee3c ch\u1ee9ng minh tr\u00ean sinh thi\u1ebft k\u00e8m v\u1edbi ANA ho\u1eb7c anti-DNA.<\/p>\n

3.4. Ph\u00e2n lo\u1ea1i th\u1ec3<\/h3>\n
    \n
  • \u00a0Th\u1ec3 c\u1ea5p: t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u n\u1ed9i t\u1ea1ng v\u00e0 n\u1eb7ng.<\/li>\n
  • Th\u1ec3 m\u1ea1n: \u00edt t\u1ed5n th\u01b0\u01a1ng n\u1ed9i t\u1ea1ng, bi\u1ec3u hi\u1ec7n ngo\u00e0i da nh\u1eb9.<\/li>\n
  • \u00a0Th\u1ec3 b\u00e1n c\u1ea5p: trung gian gi\u1eefa hai th\u1ec3 tr\u00ean.<\/li>\n
  • \u00a0Th\u1ec3 h\u1ed7n h\u1ee3p: h\u1ed9i ch\u1ee9ng Sharp: th\u1ec3 b\u1ec7nh h\u1ed7n h\u1ee3p gi\u1eefa lupus v\u00e0 x\u01a1 c\u1ee9ng b\u00ec, c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng: vi\u00eam nhi\u1ec1u kh\u1edbp, h\u1ed9i ch\u1ee9ng Raynaud, ng\u00f3n tay h\u00ecnh kh\u00fac d\u1ed3i, h\u1eb9p th\u1ef1c qu\u1ea3n, vi\u00eam \u0111a.<\/li>\n<\/ul>\n

    3.5. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n
      \n
    • Th\u1ea5p kh\u1edbp c\u1ea5p.<\/li>\n
    • \u00a0C\u00e1c b\u1ec7nh thu\u1ed9c nh\u00f3m b\u1ec7nh m\u00f4 li\u00ean k\u1ebft kh\u00e1c: Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p, x\u01a1 c\u1ee9ng b\u00ec to\u00e0n th\u1ec3, vi\u00eam \u0111a c\u01a1, vi\u00eam da c\u01a1\u2026<\/li>\n
    • C\u00e1c b\u1ec7nh l\u00ed c\u1ee7a h\u1ec7 t\u1ea1o m\u00e1u: suy t\u1ee7y, xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u c\u00e1c nguy\u00ean nh\u00e2n
      \nkh\u00e1c.<\/li>\n
    • \u00a0C\u00e1c b\u1ec7nh l\u00ed th\u1eadn, tim, ph\u1ed5i m\u1ea1n t\u00ednh do c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

      B\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng – (Systemic lupus erythematosus- SLE) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd vi\u00eam m\u00e3n t\u00ednh\u00a0khi h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch t\u1ea5n c\u00f4ng c\u00e1c t\u1ebf b\u00e0o v\u00e0 m\u00f4 trong c\u01a1 th\u1ec3. B\u1ec7nh n\u00e0y l\u00e0 b\u1ec7nh kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0ng c\u0169ng kh\u00f4ng hi\u1ebfm g\u1eb7p. 70-90% th\u01b0\u1eddng m\u1eafc \u1edf ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh s\u1ea3n, […]<\/p>\n","protected":false},"author":14,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[29,33],"tags":[3],"yoast_head":"\nLupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng: ch\u1ea9n \u0111o\u00e1n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y T\u1ebf<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd t\u1ef1 mi\u1ec5n, h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch t\u1ea5n c\u00f4ng c\u00e1c m\u00f4 trong c\u01a1 th\u1ec3. C\u00f9ng t\u00ecm hi\u1ec3u c\u00e1ch \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh n\u00e0y.\" \/>\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=\"Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng: ch\u1ea9n \u0111o\u00e1n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y T\u1ebf\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd t\u1ef1 mi\u1ec5n, h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch t\u1ea5n c\u00f4ng c\u00e1c m\u00f4 trong c\u01a1 th\u1ec3. 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