{"id":20933,"date":"2023-04-14T20:49:25","date_gmt":"2023-04-14T13:49:25","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20933"},"modified":"2023-04-17T15:44:37","modified_gmt":"2023-04-17T08:44:37","slug":"uc-che-kenh-canxi-va-chi-dinh-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/","title":{"rendered":"Ch\u1eb9n k\u00eanh calci v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng"},"content":{"rendered":"

Ch\u1eb9n k\u00eanh canxi (CCB) l\u00e0 m\u1ed9t nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc k\u00eanh canxi n\u1eb1m tr\u00ean m\u00e0ng t\u1ebf b\u00e0o c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u v\u00e0 c\u01a1 tim, do \u0111\u00f3 l\u00e0m gi\u00e1n \u0111o\u1ea1n s\u1ef1 di chuy\u1ec3n c\u1ee7a d\u00f2ng canxi \u0111i v\u00e0o trong t\u1ebf b\u00e0o.<\/strong><\/p>\n

1.T\u0103ng huy\u1ebft \u00e1p <\/strong><\/h2>\n

Ch\u1eb9n k\u00eanh canxi (\u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u00f3m DHP t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p, do l\u00e0m gi\u1ea3m c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch ch\u00ednh v\u00e0 t\u1eed vong.<\/p>\n

Thu\u1ed1c ch\u1eb9n k\u00eanh canxi l\u00e0 m\u1ed9t trong nh\u1eefng nh\u00f3m thu\u1ed1c kh\u1edfi tr\u1ecb t\u0103ng huy\u1ebft \u00e1p b\u00ean c\u1ea1nh c\u00e1c nh\u00f3m thu\u1ed1c kh\u00e1c nh\u01b0 \u1ee9c ch\u1ebf men chuy\u1ec3n, ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin, l\u1ee3i ti\u1ec3u thiazide.<\/p>\n

\u01afu ti\u00ean s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p thu\u1ed1c ch\u1eb9n k\u00eanh canxi v\u1edbi thu\u1ed1c \u01afCMC ho\u1eb7c \u01afCTT ngay t\u1eeb \u0111\u1ea7u, ngo\u1ea1i tr\u1eeb c\u00e1c tr\u01b0\u1eddng h\u1ee3p<\/p>\n

    \n
  • T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 nguy c\u01a1 th\u1ea5p \u00a0(HA t\u00e2m thu<150mmHg) ho\u1eb7c \u1edf b\u1ec7nh nh\u00e2n cao tu\u1ed5i ho\u1eb7c th\u1ec3 tr\u1ea1ng y\u1ebfu..<\/li>\n
  • Suy tim c\u00f3 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u th\u1ea5t tr\u00e1i gi\u1ea3m.<\/li>\n<\/ul>\n

    Thu\u1ed1c ch\u1eb9n k\u00eanh canxi l\u00e0 thu\u1ed1c hi\u1ec7u qu\u1ea3 nh\u1ea5t \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p cho b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, thu\u1ed1c c\u0169ng \u0111\u1eb7c bi\u1ec7t c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean ch\u1ee7ng t\u1ed9c ng\u01b0\u1eddi da \u0111en. Thu\u1ed1c ch\u1eb9n k\u00eanh canxi c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111\u1ed9t qu\u1ef5 n\u00e3o cao h\u01a1n c\u00e1c lo\u1ea1i thu\u1ed1c h\u1ea1 \u00e1p kh\u00e1c, hi\u1ec7u qu\u1ea3 \u00edt nh\u1ea5t t\u01b0\u01a1ng t\u1ef1 c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c trong \u0111i\u1ec1u tr\u1ecb THA \u1edf ng\u01b0\u1eddi c\u00f3 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0 \u00edt hi\u1ec7u qu\u1ea3 h\u01a1n trong suy tim.<\/p>\n

    M\u1ed9t s\u1ed1 b\u00e1o c\u00e1o c\u0169ng cho th\u1ea5y thu\u1ed1c ch\u1eb9n k\u00eanh canxi c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n c\u00e1c thu\u1ed1c ch\u1eb9n beta trong vi\u1ec7c l\u00e0m ch\u1eadm qu\u00e1 tr\u00ecnh x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh v\u00e0 gi\u1ea3m ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i v\u00e0 gi\u1ea3m protein ni\u1ec7u. Trong t\u0103ng huy\u1ebft \u00e1p v\u1edbi b\u1ec7nh th\u1eadn, non \u2013 DHP l\u00e0m gi\u1ea3m protein ni\u1ec7u t\u1ed1t h\u01a1n DHP. Thu\u1ed1c c\u0169ng c\u00f3 \u01b0u \u0111i\u1ec3m h\u1ea1 huy\u1ebft \u00e1p t\u1ed1t m\u00e0 kh\u00f4ng g\u00e2y t\u0103ng lipid m\u00e1u hay kh\u00e1ng insulin v\u00e0 kh\u00f4ng t\u00e1c \u0111\u1ed9ng v\u00e0o ch\u1ee9c n\u0103ng giao c\u1ea3m.<\/p>\n

    H\u1ea7u h\u1ebft c\u00e1c nghi\u00ean c\u1ee9u ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng (RCT) cho th\u1ea5y l\u1ee3i \u00edch c\u1ee7a thu\u1ed1c ch\u1eb9n k\u00eanh canxi l\u00e0 s\u1eed d\u1ee5ng DHP (\u0111\u1eb7c bi\u1ec7t l\u00e0 amlodipine). M\u1ed9t s\u1ed1 l\u01b0\u1ee3ng nh\u1ecf h\u01a1n c\u00e1c RCT \u0111\u00e3 so s\u00e1nh c\u00e1c thu\u1ed1c non-DHP (verapamil v\u00e0 diltiazem) v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0 kh\u00f4ng cho th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 v\u1ec1 hi\u1ec7u qu\u1ea3.<\/p>\n

    N\u00ean s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n k\u00eanh canxi d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i v\u00ec l\u1ee3i \u00edch d\u00f9ng 1 l\u1ea7n\/24h v\u00e0 gi\u1ea3m t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n. Nicardipine li\u1ec1u 5-15 mg\/h truy\u1ec1n t\u0129nh m\u1ea1ch d\u00f9ng trong t\u0103ng huy\u1ebft \u00e1p c\u1ea5p c\u1ee9u.<\/p>\n

    2.B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh<\/strong><\/h2>\n

    2.1<\/strong>. H\u1ed9i ch\u1ee9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n (B\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 ho\u1eb7c \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh)<\/strong><\/h3>\n

    Thu\u1ed1c ch\u1eb9n k\u00eanh canxi gi\u00fap c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c v\u00e0 thi\u1ebfu m\u00e1u c\u01a1 tim nh\u01b0ng ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 gi\u1ea3m bi\u1ebfn c\u1ed1 ch\u00ednh ho\u1eb7c t\u1eed vong \u1edf b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh \u0110MV m\u1ea1n t\u00ednh.<\/p>\n

    Trong \u0111i\u1ec1u tr\u1ecb \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh, thu\u1ed1c ch\u1eb9n beta v\u00e0\/ho\u1eb7c thu\u1ed1c ch\u1eb9n k\u00eanh canxi \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay \u0111\u1ec3 ki\u1ec3m so\u00e1t nh\u1ecbp tim v\u00e0 tri\u1ec7u ch\u1ee9ng (ch\u1ec9 \u0111\u1ecbnh nh\u00f3m I, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng A) (Khuy\u1ebfn c\u00e1o c\u1ee7a ESC 2019 v\u1ec1 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0110MV m\u1ea1n t\u00ednh).<\/p>\n

    Thu\u1ed1c ch\u1eb9n k\u00eanh canxi nh\u00f3m DHP \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p v\u1edbi thu\u1ed1c ch\u1eb9n beta n\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c b\u1eb1ng thu\u1ed1c ch\u1eb9n beta (ch\u1ec9 \u0111\u1ecbnh nh\u00f3m IIa, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng C). Thu\u1ed1c ch\u1eb9n k\u00eanh canxi thay th\u1ebf cho thu\u1ed1c ch\u1eb9n beta n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng dung n\u1ea1p v\u1edbi thu\u1ed1c ch\u1eb9n beta. N\u00ean xem x\u00e9t k\u1ebft h\u1ee3p thu\u1ed1c ch\u1eb9n beta v\u1edbi DHP ngay t\u1eeb \u0111\u1ea7u (ch\u1ec9 \u0111\u1ecbnh nh\u00f3m IIa, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng B).<\/p>\n

    Tr\u01b0\u1eddng h\u1ee3p nh\u1ecbp tim nhanh > 80 nh\u1ecbp\/ph\u00fat, l\u1ef1a ch\u1ecdn thu\u1ed1c ch\u1eb9n k\u00eanh canxi l\u00e0 c\u00e1c non-DHP.<\/p>\n

    N\u1ebfu nh\u1ecbp tim ch\u1eadm < 50 nh\u1ecbp\/ph\u00fat, l\u1ef1a ch\u1ecdn thu\u1ed1c ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m DHP. Tr\u01b0\u1eddng h\u1ee3p huy\u1ebft \u00e1p th\u1ea5p, s\u1eed d\u1ee5ng li\u1ec1u th\u1ea5p ch\u1eb9n beta ho\u1eb7c non-DHP v\u00e0 theo d\u00f5i s\u00e1t s\u1ef1 dung n\u1ea1p, nh\u1ea5t l\u00e0 nh\u1ecbp tim v\u00e0 huy\u1ebft \u00e1p.<\/p>\n

    Kh\u00f4ng d\u00f9ng thu\u1ed1c ch\u1eb9n k\u00eanh canxi khi c\u00f3 suy tim, suy ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i tr\u1eeb tr\u01b0\u1eddng h\u1ee3p c\u00f3 k\u00e8m theo t\u0103ng huy\u1ebft \u00e1p<\/p>\n

    2.2<\/strong>. \u0110au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh <\/strong><\/h3>\n

    Trong s\u1ed1 c\u00e1c thu\u1ed1c ch\u1eb9n k\u00eanh canxi, ch\u1ec9 c\u00f3 non \u2013 DHP (verapamil ho\u1eb7c diltiazem) c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng cho \u0111i\u1ec1u tr\u1ecb \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh.<\/p>\n

    \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p kh\u00f4ng c\u00f3 ST ch\u00eanh l\u00ean, v\u1eabn c\u00f2n ho\u1eb7c t\u00e1i ph\u00e1t \u0111au ng\u1ef1c m\u00e0 c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi thu\u1ed1c ch\u1eb9n beta, c\u00e1c non-DHP n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng n\u1ebfu kh\u00f4ng c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 sau: r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i ho\u1eb7c nguy c\u01a1 s\u1ed1c tim, kho\u1ea3ng PR l\u1edbn h\u01a1n 0,24 gi\u00e2y ho\u1eb7c block nh\u0129 th\u1ea5t \u0111\u1ed9 hai ho\u1eb7c ba m\u00e0 kh\u00f4ng c\u00f3 m\u00e1y t\u1ea1o nh\u1ecbp tim.<\/p>\n

    Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng c\u00e1c DHP cho \u0111au th\u1eafc ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh m\u00e0 kh\u00f4ng s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m \u0111\u1ed3ng th\u1eddi (do nguy c\u01a1 k\u00edch th\u00edch ph\u1ea3n x\u1ea1 giao c\u1ea3m).<\/p>\n

    2.3<\/strong>. Co th\u1eaft m\u1ea1ch v\u00e0nh <\/strong><\/h3>\n

    Co th\u1eaft m\u1ea1ch v\u00e0nh x\u1ea3y ra trong nhi\u1ec1u b\u1ec7nh c\u1ea3nh kh\u00e1c nhau. Tr\u01b0\u1eddng h\u1ee3p co th\u1eaft m\u1ea1ch v\u00e0nh trong \u0111au ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh, c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y thu\u1ed1c ch\u1eb9n beta c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n nifedipine, th\u1eadm ch\u00ed s\u1eed d\u1ee5ng nifedipine m\u00e0 kh\u00f4ng \u0111\u1ed3ng th\u1eddi ph\u1ed1i h\u1ee3p phong t\u1ecfa th\u1ee5 th\u1ec3 beta giao c\u1ea3m c\u00f2n c\u00f3 th\u1ec3 c\u00f3 h\u1ea1i do l\u00e0m t\u0103ng ph\u1ea3n x\u1ea1 giao c\u1ea3m d\u01b0\u1edbi t\u00e1c d\u1ee5ng gi\u00e3n m\u1ea1ch c\u1ee7a nifedipine. \u1ede c\u00e1c tr\u01b0\u1eddng h\u1ee3p co th\u1eaft m\u1ea1ch v\u00e0nh g\u00e2y \u0111au th\u1eaft ng\u1ef1c do l\u1ea1nh ho\u1eb7c gi\u1ea3m th\u00f4ng kh\u00ed v\u00e0 trong \u0111au th\u1eaft ng\u1ef1c bi\u1ebfn th\u1ec3 prinzmetal, t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c ch\u1eb9n k\u00eanh canxi \u0111\u1ec1u c\u00f3 hi\u1ec7u qu\u1ea3.<\/p>\n

    2.4<\/strong>. Sau nh\u1ed3i m\u00e1u c\u01a1 tim <\/strong><\/h3>\n

    Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u trong NMCT, nh\u01b0ng trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi ch\u1eb9n beta giao c\u1ea3m, c\u00f3 th\u1ec3 thay th\u1ebf b\u1eb1ng verapamil ho\u1eb7c diltiazem do c\u00f3 kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 c\u01a1 tim v\u1edbi \u0111i\u1ec1u ki\u1ec7n kh\u00f4ng c\u00f3 k\u00e8m theo suy th\u1ea5t tr\u00e1i.<\/p>\n

    2<\/strong>.<\/strong>5<\/strong>. Nh\u1ecbp nhanh tr\u00ean th\u1ea5t<\/strong><\/h3>\n

    Verapamil v\u00e0 diltiazem \u1ee9c ch\u1ebf n\u00fat nh\u0129 th\u1ea5t n\u00ean c\u00f3 t\u00e1c d\u1ee5ng \u0111i\u1ec1u tr\u1ecb nh\u1ecbp tim nhanh tr\u00ean th\u1ea5t. Nifedipine v\u00e0 c\u00e1c DHP kh\u00e1c kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng n\u00e0y.<\/p>\n

    2<\/strong>.<\/strong>6<\/strong>. C\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u00e1c <\/strong><\/h3>\n
      \n
    • H\u1ed9i ch\u1ee9ng Raynaud: Nifedipine (d\u1ea1ng c\u00f3 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i).<\/li>\n
    • \u00a0D\u1ef1 ph\u00f2ng co th\u1eaft m\u1ea1ch n\u00e3o th\u1ee9 ph\u00e1t sau xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n: nimodipine.<\/li>\n
    • \u00a0\u0110au n\u1eeda \u0111\u1ea7u: unarizine.<\/li>\n<\/ul>\n

      3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/h2>\n

      Trong suy tim, c\u00e1c non-DHP b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh do t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m co b\u00f3p c\u01a1 tim.<\/p>\n

        \n
      • DHP th\u1ebf h\u1ec7 1 (nifedipine) tuy l\u00e0 thu\u1ed1c gi\u00e3n m\u1ea1ch nh\u01b0ng c\u0169ng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong suy tim do c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c co b\u00f3p c\u1ee7a c\u01a1 tim.<\/li>\n
      • DHP th\u1ebf h\u1ec7 2 (amlodipine, felodipine) \u00edt \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn co b\u00f3p c\u01a1 tim, c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh trong THA c\u00f3 \u0111i k\u00e8m suy tim khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u00e1c nh\u00f3m thu\u1ed1c kh\u00e1c ho\u1eb7c ph\u1ed1i h\u1ee3p c\u00f9ng thu\u1ed1c \u01afCMC, ch\u1eb9n th\u1ee5 th\u1ec3 AT1.<\/li>\n<\/ul>\n

        C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a DHP bao g\u1ed3m: H\u1eb9p van \u0110MC n\u1eb7ng, b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i c\u00f3 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i, suy tim n\u1eb7ng, \u0111au ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh \u0111e d\u1ecda NMCT.<\/p>\n

        C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a non-DHP bao g\u1ed3m: suy tim t\u00e2m thu, suy n\u00fat xoang, nh\u1ecbp ch\u1eadm, block nh\u0129 th\u1ea5t.<\/p>\n","protected":false},"excerpt":{"rendered":"

        Ch\u1eb9n k\u00eanh canxi (CCB) l\u00e0 m\u1ed9t nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc k\u00eanh canxi n\u1eb1m tr\u00ean m\u00e0ng t\u1ebf b\u00e0o c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u v\u00e0 c\u01a1 tim, do \u0111\u00f3 l\u00e0m gi\u00e1n \u0111o\u1ea1n s\u1ef1 di chuy\u1ec3n c\u1ee7a d\u00f2ng canxi \u0111i v\u00e0o trong t\u1ebf b\u00e0o. 1.T\u0103ng huy\u1ebft \u00e1p Ch\u1eb9n k\u00eanh canxi (\u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u00f3m DHP t\u00e1c d\u1ee5ng […]<\/p>\n","protected":false},"author":7,"featured_media":20900,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nCh\u1eb9n k\u00eanh canxi v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng<\/title>\n<meta name=\"description\" content=\"Ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m thu\u1ed1c ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch. Tham kh\u1ea3o c\u00e1c nh\u00f3m thu\u1ed1c trong b\u00e0i vi\u1ebft sau \u0111\u00e2y.\" \/>\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=\"Ch\u1eb9n k\u00eanh canxi v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng\" \/>\n<meta property=\"og:description\" content=\"Ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m thu\u1ed1c ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch. Tham kh\u1ea3o c\u00e1c nh\u00f3m thu\u1ed1c trong b\u00e0i vi\u1ebft sau \u0111\u00e2y.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-14T13:49:25+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-17T08:44:37+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tai-xuong-3.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"254\" \/>\n\t<meta property=\"og:image:height\" content=\"198\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/\",\"name\":\"Ch\u1eb9n k\u00eanh canxi v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-14T13:49:25+00:00\",\"dateModified\":\"2023-04-17T08:44:37+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"Ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m thu\u1ed1c ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch. Tham kh\u1ea3o c\u00e1c nh\u00f3m thu\u1ed1c trong b\u00e0i vi\u1ebft sau \u0111\u00e2y.\",\"breadcrumb\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ch\u1eb9n k\u00eanh calci v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\",\"name\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"caption\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ch\u1eb9n k\u00eanh canxi v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng","description":"Ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m thu\u1ed1c ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch. Tham kh\u1ea3o c\u00e1c nh\u00f3m thu\u1ed1c trong b\u00e0i vi\u1ebft sau \u0111\u00e2y.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Ch\u1eb9n k\u00eanh canxi v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng","og_description":"Ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m thu\u1ed1c ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch. Tham kh\u1ea3o c\u00e1c nh\u00f3m thu\u1ed1c trong b\u00e0i vi\u1ebft sau \u0111\u00e2y.","og_url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/","og_site_name":"Vinmec","article_published_time":"2023-04-14T13:49:25+00:00","article_modified_time":"2023-04-17T08:44:37+00:00","og_image":[{"width":254,"height":198,"url":"https:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tai-xuong-3.jpg","type":"image\/jpeg"}],"author":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","twitter_card":"summary_large_image","twitter_misc":{"Written by":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/","url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/","name":"Ch\u1eb9n k\u00eanh canxi v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-14T13:49:25+00:00","dateModified":"2023-04-17T08:44:37+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"Ch\u1eb9n k\u00eanh canxi l\u00e0 nh\u00f3m thu\u1ed1c ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch. Tham kh\u1ea3o c\u00e1c nh\u00f3m thu\u1ed1c trong b\u00e0i vi\u1ebft sau \u0111\u00e2y.","breadcrumb":{"@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-kenh-canxi-va-chi-dinh-lam-sang\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Ch\u1eb9n k\u00eanh calci v\u00e0 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629","name":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","contentUrl":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","caption":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20933"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=20933"}],"version-history":[{"count":3,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20933\/revisions"}],"predecessor-version":[{"id":21068,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20933\/revisions\/21068"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media\/20900"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=20933"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=20933"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=20933"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}