{"id":21192,"date":"2023-04-27T23:48:50","date_gmt":"2023-04-27T16:48:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21192"},"modified":"2023-05-06T16:39:50","modified_gmt":"2023-05-06T09:39:50","slug":"thuoc-chen-beta-trong-dieu-tri-hoi-chung-mach-vanh-man-tinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/27\/thuoc-chen-beta-trong-dieu-tri-hoi-chung-mach-vanh-man-tinh\/","title":{"rendered":"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh"},"content":{"rendered":"<p><strong>Thu\u1ed1c ch\u1eb9n beta l\u00e0 li\u1ec7u ph\u00e1p \u0111\u1ea7u tay trong vi\u1ec7c ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng \u1edf b\u1ec7nh nh\u00e2n \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh m\u1ea1n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111au th\u1eaft ng\u1ef1c do g\u1eafng s\u1ee9c.<\/strong><\/p>\n<h2>1. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh<\/h2>\n<p>T\u00e1c d\u1ee5ng sinh l\u00fd c\u1ee7a catecholamine (norepinephrine v\u00e0 epinephrine) \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t qua trung gian c\u00e1c th\u1ee5 th\u1ec3 adrenergic alpha v\u00e0 beta. C\u1ee5 th\u1ec3, c\u00f3 \u00edt nh\u1ea5t ba lo\u1ea1i th\u1ee5 th\u1ec3 beta ri\u00eang bi\u1ec7t:<\/p>\n<ul>\n<li><strong>Beta-1,<\/strong> \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y ch\u1ee7 y\u1ebfu trong c\u01a1 tim. K\u00edch ho\u1ea1t c\u00e1c th\u1ee5 th\u1ec3 n\u00e0y d\u1eabn \u0111\u1ebfn t\u0103ng nh\u1ecbp tim, kh\u1ea3 n\u0103ng co b\u00f3p v\u00e0 d\u1eabn truy\u1ec1n nh\u0129 th\u1ea5t (AV) v\u00e0 gi\u1ea3m kh\u1ea3 n\u0103ng kh\u00fac x\u1ea1 c\u1ee7a n\u00fat AV.<\/li>\n<li><strong>Beta-2<\/strong>, hi\u1ec7n di\u1ec7n trong c\u01a1 tim nh\u01b0ng n\u1ed5i b\u1eadt h\u01a1n \u1edf c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u ngo\u1ea1i vi v\u00e0 ph\u1ebf qu\u1ea3n. K\u00edch ho\u1ea1t c\u00e1c th\u1ee5 th\u1ec3 n\u00e0y d\u1eabn \u0111\u1ebfn gi\u00e3n m\u1ea1ch v\u00e0 gi\u00e3n ph\u1ebf qu\u1ea3n.<\/li>\n<li><strong>Beta-3<\/strong>, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong m\u00f4 m\u1ee1 v\u00e0 tim. K\u00edch ho\u1ea1t c\u00e1c th\u1ee5 th\u1ec3 n\u00e0y c\u00f3 th\u1ec3 l\u00e0m trung gian sinh nhi\u1ec7t do catecholamine g\u00e2y ra v\u00e0 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng co b\u00f3p c\u1ee7a tim.<\/li>\n<\/ul>\n<p>Thu\u1ed1c ch\u1eb9n beta ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf c\u1ea1nh tranh catecholamine li\u00ean k\u1ebft v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 n\u00e0y. M\u1ed9t s\u1ed1 ch\u1ecdn l\u1ecdc h\u01a1n \u0111\u1ed1i v\u1edbi th\u1ee5 th\u1ec3 beta-1.<\/p>\n<figure id=\"attachment_21222\" aria-describedby=\"caption-attachment-21222\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-21222 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/front-view-young-male-doctor-medical-suit-having-heart-ache-yellow-background-300x200.jpg\" alt=\"thuoc-chen-beta-trong-dieu-tri-hoi-chung-mach-vanh-man-tinh\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/front-view-young-male-doctor-medical-suit-having-heart-ache-yellow-background-300x200.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/front-view-young-male-doctor-medical-suit-having-heart-ache-yellow-background-1024x683.jpg 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/front-view-young-male-doctor-medical-suit-having-heart-ache-yellow-background-768x512.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/front-view-young-male-doctor-medical-suit-having-heart-ache-yellow-background-1536x1025.jpg 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/front-view-young-male-doctor-medical-suit-having-heart-ache-yellow-background-2048x1366.jpg 2048w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-21222\" class=\"wp-caption-text\">Minh ho\u1ea1 c\u01a1n \u0111au th\u1eaft ng\u1ef1c<\/figcaption><\/figure>\n<h3><strong>1.1. T\u0103ng bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c th\u1ee5 th\u1ec3 beta <\/strong><\/h3>\n<p>M\u1eadt \u0111\u1ed9 th\u1ee5 th\u1ec3 beta l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh c\u00f3 th\u1ec3 thay \u0111\u1ed5i trong c\u00e1c \u0111i\u1ec1u ki\u1ec7n sinh l\u00fd kh\u00e1c nhau. \u0110\u1eb7c bi\u1ec7t, li\u1ec7u ph\u00e1p ch\u1eb9n beta m\u00e3n t\u00ednh d\u1eabn \u0111\u1ebfn s\u1ef1 gia t\u0103ng m\u1eadt \u0111\u1ed9 th\u1ee5 th\u1ec3. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 quan tr\u1ecdng v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng, v\u00ec ng\u1eebng thu\u1ed1c ch\u1eb9n beta \u0111\u1ed9t ng\u1ed9t d\u1eabn \u0111\u1ebfn qu\u00e1 m\u1eabn c\u1ea3m tho\u00e1ng qua v\u1edbi catecholamine, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn \u0111au th\u1eaft ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim ho\u1eb7c t\u1eed vong. Nh\u1eefng bi\u1ebfn ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 x\u1ea3y ra ngay c\u1ea3 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 <a href=\"https:\/\/vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/tong-quan-benh-mach-vanh-man\/\">b\u1ec7nh m\u1ea1ch v\u00e0nh<\/a> r\u00f5 r\u00e0ng tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n<h3><strong>1.2. T\u00e1c d\u1ee5ng tim m\u1ea1ch c\u1ee7a thu\u1ed1c ch\u1eb9n beta <\/strong>trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh<\/h3>\n<p>T\u00e1c d\u1ee5ng \u0111i\u1ec1u tr\u1ecb c\u00f3 l\u1ee3i c\u1ee7a thu\u1ed1c ch\u1eb9n beta \u1edf b\u1ec7nh nh\u00e2n \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh \u0111\u01b0\u1ee3c trung gian b\u1edfi s\u1ef1 gi\u1ea3m nhu c\u1ea7u oxy c\u1ee7a c\u01a1 tim. Nhu c\u1ea7u oxy c\u1ee7a c\u01a1 tim thay \u0111\u1ed5i tr\u1ef1c ti\u1ebfp theo nh\u1ecbp tim, kh\u1ea3 n\u0103ng co b\u00f3p v\u00e0 s\u1ee9c c\u0103ng c\u1ee7a th\u00e0nh t\u00e2m th\u1ea5t tr\u00e1i, m\u1ed7i y\u1ebfu t\u1ed1 n\u00e0y \u0111\u1ec1u gi\u1ea3m \u0111i khi ch\u1eb9n beta. Vi\u1ec7c gi\u1ea3m \u00e1p l\u1ef1c th\u00e0nh m\u1ea1ch m\u1ed9t ph\u1ea7n l\u00e0 do t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p c\u1ee7a c\u00e1c thu\u1ed1c n\u00e0y.<\/p>\n<p>S\u1ef1 suy gi\u1ea3m nh\u1ecbp tim \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi c\u1ea3 m\u1ee9c \u0111\u1ed9 m\u00e0 nh\u1ecbp tim \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t m\u1ed9t c\u00e1ch giao c\u1ea3m (nh\u01b0 khi t\u1eadp th\u1ec3 d\u1ee5c ho\u1eb7c c\u0103ng th\u1eb3ng) v\u00e0 c\u00e1c \u0111\u1eb7c t\u00ednh c\u1ee7a thu\u1ed1c ch\u1eb9n beta. Nh\u1eefng lo\u1ea1i thu\u1ed1c c\u00f3 ho\u1ea1t t\u00ednh giao c\u1ea3m n\u1ed9i t\u1ea1i th\u1ef1c s\u1ef1 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nh\u1ecbp tim khi ngh\u1ec9 ng\u01a1i. Tuy nhi\u00ean, ch\u00fang v\u1eabn c\u00f3 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb \u0111au th\u1eaft ng\u1ef1c v\u00ec ch\u00ednh vi\u1ec7c gi\u1ea3m nh\u1ecbp tim khi g\u1eafng s\u1ee9c m\u1edbi l\u00e0 \u0111i\u1ec1u quan tr\u1ecdng h\u00e0ng \u0111\u1ea7u.<\/p>\n<p>T\u00e1c d\u1ee5ng gi\u1ea3m co b\u00f3p c\u01a1 tim c\u1ee7a thu\u1ed1c ch\u1eb9n beta, \u00edt nh\u1ea5t v\u1ec1 m\u1eb7t l\u00fd thuy\u1ebft, c\u00f3 th\u1ec3 c\u00f3 t\u00e1c \u0111\u1ed9ng thu\u1eadn l\u1ee3i \u0111\u1ebfn m\u1ee9c ti\u00eau th\u1ee5 oxy c\u1ee7a c\u01a1 tim \u1edf b\u1ec7nh nh\u00e2n \u0111au th\u1eaft ng\u1ef1c. Tr\u01b0\u1edbc \u0111\u00e2y, thu\u1ed1c ch\u1eb9n beta \u0111\u01b0\u1ee3c tr\u00e1nh s\u1eed d\u1ee5ng \u1edf b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m th\u1ea5t tr\u00e1i, do lo ng\u1ea1i r\u1eb1ng t\u00e1c d\u1ee5ng gi\u1ea3m co b\u00f3p c\u01a1 tim c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y ho\u1eb7c l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam t\u00ecnh tr\u1ea1ng suy tim. Tuy nhi\u00ean, kinh nghi\u1ec7m l\u00e2m s\u00e0ng v\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng l\u1edbn \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng c\u00e1c thu\u1ed1c n\u00e0y th\u1ef1c s\u1ef1 k\u00e9o d\u00e0i th\u1eddi gian s\u1ed1ng s\u00f3t \u1edf b\u1ec7nh nh\u00e2n suy tim. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y, n\u00ean b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ch\u1eb9n beta \u1edf li\u1ec1u th\u1ea5p v\u00e0 \u0111i\u1ec1u ch\u1ec9nh t\u00ecnh tr\u1ea1ng qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Thu\u1ed1c ch\u1eb9n beta c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u01b0u l\u01b0\u1ee3ng m\u00e1u m\u1ea1ch v\u00e0nh, m\u1eb7c d\u00f9 c\u00f3 nh\u1eefng t\u00e1c d\u1ee5ng c\u1ea1nh tranh. Thu\u1ed1c ch\u1eb9n beta \u1ee9c ch\u1ebf gi\u00e3n m\u1ea1ch v\u00e0nh qua trung gian adrenergic, do \u0111\u00f3 l\u00e0m t\u0103ng s\u1ee9c c\u1ea3n m\u1ea1ch v\u00e0nh v\u00e0 gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u m\u1ea1ch v\u00e0nh. Tuy nhi\u00ean, t\u00e1c d\u1ee5ng c\u00f3 h\u1ea1i ti\u1ec1m \u1ea9n n\u00e0y \u0111\u01b0\u1ee3c kh\u1eafc ph\u1ee5c b\u1eb1ng c\u00e1ch gi\u1ea3m nh\u1ecbp tim (gi\u00fap t\u0103ng c\u01b0\u1eddng t\u01b0\u1edbi m\u00e1u m\u1ea1ch v\u00e0nh b\u1eb1ng c\u00e1ch k\u00e9o d\u00e0i th\u1eddi gian t\u00e2m tr\u01b0\u01a1ng) v\u00e0 nhu c\u1ea7u oxy c\u1ee7a c\u01a1 tim.<\/p>\n<p>Thu\u1ed1c ch\u1eb9n beta kh\u00f4ng ch\u1ecdn l\u1ecdc c\u00f3 th\u1ec3 l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam t\u00ecnh tr\u1ea1ng co th\u1eaft m\u1ea1ch v\u00e0nh \u1edf b\u1ec7nh nh\u00e2n \u0111au th\u1eaft ng\u1ef1c bi\u1ebfn th\u1ec3 v\u00e0 n\u00ean tr\u00e1nh d\u00f9ng.<\/p>\n<h2>2. D\u01b0\u1ee3c l\u00fd h\u1ecdc thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh<\/h2>\n<p>M\u1ed9t s\u1ed1 thu\u1ed1c ch\u1eb9n beta kh\u00e1c nhau \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong l\u00e2m s\u00e0ng. C\u00e1c \u0111\u1eb7c t\u00ednh nh\u01b0 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc, t\u00ednh ch\u1ecdn l\u1ecdc tr\u00ean tim, ho\u1ea1t t\u00ednh giao c\u1ea3m n\u1ed9i t\u1ea1i v\u00e0 ho\u1ea1t t\u00ednh ch\u1eb9n alpha adrenergic l\u00e0 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m quan tr\u1ecdng c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t khi l\u1ef1a ch\u1ecdn m\u1ed9t thu\u1ed1c c\u1ee5 th\u1ec3.<\/p>\n<h3><strong>2.1. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc <\/strong>thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh<\/h3>\n<p>M\u1eb7c d\u00f9 c\u00e1c thu\u1ed1c ch\u1eb9n beta c\u00f3 t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd t\u01b0\u01a1ng t\u1ef1 nhau, nh\u01b0ng \u0111\u1eb7c t\u00ednh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a ch\u00fang kh\u00e1c nhau \u0111\u00e1ng k\u1ec3 theo nh\u1eefng c\u00e1ch c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh h\u1eefu \u00edch l\u00e2m s\u00e0ng v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a ch\u00fang. Gi\u1eefa c\u00e1c lo\u1ea1i thu\u1ed1c ri\u00eang l\u1ebb, c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 m\u1ee9c \u0111\u1ed9 h\u1ea5p thu ho\u00e0n to\u00e0n qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, l\u01b0\u1ee3ng chuy\u1ec3n h\u00f3a l\u1ea7n \u0111\u1ea7u qua gan, \u0111\u1ed9 h\u00f2a tan trong lipid, g\u1eafn v\u1edbi protein, m\u1ee9c \u0111\u1ed9 ph\u00e2n b\u1ed1 trong c\u01a1 th\u1ec3, th\u00e2m nh\u1eadp v\u00e0o n\u00e3o, n\u1ed3ng \u0111\u1ed9 trong tim, t\u1ed1c \u0111\u1ed9 chuy\u1ec3n h\u00f3a sinh h\u1ecdc \u1edf gan, t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd, ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a, v\u00e0 \u0111\u1ed9 thanh th\u1ea3i qua th\u1eadn c\u1ee7a thu\u1ed1c v\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a n\u00f3.<\/p>\n<p>Tr\u00ean c\u01a1 s\u1edf c\u00e1c \u0111\u1eb7c t\u00ednh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a ch\u00fang, thu\u1ed1c ch\u1eb9n beta c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n th\u00e0nh hai lo\u1ea1i ch\u00ednh.<\/p>\n<ul>\n<li>Nh\u1eefng ch\u1ea5t b\u1ecb lo\u1ea1i b\u1ecf b\u1edfi s\u1ef1 chuy\u1ec3n h\u00f3a \u1edf gan<\/li>\n<li>Nh\u1eefng ch\u1ea5t \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua th\u1eadn<\/li>\n<\/ul>\n<p>C\u00e1c thu\u1ed1c thu\u1ed9c nh\u00f3m th\u1ee9 nh\u1ea5t (nh\u01b0 propranolol v\u00e0 metoprolol ) tan trong lipid, \u0111\u01b0\u1ee3c h\u1ea5p thu g\u1ea7n nh\u01b0 ho\u00e0n to\u00e0n \u1edf ru\u1ed9t non v\u00e0 \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a ph\u1ea7n l\u1edbn \u1edf gan. Ch\u00fang \u0111i v\u00e0o h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng (CNS) \u1edf n\u1ed3ng \u0111\u1ed9 cao, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng t\u1ef7 l\u1ec7 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a CNS. Ch\u00fang c\u00f3 xu h\u01b0\u1edbng c\u00f3 sinh kh\u1ea3 d\u1ee5ng thay \u0111\u1ed5i cao v\u00e0 th\u1eddi gian b\u00e1n h\u1ee7y trong huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1ng \u0111\u1ed1i ng\u1eafn.<\/p>\n<p>Ng\u01b0\u1ee3c l\u1ea1i, c\u00e1c lo\u1ea1i thu\u1ed1c thu\u1ed9c nh\u00f3m th\u1ee9 hai (nh\u01b0 atenolol v\u00e0 sotalol) d\u1ec5 tan trong n\u01b0\u1edbc h\u01a1n, \u0111\u01b0\u1ee3c h\u1ea5p thu kh\u00f4ng ho\u00e0n to\u00e0n qua ru\u1ed9t, \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i qua th\u1eadn v\u00e0 kh\u00f4ng d\u1ec5 d\u00e0ng x\u00e2m nh\u1eadp v\u00e0o h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng. Ch\u00fang cho th\u1ea5y \u00edt kh\u00e1c bi\u1ec7t h\u01a1n v\u1ec1 sinh kh\u1ea3 d\u1ee5ng v\u00e0 c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y trong huy\u1ebft t\u01b0\u01a1ng d\u00e0i h\u01a1n.<\/p>\n<h3><strong>2.2. T\u00ednh ch\u1ecdn l\u1ecdc tr\u00ean tim\u00a0 <\/strong><\/h3>\n<p>T\u00ednh ch\u1ecdn l\u1ecdc tr\u00ean tim \u0111\u1ec1 c\u1eadp \u0111\u1ebfn kh\u1ea3 n\u0103ng c\u1ee7a m\u1ed9t lo\u1ea1i thu\u1ed1c ng\u0103n ch\u1eb7n \u01b0u ti\u00ean c\u00e1c th\u1ee5 th\u1ec3 beta-1. C\u00e1c thu\u1ed1c ch\u1eb9n beta kh\u00f4ng ch\u1ecdn l\u1ecdc c\u00f3 \u00e1i l\u1ef1c ngang nhau \u0111\u1ed1i v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 beta-1 v\u00e0 beta-2, trong khi c\u00e1c thu\u1ed1c ch\u1ecdn l\u1ecdc tr\u00ean tim s\u1ebd ch\u1ee7 y\u1ebfu \u1ee9c ch\u1ebf c\u00e1c th\u1ee5 th\u1ec3 beta 1. T\u00ednh ch\u1ecdn l\u1ecdc tr\u00ean tim l\u00e0 m\u1ed9t \u0111\u1eb7c t\u00ednh t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 s\u1ef1 \u1ee9c ch\u1ebf \u0111\u00e1ng k\u1ec3 th\u1ee5 th\u1ec3 beta-2 c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf li\u1ec1u cao h\u01a1n th\u01b0\u1eddng \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c.<\/p>\n<h3><strong>2.3. Ho\u1ea1t \u0111\u1ed9ng giao c\u1ea3m n\u1ed9i t\u1ea1i <\/strong><\/h3>\n<p>M\u1ed9t s\u1ed1 thu\u1ed1c ch\u1eb9n beta (ch\u1eb3ng h\u1ea1n nh\u01b0 pindolol v\u00e0 acebutolol) c\u00f3 ho\u1ea1t t\u00ednh giao c\u1ea3m n\u1ed9i t\u1ea1i, c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ho\u1ea1t \u0111\u1ed9ng ch\u1ee7 v\u1eadn t\u1eebng ph\u1ea7n, cung c\u1ea5p k\u00edch th\u00edch beta m\u1ee9c \u0111\u1ed9 th\u1ea5p khi ngh\u1ec9 ng\u01a1i nh\u01b0ng ho\u1ea1t \u0111\u1ed9ng nh\u01b0 thu\u1ed1c ch\u1eb9n beta \u0111i\u1ec3n h\u00ecnh khi ho\u1ea1t \u0111\u1ed9ng giao c\u1ea3m cao.<\/p>\n<h3><strong>2.4. Ho\u1ea1t \u0111\u1ed9ng ch\u1eb7n alpha-adrenergic\u00a0 <\/strong><\/h3>\n<p>Labetalol v\u00e0 carvedilol ng\u0103n ch\u1eb7n c\u1ea3 th\u1ee5 th\u1ec3 beta v\u00e0 alpha. K\u1ebft qu\u1ea3 l\u00e0 ch\u00fang l\u00e0m gi\u1ea3m s\u1ee9c c\u1ea3n m\u1ea1ch m\u00e1u ngo\u1ea1i vi v\u00e0 m\u1ea1ch v\u00e0nh. C\u1ea3 hai \u0111\u1ec1u ch\u1eb7n\u00a0beta kh\u00f4ng ch\u1ecdn l\u1ecdc kh\u00f4ng c\u00f3 ho\u1ea1t t\u00ednh giao c\u1ea3m n\u1ed9i t\u1ea1i.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Thu\u1ed1c ch\u1eb9n beta l\u00e0 li\u1ec7u ph\u00e1p \u0111\u1ea7u tay trong vi\u1ec7c ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng \u1edf b\u1ec7nh nh\u00e2n \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh m\u1ea1n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111au th\u1eaft ng\u1ef1c do g\u1eafng s\u1ee9c. 1. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh T\u00e1c d\u1ee5ng sinh l\u00fd [&hellip;]<\/p>\n","protected":false},"author":60,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Thu\u1ed1c ch\u1eb9n Beta trong h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh - Vinmec<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednhl\u00e0 li\u1ec7u ph\u00e1p \u0111\u1ea7u tay trong vi\u1ec7c ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng \u1edf b\u1ec7nh nh\u00e2n.\" \/>\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=\"Thu\u1ed1c ch\u1eb9n Beta trong h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh - 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