{"id":21493,"date":"2023-04-16T14:33:41","date_gmt":"2023-04-16T07:33:41","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21493"},"modified":"2023-04-17T12:43:30","modified_gmt":"2023-04-17T05:43:30","slug":"viem-teo-da-day-man-tinh-dinh-nghia-phan-loai-va-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/viem-teo-da-day-man-tinh-dinh-nghia-phan-loai-va-chan-doan\/","title":{"rendered":"Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh: \u0110\u1ecbnh ngh\u0129a, ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"<p><strong>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u00a0hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n l\u00e0 m\u1ed9t h\u00ecnh th\u00e1i c\u1ee7a vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 ngo\u00e0i h\u00ecnh \u1ea3nh th\u1ec3 hi\u1ec7n s\u1ef1 vi\u00eam m\u1ea1n t\u00ednh c\u00f2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e0m thi\u1ec3u s\u1ea3n (teo) bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y, c\u00f3 th\u1ec3 b\u1ecb thay th\u1ebf b\u1eb1ng bi\u1ec3u m\u00f4 tr\u1ee5 c\u1ee7a ru\u1ed9t. Nh\u00f3m b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eefng bi\u1ebfn ch\u1ee9ng n\u1eb7ng \u00a0n\u1ec1 h\u01a1n, \u0111\u1eb7c bi\u1ec7t l\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y, n\u00ean c\u1ea7n c\u00f3 chi\u1ebfn l\u01b0\u1ee3t ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/strong><\/p>\n<h2>1. \u0110\u1ecbnh ngh\u0129a v\u00e0 ph\u00e2n lo\u1ea1i<\/h2>\n<p>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh (chronic atrophic gastritis) hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n (metaplastic atrophic gastritis) l\u00e0 m\u1ed9t h\u00ecnh th\u00e1i c\u1ee7a vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 ngo\u00e0i h\u00ecnh \u1ea3nh m\u00f4 b\u1ec7nh h\u1ecdc th\u1ec3 hi\u1ec7n s\u1ef1 vi\u00eam m\u1ea1n t\u00ednh (s\u1ef1 x\u00e2m nhi\u1ec5m c\u1ee7a c\u00e1c t\u1ebf b\u00e0o vi\u00eam m\u1ea1n t\u00ednh &#8211; c\u00e1c t\u1ebf b\u00e0o \u0111\u01a1n nh\u00e2n nh\u01b0 mono b\u00e0o, t\u01b0\u01a1ng b\u00e0o v\u00e0 lympho b\u00e0o) c\u00f2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e0m thi\u1ec3u s\u1ea3n (teo) bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y c\u00f3 th\u1ec3 b\u1ecb thay th\u1ebf b\u1eb1ng bi\u1ec3u m\u00f4 tr\u1ee5 c\u1ee7a ru\u1ed9t.<\/p>\n<p>Vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u0111\u01b0\u1ee3c chia l\u00e0m 03 d\u1ea1ng ch\u00ednh d\u1ef1a tr\u00ean nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0ng ch\u1ee7 y\u1ebfu l\u00e0 h\u00ecnh th\u00e1i t\u1ed5n th\u01b0\u01a1ng quan s\u00e1t b\u1eb1ng n\u1ed9i soi hay b\u1eb1ng gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc. B\u00ean c\u1ea1nh vi\u00eam hang v\u1ecb do Helicobacter pylori, th\u00ec vi\u00eam teo ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh l\u00fd thu\u1ed9c nh\u00f3m vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh. Trong \u0111\u00f3, vi\u00eam teo d\u1ea1 d\u00e0y c\u00f3 hai d\u1ea1ng b\u1ec7nh ch\u00ednh l\u00e0 Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do t\u1ef1 mi\u1ec5n (autoimmune metaplastic atrophic gastritis \u00a0&#8211; AMAG) v\u00e0 Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do m\u00f4i tr\u01b0\u1eddng (environmental metaplastic atrophic gastritis &#8211; EMAG). Hai d\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 kh\u00e1c bi\u1ec7t v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh sinh b\u1ec7nh v\u00e0 c\u1ea3 h\u00ecnh th\u00e1i l\u00e2m s\u00e0ng. Nh\u01b0ng trong r\u1ea5t nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, c\u00f3 s\u1ef1 ch\u1ed3ng l\u1ea5p hai d\u1ea1ng n\u00e0y tr\u00ean m\u00f4 b\u1ec7nh h\u1ecdc d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e1i l\u00e2m s\u00e0ng kh\u00f3 ph\u00e2n bi\u1ec7t.<\/p>\n<ul>\n<li><strong>Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do t\u1ef1 mi\u1ec5n (autoimmune metaplastic atrophic gastritis \u00a0&#8211; AMAG)<\/strong> &#8211; L\u00e0 d\u1ea1ng sang th\u01b0\u01a1ng thi\u1ec3u d\u01b0\u1ee1ng (hay c\u00f2n g\u1ecdi l\u00e0 teo) v\u00e0 chuy\u1ec3n s\u1ea3n c\u1ee7a bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y, \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u1eadp trung \u1edf v\u00f9ng th\u00e2n v\u1ecb (corpus). C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean m\u00f4 h\u00ecnh \u0111\u1ed9ng v\u1eadt cho th\u1ea5y s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a kh\u00e1ng th\u1ec3 kh\u00e1ng b\u01a1m H+\/K+-ATPase tr\u00ean t\u1ebf b\u00e0o th\u00e0nh \u1edf m\u1ed9t s\u1ed1 c\u00e1 th\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c AMAG. \u0110\u1ed3ng th\u1eddi, c\u00e1c ch\u1ee9ng c\u1ee9 v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc c\u0169ng cho th\u1ea5y s\u1ef1 th\u00e2m nhi\u1ec5m b\u1ea5t thu\u1eddng c\u1ee7a c\u00e1c t\u1ebf b\u00e0o lympho T CD4+ v\u00e0 ph\u1ea3n \u1ee9ng b\u1ea5t th\u01b0\u1eddng c\u1ee7a c\u00e1c t\u1ebf b\u00e0o n\u00e0y v\u1edbi b\u01a1m H+\/K+-ATPase. B\u1eb1ng ch\u1ee9ng v\u1ec1 c\u01a1 ch\u1ebf c\u0169ng nh\u01b0 h\u00ecnh th\u00e1i c\u1ee7a ph\u1ea3n \u1ee9ng c\u1ee7a ph\u1ea3n \u1ee9ng t\u1ef1 mi\u1ec5n c\u1ee7a AMAG ch\u01b0a th\u1ef1c s\u1ef1 r\u00f5 r\u00e0ng.<\/li>\n<li><strong>Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do m\u00f4i tr\u01b0\u1eddng (environmental metaplastic atrophic gastritis &#8211; EMAG)<\/strong> &#8211; L\u00e0 d\u1ea1ng sang th\u01b0\u01a1ng thi\u1ec3u d\u01b0\u1ee1ng (hay c\u00f2n g\u1ecdi l\u00e0 teo) v\u00e0 chuy\u1ec3n s\u1ea3n ru\u1ed9t c\u1ee7a bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y, \u0111\u1eb7c tr\u01b0ng l\u00e0 ph\u00e2n b\u1ed1 c\u1ee7a sang th\u01b0\u01a1ng lan t\u1ecfa \u1edf c\u1ea3 hang v\u1ecb v\u00e0 th\u00e2n v\u1ecb. C\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 \u0111\u00f3ng g\u00f3p v\u00e0o c\u01a1 ch\u1ebf sinh b\u1ec7nh h\u1ecdc c\u1ee7a EMAG, trong \u0111\u00f3 ph\u1ea7n l\u1edbn \u0111\u1ec1u c\u00f3 li\u00ean quan \u0111\u1ebfn vi khu\u1ea9n HP. C\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn di truy\u1ec1n, ch\u1ee7ng t\u1ed9c \u0111\u1eb7c bi\u1ec7t l\u00e0 ch\u1ebf \u0111\u1ed9 \u0103n c\u0169ng g\u00f3p ph\u1ea7n v\u00e0o qu\u00e1 tr\u00ecnh b\u1ec7nh sinh c\u1ee7a EMAG. M\u1ed9t s\u1ed1 nh\u00f3m d\u00e2n t\u1ed9c c\u00f3 nguy c\u01a1 m\u1eafc EMAG cao bao g\u1ed3m ng\u01b0\u1eddi M\u1ef9 g\u1ed1c Phi, ng\u01b0\u1eddi Scandinavia, ng\u01b0\u1eddi \u00c1 ch\u00e2u, ng\u01b0\u1eddi M\u1ef9 Latinh, ng\u01b0\u1eddi Trung M\u1ef9 v\u00e0 Nam M\u1ef9, ng\u01b0\u1eddi Nh\u1eadt B\u1ea3n v\u00e0 Trung Qu\u1ed1c.<\/li>\n<\/ul>\n<h2>2. Ch\u1ea9n \u0111o\u00e1n vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh<\/h2>\n<p>Vi\u00eam teo ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh d\u1ef1a tr\u00ean c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc. Ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3o s\u00e1t l\u1ef1a ch\u1ecdn \u01b0u ti\u00ean l\u00e0 n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean c\u00f3 sinh thi\u1ebft. Ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean c\u00f3 sinh thi\u1ebft xu\u1ea5t ph\u00e1t t\u1eeb nghi ng\u1edd vi\u00eam d\u1ea1 d\u00e0y qua c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/p>\n<p>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a m\u1ed7i d\u1ea1ng trong nh\u00f3m n\u00e0y \u00a0(EMAG hay AMAG) c\u00f3 th\u1ec3 r\u1ea5t kh\u00e1c nhau v\u00e0 s\u1ebd \u0111\u01b0\u1ee3c b\u00e0n lu\u1eadn c\u1ee5 th\u1ec3 trong c\u00e1c b\u00e0i vi\u1ebft ri\u00eang c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd n\u00e0y. Trong vi\u00eam teo ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y, do s\u1ef1 t\u1ed5n th\u01b0\u01a1ng g\u00e2y thi\u1ec3u d\u01b0\u1ee1ng v\u00e0 chuy\u1ec3n s\u1ea3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o ch\u1ee9c n\u0103ng chuy\u00ean bi\u1ec7t c\u1ee7a tuy\u1ebfn d\u1ea1 d\u00e0y c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m b\u00e0i ti\u1ebft m\u1ed9t s\u1ed1 s\u1ea3n ph\u1ea9m quan tr\u1ecdng nh\u01b0: axit d\u1ea1 d\u00e0y, Pepsinogen v\u00e0 y\u1ebfu t\u1ed1 n\u1ed9i t\u1ea1i (intrinsic factor &#8211; c\u00f3 vai tr\u00f2 trong h\u1ea5p thu vitamin B12). M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng chung hay ph\u1ed5 bi\u1ebfn c\u00f3 th\u1ec3 g\u1eb7p l\u00e0: \u0111au b\u1ee5ng th\u01b0\u1ee3ng v\u1ecb, kh\u00f3 ti\u00eau, ti\u00eau ch\u1ea3y, thi\u1ebfu m\u00e1u v\u00e0 c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng lo\u1ea1n khu\u1ea9n d\u1ea1 d\u00e0y v\u00e0 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ru\u1ed9t.<\/p>\n<figure style=\"width: 377px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/th.bing.com\/th\/id\/OIG.TKoxve1Gxz1GqOxYRuo_?pid=ImgGn\" alt=\"Minh-hoa-viem-da-day-man\" width=\"377\" height=\"377\" \/><figcaption class=\"wp-caption-text\">Minh h\u1ecda vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh<\/figcaption><\/figure>\n<p>N\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean c\u00f3 sinh thi\u1ebft v\u1eeba c\u00f3 th\u1ec3 cung c\u1ea5p h\u00ecnh \u1ea3nh \u0111\u1ea1i th\u1ec3 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng vi\u00eam v\u1eeba c\u00f3 th\u1ec3 cho th\u00f4ng tin ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh qua ph\u00e2n t\u00edch m\u00f4 b\u1ec7nh h\u1ecdc. Nh\u01b0 \u0111\u00e3 \u0111\u1ec1 c\u1eadp \u1edf tr\u00ean, \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 ngo\u00e0i h\u00ecnh \u1ea3nh m\u00f4 b\u1ec7nh h\u1ecdc th\u1ec3 hi\u1ec7n s\u1ef1 vi\u00eam m\u1ea1n t\u00ednh (s\u1ef1 x\u00e2m nhi\u1ec5m c\u1ee7a c\u00e1c t\u1ebf b\u00e0o vi\u00eam m\u1ea1n t\u00ednh &#8211; c\u00e1c t\u1ebf b\u00e0o \u0111\u01a1n nh\u00e2n nh\u01b0 mono b\u00e0o, t\u01b0\u01a1ng b\u00e0o v\u00e0 lympho b\u00e0o) c\u00f2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e0m thi\u1ec3u s\u1ea3n (teo) bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y c\u00f3 th\u1ec3 b\u1ecb thay th\u1ebf b\u1eb1ng bi\u1ec3u m\u00f4 tr\u1ee5 c\u1ee7a ru\u1ed9t. Ph\u00e2n t\u00edch m\u00f4 b\u1ec7nh h\u1ecdc c\u00f2n cho ph\u00e9p \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9, qua \u0111\u00f3 ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng ung th\u01b0 h\u00f3a c\u1ee7a t\u1ed5n th\u01b0\u01a1ng chuy\u1ec3n s\u1ea3n. \u0110\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n tr\u00ean gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc, c\u00f3 th\u1ec3 d\u00f9ng thang OLGA\/OLGIM \u0111\u1ec3 \u0111\u00e1nh gi\u00e1.<\/p>\n<p>N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm, b\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m, trong \u0111\u00f3 c\u00f3 kh\u1ea3 n\u0103ng ph\u00e1t tri\u1ec3n th\u00e0nh ung th\u01b0 d\u1ea1 d\u00e0y. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe v\u00e0 ph\u00f2ng ng\u1eeba b\u1ec7nh ung th\u01b0 d\u1ea1 d\u00e0y. T\u1ea1i B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf <a href=\"https:\/\/www.vinmec.com\/vi\/dangkykham\/\">Vinmec,<\/a> c\u00e1c chuy\u00ean gia v\u00e0 k\u1ef9 thu\u1eadt hi\u1ec7n \u0111\u1ea1i trong l\u0129nh v\u1ef1c ti\u00eau h\u00f3a s\u1eb5n s\u00e0ng h\u1ed7 tr\u1ee3 v\u00e0 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u1ee7a b\u1ec7nh nh\u00e2n m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c v\u00e0 k\u1ecbp th\u1eddi.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u00a0hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n l\u00e0 m\u1ed9t h\u00ecnh th\u00e1i c\u1ee7a vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 ngo\u00e0i h\u00ecnh \u1ea3nh th\u1ec3 hi\u1ec7n s\u1ef1 vi\u00eam m\u1ea1n t\u00ednh c\u00f2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e0m thi\u1ec3u s\u1ea3n (teo) bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y, [&hellip;]<\/p>\n","protected":false},"author":37,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh: \u0110\u1ecbnh ngh\u0129a, ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/title>\n<meta name=\"description\" content=\"Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u00a0hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n l\u00e0 m\u1ed9t h\u00ecnh th\u00e1i c\u1ee7a vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh\" \/>\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 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