{"id":21645,"date":"2023-04-15T21:26:19","date_gmt":"2023-04-15T14:26:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21645"},"modified":"2023-04-17T14:43:44","modified_gmt":"2023-04-17T07:43:44","slug":"loi-tieu-thiazide-trong-dieu-tri-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/","title":{"rendered":"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng"},"content":{"rendered":"

L\u1ee3i ti\u1ec3u thiazide c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m thu kho\u1ea3ng 10-15 mmHg, l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng t\u1eeb 5 \u2013 10 mmHg. Thiazide c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p hi\u1ec7u qu\u1ea3 v\u1edbi h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00e1c \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 t\u1ed1t h\u01a1n.<\/strong><\/p>\n

1.Ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c l\u1ee3i ti\u1ec3u thiazide<\/strong><\/h2>\n

Thu\u1ed1c l\u1ee3i ti\u1ec3u thiazide \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p v\u1edbi m\u1ee9c \u0111\u1ed9 I m\u1ee9c b\u1eb1ng ch\u1ee9ng A theo khuy\u1ebfn c\u00e1o c\u1ee7a ESC\/ESH<\/a> 2019.<\/p>\n

L\u1ee3i ti\u1ec3u thiazide c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m thu kho\u1ea3ng 10-15 mmHg, l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng t\u1eeb 5 \u2013 10 mmHg. Ng\u01b0\u1eddi \u0111\u00e1p \u1ee9ng v\u1edbi thiazide th\u01b0\u1eddng c\u00f3 n\u1ed3ng \u0111\u1ed9 renin th\u1ea5p hay b\u1ecb t\u0103ng huy\u1ebft \u00e1p do dung n\u1ea1p nhi\u1ec1u mu\u1ed1i nh\u01b0 ng\u01b0\u1eddi gi\u00e0, ng\u01b0\u1eddi da \u0111en v\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n nh\u01b0 b\u00e9o ph\u00ec. Thiazide c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p hi\u1ec7u qu\u1ea3 v\u1edbi h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00e1c \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 t\u1ed1t h\u01a1n. S\u1ef1 kh\u00e1c nhau trong hi\u1ec7u qu\u1ea3 \u0111\u01a1n tr\u1ecb v\u1edbi thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n ho\u1eb7c ch\u1eb9n th\u1ee5 th\u1ec3 gi\u1eefa c\u00e1c ch\u1ee7ng t\u1ed9c (th\u01b0\u1eddng l\u00e0 ng\u01b0\u1eddi da \u0111en kh\u00f4ng \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111\u01a1n tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c thu\u1ed1c n\u00e0y) s\u1ebd gi\u1ea3m khi \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p thiazide.<\/p>\n

L\u1ee3i ti\u1ec3u thiazide th\u01b0\u1eddng \u00edt hi\u1ec7u qu\u1ea3 khi m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn gi\u1ea3m xu\u1ed1ng d\u01b0\u1edbi 40 mL\/ph\u00fat\/1,73m2 do thu\u1ed1c \u00edt \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn v\u1ecb tr\u00ed t\u00e1c d\u1ee5ng \u1edf \u1ed1ng l\u01b0\u1ee3n xa. Li\u1ec1u cao h\u01a1n c\u1ee7a l\u1ee3i ti\u1ec3u thiazide \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 g\u00e2y ra \u0111\u01b0\u1ee3c t\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh nh\u01b0ng vi\u1ec7c t\u0103ng li\u1ec1u thiazide th\u01b0\u1eddng kh\u00f3 \u00e1p d\u1ee5ng do c\u00f3 nguy c\u01a1 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n tr\u00ean chuy\u1ec3n h\u00f3a v\u00e0 \u0111i\u1ec7n gi\u1ea3i. C\u00f3 b\u1eb1ng ch\u1ee9ng g\u1ea7n \u0111\u00e2y cho th\u1ea5y chlorthalidone v\u1eabn gi\u1eef \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 \u1edf b\u1ec7nh nh\u00e2n t\u0103ng huy\u1ebft \u00e1p kh\u00f3 ki\u1ec3m so\u00e1t.<\/p>\n

\u1ede b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh k\u00e8m t\u0103ng huy\u1ebft \u00e1p, thu\u1ed1c l\u1ee3i ti\u1ec3u quai \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u01a1n v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng hai ho\u1eb7c ba l\u1ea7n m\u1ed7i ng\u00e0y \u0111\u1ec3 duy tr\u00ec hi\u1ec7u qu\u1ea3. Metolazone v\u1eabn gi\u1eef \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn khi c\u00e1c l\u1ee3i ti\u1ec3u kh\u00e1c b\u1ecb kh\u00e1ng. N\u00f3 c\u00f3 s\u1ef1 h\u1ea5p thu ch\u1eadm v\u00e0 b\u00e0i ti\u1ebft t\u1eebng l\u00fac, do \u0111\u00f3, kh\u1ea3 d\u1ee5ng sinh h\u1ecdc cao h\u01a1n c\u00e1c thiazide. Metolazone \u0111\u01b0\u1ee3c d\u00e0nh ri\u00eang k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u quai \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch. Thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng h\u1eb1ng ng\u00e0y trong m\u1ed9t th\u1eddi gian ng\u1eafn (3-5 ng\u00e0y) \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 th\u1ea3i d\u1ecbch, sau \u0111\u00f3 gi\u1ea3m xu\u1ed1ng kho\u1ea3ng ba l\u1ea7n m\u1ed7i tu\u1ea7n.<\/p>\n

L\u1ef1a ch\u1ecdn gi\u1eefa thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1ed1ng thiazide v\u00e0 thiazide: C\u00e1c nghi\u00ean c\u1ee9u cho r\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1ed1ng thiazide (nh\u01b0 chlorthalidone 12,5 \u2013 25 mg\/24h) \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u01a1n so v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u lo\u1ea1i thiazide. Tuy nhi\u00ean, s\u1ef1 l\u1ef1a ch\u1ecdn c\u00f3 th\u1ec3 thay \u0111\u1ed5i theo l\u00e2m s\u00e0ng:<\/p>\n

\u1ede h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc \u0111\u00e2y kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u thiazide, 12,5 \u2013 25 mg\/24h chlorthalidone ho\u1eb7c 1,25 \u2013 5 mg\/24h indapamide thay v\u00ec hydrochlorothiazide. Tuy nhi\u00ean, trong s\u1ed1 nh\u1eefng b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i c\u00f3 huy\u1ebft \u00e1p cao h\u01a1n 10mmHg so v\u1edbi huy\u1ebft \u00e1p m\u1ee5c ti\u00eau, hydrochlorothiazide li\u1ec1u th\u1ea5p l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn h\u1ee3p l\u00fd.<\/p>\n

Nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng hydrochlorothiazide li\u1ec1u th\u1ea5p ch\u01b0a \u0111\u1ea1t m\u1ee9c huy\u1ebft \u00e1p m\u1ee5c ti\u00eau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c chuy\u1ec3n sang chlorthalidone ho\u1eb7c indapamide.<\/p>\n

2.Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n
    \n
  • M\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn < 10 mL\/ph\u00fat. Qu\u00e1 m\u1eabn v\u1edbi thu\u1ed1c.<\/li>\n
  • B\u1ec7nh nh\u00e2n cho con b\u00fa.<\/li>\n<\/ul>\n

    3.C\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb chung v\u00e0 c\u00e1c b\u1eb1ng ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/h2>\n
      \n
    • Hi\u1ec7u qu\u1ea3 c\u1ee7a l\u1ee3i ti\u1ec3u thiazide trong vi\u1ec7c gi\u1ea3m c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch li\u00ean quan \u0111\u1ebfn t\u0103ng huy\u1ebft \u00e1p th\u01b0\u1eddng \u0111\u01b0\u1ee3c coi l\u00e0 t\u00e1c d\u1ee5ng chung c\u1ee7a c\u1ea3 nh\u00f3m, kh\u00f4ng c\u00f3 nghi\u00ean c\u1ee9u so s\u00e1nh tr\u1ef1c ti\u1ebfp c\u00e1c thu\u1ed1c trong nh\u00f3m.<\/li>\n
    • Tr\u00ean c\u01a1 s\u1edf l\u00e0m gi\u1ea3m c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch trong c\u00e1c nghi\u00ean c\u1ee9u, vi\u1ec7c s\u1eed d\u1ee5ng chlorthalidone th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng, v\u00ec c\u00e1c thu\u1ed1c l\u1ee3i ti\u1ec3u thiazide kh\u00e1c (\u0111\u1eb7c bi\u1ec7t l\u00e0 d\u1ef1a tr\u00ean hydrochlorothiazide) mang l\u1ea1i l\u1ee3i \u00edch \u00edt h\u01a1n trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng. M\u1ed9t v\u00e0i th\u1eed nghi\u1ec7m v\u1edbi hydrochlorothiazide trong \u0111\u00f3 \u0111\u00e3 l\u00e0m gi\u1ea3m c\u00e1c bi\u1ebfn c\u1ed1 b\u1ec7nh tim m\u1ea1ch khi s\u1eed d\u1ee5ng li\u1ec1u cao h\u01a1n (\u226525-50 mg\/24h) so v\u1edbi s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn hi\u1ec7n nay, trong khi ch\u1ebf \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb li\u1ec1u th\u1ea5p h\u01a1n trong s\u1eed d\u1ee5ng l\u00e2m s\u00e0ng ng\u00e0y nay \u0111\u01b0\u1ee3c cho r\u1eb1ng k\u00e9m h\u01a1n. Nguy\u00ean nh\u00e2n c\u1ee7a s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y v\u1eabn ch\u01b0a gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c. Hi\u1ec7n nay, ng\u01b0\u1eddi ta th\u1ea5y r\u1eb1ng chlorthalidone m\u1ea1nh g\u1ea5p 1,5 l\u1ea7n so v\u1edbi hydrochlorothiazide, khi \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 li\u00ean quan \u0111\u1ebfn li\u1ec1u c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee9c gi\u1ea3m t\u00edch tu\u1ea7n ho\u00e0n nh\u1ea5t \u0111\u1ecbnh.<\/li>\n
    • Thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1ed1ng thiazide (thiazide-like): Chlorthalidone v\u00e0 indapamide l\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1ed1ng thiazide th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, l\u00e0 thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p m\u1ea1nh h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi hydrochlorothiazide. Trong m\u1ed9t ph\u00e2n t\u00edch t\u1ed5ng h\u1ee3p c\u1ee7a 14 th\u1eed nghi\u1ec7m so s\u00e1nh vi\u1ec7c gi\u1ea3m huy\u1ebft \u00e1p v\u1edbi m\u1ed9t trong ba m\u1ee9c li\u1ec1u hydrochlorothiazide (th\u1ea5p, trung b\u00ecnh, cao) v\u1edbi m\u1ee9c li\u1ec1u t\u01b0\u01a1ng t\u1ef1 c\u1ee7a m\u1ed9t trong nh\u1eefng thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1ed1ng thiazide, gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m thu cao h\u01a1n v\u1edbi chlorthalidone v\u00e0 indapamide (t\u01b0\u01a1ng \u1ee9ng 3,6 v\u00e0 5,1 mmHg). Trong th\u1eed nghi\u1ec7m t\u0103ng huy\u1ebft \u00e1p tr\u00ean ng\u01b0\u1eddi cao tu\u1ed5i, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng indapamide \u0111\u00e3 gi\u00fap gi\u1ea3m \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 t\u1eed vong do \u0111\u1ed9t qu\u1ef5 39%, gi\u1ea3m 21% t\u1ef7 l\u1ec7 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n v\u00e0 gi\u1ea3m 64% t\u1ef7 l\u1ec7 suy tim.<\/li>\n
    • M\u1ed9t \u0111i\u1ec3m kh\u00e1c bi\u1ec7t quan tr\u1ecdng l\u00e0 th\u1eddi gian t\u00e1c d\u1ee5ng c\u1ee7a chlorthalidone v\u00e0 indapamide d\u00e0i h\u01a1n (24h tr\u1edf l\u00ean so v\u1edbi 6 \u2013 12h v\u1edbi hydrochlorothiazide).<\/li>\n<\/ul>\n

      4.Li\u1ec1u d\u00f9ng<\/strong><\/h2>\n

      Kho\u1ea3ng 50% b\u1ec7nh nh\u00e2n s\u1ebd \u0111\u00e1p \u1ee9ng li\u1ec1u ban \u0111\u1ea7u, ngay c\u1ea3 v\u1edbi li\u1ec1u nh\u1ecf. T\u0103ng li\u1ec1u hydrochlorothiazide l\u00ean 25 mg\/24h c\u00f3 th\u1ec3 t\u0103ng th\u00eam kho\u1ea3ng 20% cho ng\u01b0\u1eddi dung n\u1ea1p thu\u1ed1c, trong khi \u1edf m\u1ee9c 50 mg\/24h 80- 90% s\u1ed1 ng\u01b0\u1eddi \u0111\u01b0\u1ee3c \u0111o th\u1ea5y gi\u1ea3m huy\u1ebft \u00e1p, d\u00f9ng li\u1ec1u 50 mg\/24h s\u1ebd d\u1eabn \u0111\u1ebfn nguy c\u01a1 h\u1ea1 kali m\u00e1u cao (50% ho\u1eb7c cao h\u01a1n) v\u00e0 vi\u1ec7c b\u1ed5 sung kali ho\u1eb7c d\u00f9ng chung v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u gi\u1eef kali l\u00e0 c\u1ea7n thi\u1ebft. V\u00ec v\u1eady, th\u01b0\u1eddng kh\u00f4ng d\u00f9ng qu\u00e1 25 mg\/24h, m\u1eb7c d\u00f9 vi\u1ec7c t\u0103ng li\u1ec1u t\u1edbi 50 mg\/24h n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n b\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00e1ng thu\u1ed1c.<\/p>\n

      5.T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n v\u00e0 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c<\/strong><\/h2>\n

      5.1 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n<\/strong><\/h3>\n
        \n
      • Gi\u1ea3m Na+ , K+ , Cl\u2013 v\u00e0 Mg2+ \/m\u00e1u, g\u00e2y m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n, chu\u1ed9t r\u00fat.<\/li>\n
      • T\u0103ng acid uric m\u00e1u ( \u0111i\u1ec1u tr\u1ecb b\u1eb1ng probenecid).<\/li>\n
      • L\u00e0m n\u1eb7ng th\u00eam ti\u1ec3u \u0111\u01b0\u1eddng ( c\u01a1 ch\u1ebf ch\u01b0a bi\u1ebft r\u00f5)<\/li>\n
      • M\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 th\u1ea5y thiazide \u1ee9c ch\u1ebf gi\u1ea3i ph\u00f3ng insulin, v\u00e0 l\u00e0m t\u0103ng b\u00e0i ti\u1ebft catecholamin d\u1eabn \u0111\u1ebfn t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft.<\/li>\n
      • D\u1ecb \u1ee9ng<\/li>\n<\/ul>\n

        5.2 T\u01b0\u01a1ng t\u00e1c thu\u1ed1c.<\/strong><\/h3>\n
          \n
        • L\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c th\u1ea3i tr\u1eeb acid uric. L\u00e0m t\u0103ng t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c glycoside tr\u1ee3 tim.<\/li>\n
        • T\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u b\u1ecb gi\u1ea3m khi d\u00f9ng chung v\u1edbi NSAIDs, t\u0103ng nguy c\u01a1 h\u1ea1 kali m\u00e1u khi d\u00f9ng chung v\u1edbi amphotericin B v\u00e0 corticoid.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

          L\u1ee3i ti\u1ec3u thiazide c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m thu kho\u1ea3ng 10-15 mmHg, l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng t\u1eeb 5 \u2013 10 mmHg. Thiazide c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p hi\u1ec7u qu\u1ea3 v\u1edbi h\u1ea7u h\u1ebft c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00e1c \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 t\u1ed1t h\u01a1n. 1.Ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c […]<\/p>\n","protected":false},"author":7,"featured_media":21646,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"\nL\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng<\/title>\n<meta name=\"description\" content=\"L\u1ee3i ti\u1ec3u thiazide trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m, Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh.\" \/>\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=\"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng\" \/>\n<meta property=\"og:description\" content=\"L\u1ee3i ti\u1ec3u thiazide trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m, Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-15T14:26:19+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-17T07:43:44+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/thiazid-1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"500\" \/>\n\t<meta property=\"og:image:height\" content=\"365\" \/>\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\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/\",\"name\":\"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-15T14:26:19+00:00\",\"dateModified\":\"2023-04-17T07:43:44+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"L\u1ee3i ti\u1ec3u thiazide trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m, Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb 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":"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng","description":"L\u1ee3i ti\u1ec3u thiazide trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m, Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh.","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":"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng","og_description":"L\u1ee3i ti\u1ec3u thiazide trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m, Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/","og_site_name":"Vinmec","article_published_time":"2023-04-15T14:26:19+00:00","article_modified_time":"2023-04-17T07:43:44+00:00","og_image":[{"width":500,"height":365,"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/thiazid-1.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":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/","name":"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-15T14:26:19+00:00","dateModified":"2023-04-17T07:43:44+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"L\u1ee3i ti\u1ec3u thiazide trong \u0111i\u1ec1u tr\u1ecb l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m, Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/loi-tieu-thiazide-trong-dieu-tri-lam-sang\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"L\u1ee3i ti\u1ec3u thiazide v\u00e0 trong \u0111i\u1ec1u tr\u1ecb 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\/21645"}],"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=21645"}],"version-history":[{"count":1,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/21645\/revisions"}],"predecessor-version":[{"id":21647,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/21645\/revisions\/21647"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media\/21646"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=21645"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=21645"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=21645"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}