{"id":21658,"date":"2023-04-18T14:54:28","date_gmt":"2023-04-18T07:54:28","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21658"},"modified":"2023-04-18T15:43:10","modified_gmt":"2023-04-18T08:43:10","slug":"thuoc-uc-che-men-chuyen-angiotensin-trong-dieu-tri-tang-huyet-ap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/thuoc-uc-che-men-chuyen-angiotensin-trong-dieu-tri-tang-huyet-ap\/","title":{"rendered":"Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p"},"content":{"rendered":"

Thu\u1ed1c \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng renin-angiotensin (RAS), \u0111\u1eb7c bi\u1ec7t l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n angiotensin (ACE) th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u00eam \u01b0u \u0111i\u1ec3m l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 thu\u1eadn l\u1ee3i h\u01a1n so v\u1edbi thu\u1ed1c ch\u1eb9n giao c\u1ea3m, thu\u1ed1c ch\u1eb9n beta v\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u.\u00a0<\/strong><\/p>\n

1. T\u1ed5ng quan v\u1ec1 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin<\/h2>\n

K\u1ec3 t\u1eeb khi captopril \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u v\u00e0o n\u0103m 1977, thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ACE) \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p v\u00e0 ba bi\u1ebfn ch\u1ee9ng ch\u00ednh c\u1ee7a n\u00f3: nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p t\u00ednh, suy tim sung huy\u1ebft v\u00e0 b\u1ec7nh th\u1eadn m\u00e3n t\u00ednh. 50 – 60% b\u1ec7nh nh\u00e2n Da tr\u1eafng c\u00f3 \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi li\u1ec7u ph\u00e1p \u0111\u01a1n tr\u1ecb li\u1ec7u b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, t\u1ef7 l\u1ec7 \u0111\u00e1p \u1ee9ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p \u0111\u1ea7u tay kh\u00e1c. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u00eam \u01b0u \u0111i\u1ec3m l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 thu\u1eadn l\u1ee3i h\u01a1n so v\u1edbi thu\u1ed1c ch\u1eb9n giao c\u1ea3m, thu\u1ed1c ch\u1eb9n beta v\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u. Nhi\u1ec1u hi\u1ec7p h\u1ed9i \u0111\u00e3 khuy\u1ebfn c\u00e1o thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 angiotensin II (ARB) l\u00e0 li\u1ec7u ph\u00e1p \u0111\u1ea7u ti\u00ean ho\u1eb7c th\u1ee9 hai trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/p>\n

\"thuoc-uc-che-men-chuyen-angiotensin-trong-dieu-tri-tang-huyet-ap\"
Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1pdoctor and patient listen pulse<\/figcaption><\/figure>\n

2. Ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng c\u1ee5 th\u1ec3 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin<\/h2>\n

C\u00f3 m\u1ed9t s\u1ed1 b\u1ed1i c\u1ea3nh trong \u0111\u00f3 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n l\u00e0 thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn v\u00ec nh\u1eefng l\u1ee3i \u00edch c\u00f3 th\u1ec3 c\u00f3 ngo\u00e0i vi\u1ec7c h\u1ea1 huy\u1ebft \u00e1p<\/p>\n

Bao g\u1ed3m:<\/p>\n

    \n
  • Suy tim v\u1edbi ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m (HFrEF)<\/li>\n
  • B\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh protein ni\u1ec7u, c\u1ea3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 kh\u00f4ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/li>\n
  • Sau nh\u1ed3i m\u00e1u c\u01a1 tim \u1edf h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy tim ho\u1eb7c gi\u1ea3m ch\u1ee9c n\u0103ng t\u00e2m thu<\/li>\n<\/ul>\n

    3. \u0110\u00e1p \u1ee9ng h\u1ea1 huy\u1ebft \u00e1p<\/h2>\n

    S\u1ef1 h\u1ea1 huy\u1ebft \u00e1p sau s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n d\u01b0\u1eddng nh\u01b0 ch\u1ee7 y\u1ebfu l\u00e0 do gi\u1ea3m h\u00ecnh th\u00e0nh angiotensin II, nh\u01b0ng gi\u1ea3m tho\u00e1i h\u00f3a kinin c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n b\u1eb1ng c\u1ea3 gi\u00e3n m\u1ea1ch tr\u1ef1c ti\u1ebfp v\u00e0 t\u0103ng s\u1ea3n xu\u1ea5t prostaglandin gi\u00e3n m\u1ea1ch.<\/p>\n

    C\u00f4ng d\u1ee5ng c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u c\u00f3 t\u00e1c d\u1ee5ng hi\u1ec7p \u0111\u1ed3ng, \u0111\u1ea1t \u0111\u01b0\u1ee3c huy\u1ebft \u00e1p m\u1ee5c ti\u00eau \u1edf 85% b\u1ec7nh nh\u00e2n t\u0103ng huy\u1ebft \u00e1p nh\u1eb9. \u0110\u00e1p \u1ee9ng h\u1ea1 huy\u1ebft \u00e1p v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u th\u01b0\u1eddng b\u1ecb h\u1ea1n ch\u1ebf b\u1edfi s\u1ef1 gia t\u0103ng gi\u1ea3i ph\u00f3ng renin do gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n v\u00e0 sau \u0111\u00f3 l\u00e0 s\u1ea3n xu\u1ea5t angiotensin II, t\u00e1c d\u1ee5ng n\u00e0y \u0111\u01b0\u1ee3c ng\u0103n ch\u1eb7n b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf men chuy\u1ec3n, d\u1eabn \u0111\u1ebfn gi\u1ea3m huy\u1ebft \u00e1p n\u1ed5i b\u1eadt h\u01a1n. V\u00ec nh\u1eefng l\u00fd do t\u01b0\u01a1ng t\u1ef1, ch\u1ebf \u0111\u1ed9 \u0103n h\u1ea1n ch\u1ebf natri c\u0169ng c\u00f3 th\u1ec3 t\u0103ng c\u01b0\u1eddng ph\u1ea3n \u1ee9ng v\u1edbi ch\u1ea5t \u1ee9c ch\u1ebf men chuy\u1ec3n.<\/p>\n

    Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n gi\u1ea3m thi\u1ec3u m\u1ed9t s\u1ed1 thay \u0111\u1ed5i chuy\u1ec3n h\u00f3a g\u00e2y ra b\u1edfi li\u1ec7u ph\u00e1p l\u1ee3i ti\u1ec3u. V\u00ed d\u1ee5, h\u1ea1 kali m\u00e1u \u00edt n\u1ed5i b\u1eadt h\u01a1n v\u00ec gi\u1ea3m h\u00ecnh th\u00e0nh angiotensin II do thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n g\u00e2y ra d\u1eabn \u0111\u1ebfn gi\u1ea3m ti\u1ebft aldosterone. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u0169ng kh\u00f4ng g\u00e2y ra t\u00ecnh tr\u1ea1ng kh\u00f4ng dung n\u1ea1p glucose, t\u0103ng lipid m\u00e1u ho\u1eb7c t\u0103ng axit uric m\u00e1u; c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9 nh\u1ea1y insulin; v\u00e0 c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u ho\u1eb7c ng\u0103n ng\u1eeba s\u1ef1 gia t\u0103ng n\u1ed3ng \u0111\u1ed9 glucose, cholesterol v\u00e0 axit uric trong huy\u1ebft thanh do thu\u1ed1c l\u1ee3i ti\u1ec3u g\u00e2y ra.<\/p>\n

    Ngo\u00e0i thu\u1ed1c l\u1ee3i ti\u1ec3u, thu\u1ed1c ch\u1eb9n k\u00eanh canxi c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng hi\u1ec7u qu\u1ea3 v\u1edbi thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n.<\/p>\n

    4. Li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin<\/h2>\n

    C\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c, li\u1ec1u l\u01b0\u1ee3ng th\u00edch h\u1ee3p c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ef7 l\u1ec7 t\u00e1c d\u1ee5ng ph\u1ee5. \u0110\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 h\u1ea1 huy\u1ebft \u00e1p khi d\u00f9ng li\u1ec1u \u0111\u1ea7u ti\u00ean do n\u1ed3ng \u0111\u1ed9 angiotensin II gi\u1ea3m \u0111\u1ed9t ng\u1ed9t, b\u1ec7nh nh\u00e2n kh\u00f4ng n\u00ean b\u1ecb suy gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n. Li\u1ec1u ban \u0111\u1ea7u c\u00f3 th\u1ec3 gi\u1ea3m m\u1ed9t n\u1eeda \u1edf b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy tim c\u00f3 nguy c\u01a1 h\u1ea1 huy\u1ebft \u00e1p cao h\u01a1n. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c ngo\u00e0i t\u00e1c d\u1ee5ng ph\u1ee5 li\u00ean quan \u0111\u1ebfn h\u1ea1 huy\u1ebft \u00e1p c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 ho, \u00edt g\u1eb7p h\u01a1n l\u00e0 t\u0103ng kali m\u00e1u v\u00e0 hi\u1ebfm khi ph\u00f9 m\u1ea1ch. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong th\u1eddi k\u1ef3 mang thai<\/p>\n

    Th\u1eddi gian t\u00e1c d\u1ee5ng thay \u0111\u1ed5i v\u1edbi c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n kh\u00e1c nhau. M\u1ed9t s\u1ed1 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed9t l\u1ea7n m\u1ed7i ng\u00e0y (v\u00ed d\u1ee5: trandolapril, lisinopril v\u00e0 benazepril ). Vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i m\u1ed9t l\u1ea7n m\u1ed7i ng\u00e0y s\u1ebd c\u1ea3i thi\u1ec7n s\u1ef1 tu\u00e2n th\u1ee7 c\u1ee7a b\u1ec7nh nh\u00e2n, gi\u1ea3m chi ph\u00ed, duy tr\u00ec ki\u1ec3m so\u00e1t h\u01a1n v\u00e0 gi\u1ea3m t\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9t ng\u1ed9t khi th\u1ee9c d\u1eady v\u00e0o bu\u1ed5i s\u00e1ng s\u1edbm, hy v\u1ecdng nh\u1edd \u0111\u00f3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 m\u1eafc c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch nghi\u00eam tr\u1ecdng v\u00e0o th\u1eddi \u0111i\u1ec3m n\u00e0y .<\/p>\n

    Sau khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m tra l\u1ea1i sau v\u00e0i tu\u1ea7n \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 h\u1ea1 huy\u1ebft \u00e1p \u0111\u1ea7y \u0111\u1ee7. N\u1ebfu huy\u1ebft \u00e1p kh\u00f4ng gi\u1ea3m ho\u1eb7c gi\u1ea3m nh\u1eb9 khi d\u00f9ng \u0111\u1ee7 li\u1ec1u, c\u00f3 th\u1ec3 ng\u1eebng thu\u1ed1c v\u00e0 b\u1eaft \u0111\u1ea7u d\u00f9ng lo\u1ea1i thu\u1ed1c kh\u00e1c. Ngo\u00e0i ra, m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u00eam v\u00e0o, ch\u1eb3ng h\u1ea1n nh\u01b0 thu\u1ed1c ch\u1eb9n k\u00eanh canxi.<\/p>\n

    N\u1ebfu huy\u1ebft \u00e1p c\u1ee7a b\u1ec7nh nh\u00e2n gi\u1ea3m do thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n nh\u01b0ng kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c huy\u1ebft \u00e1p m\u1ee5c ti\u00eau, c\u00f3 th\u1ec3 t\u0103ng d\u1ea7n li\u1ec1u l\u01b0\u1ee3ng \u0111\u1ebfn m\u1ee9c t\u1ed1i \u0111a. Tuy nhi\u00ean, vi\u1ec7c b\u1ed5 sung m\u1ed9t lo\u1ea1i thu\u1ed1c th\u1ee9 hai t\u1eeb m\u1ed9t nh\u00f3m kh\u00e1c s\u1ebd mang l\u1ea1i hi\u1ec7u qu\u1ea3 h\u1ea1 huy\u1ebft \u00e1p l\u1edbn h\u01a1n nhi\u1ec1u.<\/p>\n

    \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch lan to\u1ea3 ho\u1eb7c suy th\u1eadn, nh\u1eefng ng\u01b0\u1eddi c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng b\u1ecb h\u1eb9p m\u1ea1ch m\u00e1u, n\u00ean \u0111o l\u1ea1i n\u1ed3ng \u0111\u1ed9 creatinine huy\u1ebft t\u01b0\u01a1ng trong v\u00f2ng m\u1ed9t \u0111\u1ebfn hai tu\u1ea7n sau khi b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n ho\u1eb7c ARB \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o duy tr\u00ec t\u01b0\u1edbi m\u00e1u th\u1eadn. Tuy nhi\u00ean, s\u1ef1 gia t\u0103ng v\u1eeba ph\u1ea3i v\u00e0 kh\u00f4ng t\u0103ng d\u1ea7n c\u1ee7a creatinine huy\u1ebft t\u01b0\u01a1ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y kh\u00f4ng n\u00ean ng\u1eebng \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Thu\u1ed1c \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng renin-angiotensin (RAS), \u0111\u1eb7c bi\u1ec7t l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n angiotensin (ACE) th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u00eam \u01b0u \u0111i\u1ec3m l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 thu\u1eadn l\u1ee3i h\u01a1n so v\u1edbi thu\u1ed1c ch\u1eb9n giao c\u1ea3m, thu\u1ed1c ch\u1eb9n beta v\u00e0 thu\u1ed1c […]<\/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":[3],"yoast_head":"\nThu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin - Vinmec<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng RAS, \u0111\u1eb7c bi\u1ec7t l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n angiotensin (ACE) th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.\" \/>\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 \u1ee9c ch\u1ebf men chuy\u1ec3n Angiotensin - 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