{"id":21723,"date":"2023-04-18T14:57:25","date_gmt":"2023-04-18T07:57:25","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21723"},"modified":"2023-04-18T15:41:32","modified_gmt":"2023-04-18T08:41:32","slug":"thuoc-chen-thu-the-angiotensin-ii-trong-dieu-tri-tang-huyet-ap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/thuoc-chen-thu-the-angiotensin-ii-trong-dieu-tri-tang-huyet-ap\/","title":{"rendered":"Thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II 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 ch\u1eb9n<\/strong>\u00a0th\u1ee5 th\u1ec3 Angiotensin II (ARB)<\/strong> th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p. <\/strong>ARB c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 t\u00e1c d\u1ee5ng \u0111\u00e3 th\u1ea5y khi \u0111\u01a1n tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c.<\/strong>\u00a0<\/strong><\/p>\n

1. Thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/h2>\n

Thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin II (ARB) can thi\u1ec7p v\u00e0o RAS b\u1eb1ng c\u00e1ch l\u00e0m suy y\u1ebfu s\u1ef1 g\u1eafn k\u1ebft c\u1ee7a angiotensin II v\u1edbi th\u1ee5 th\u1ec3 AT1 tr\u00ean m\u00e0ng t\u1ebf b\u00e0o, do \u0111\u00f3 \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a angiotensin II. \u1ee8c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a angiotensin II d\u1eabn \u0111\u1ebfn t\u0103ng n\u1ed3ng \u0111\u1ed9 renin, angiotensin I v\u00e0 angiotensin II trong huy\u1ebft t\u01b0\u01a1ng. Tuy nhi\u00ean, s\u1ef1 t\u00edch t\u1ee5 c\u00e1c ti\u1ec1n ch\u1ea5t n\u00e0y kh\u00f4ng l\u1ea5n \u00e1t \u0111\u01b0\u1ee3c s\u1ef1 phong t\u1ecfa th\u1ee5 th\u1ec3, b\u1eb1ng ch\u1ee9ng l\u00e0 s\u1ef1 s\u1ee5t gi\u1ea3m li\u00ean t\u1ee5c c\u1ea3 huy\u1ebft \u00e1p v\u00e0 n\u1ed3ng \u0111\u1ed9 aldosterone huy\u1ebft t\u01b0\u01a1ng.<\/p>\n

\"thuoc-chen-thu-the-angiotensin-ii-trong-dieu-tri-tang-huyet-ap\"
Thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/figcaption><\/figure>\n

2. S\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 ARB<\/h2>\n

C\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 v\u1ec1 d\u01b0\u1ee3c l\u00fd trong t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (ACE) v\u00e0 thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin II (ARB), nh\u01b0ng c\u00f3 m\u1ed9t s\u1ed1 kh\u00e1c bi\u1ec7t v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn. \u00cdt nh\u1ea5t ba y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 d\u01b0\u1ee3c l\u00fd:<\/p>\n

    \n
  • ACE l\u00e0 m\u1ed9t kininase. Do \u0111\u00f3, vi\u1ec7c \u1ee9c ch\u1ebf enzym n\u00e0y, enzym n\u00e0y th\u01b0\u1eddng l\u00e0m suy gi\u1ea3m bradykinin, b\u1eb1ng ch\u1ea5t \u1ee9c ch\u1ebf men chuy\u1ec3n s\u1ebd d\u1eabn \u0111\u1ebfn t\u0103ng n\u1ed3ng \u0111\u1ed9 kinin, m\u1ed9t t\u00e1c d\u1ee5ng kh\u00f4ng th\u1ea5y \u0111\u01b0\u1ee3c v\u1edbi ARB. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra ho c\u00f3 th\u1ec3 th\u1ea5y khi d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n (nh\u01b0ng kh\u00f4ng ph\u1ea3i v\u1edbi ARB), m\u1eb7c d\u00f9 n\u1ed3n g \u0111\u1ed9 bradykinin cao c\u0169ng c\u00f3 th\u1ec3 cung c\u1ea5p th\u00eam t\u00e1c d\u1ee5ng gi\u00e3n m\u1ea1ch v\u00e0 c\u00e1c l\u1ee3i \u00edch kh\u00e1c kh\u00f4ng \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y v\u1edbi ARB.<\/li>\n
  • B\u1eb1ng c\u00e1ch gi\u1ea3m s\u1ea3n xu\u1ea5t angiotensin II, thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a c\u1ea3 th\u1ee5 th\u1ec3 AT1 v\u00e0 AT2, ARBs ch\u1ec9 ch\u1eb9n th\u1ee5 th\u1ec3 AT1.<\/li>\n
  • \u1ede tim, th\u1eadn v\u00e0 c\u00f3 l\u1ebd c\u1ea3 m\u1ea1ch m\u00e1u, vi\u1ec7c s\u1ea3n xu\u1ea5t angiotensin II c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00fac t\u00e1c b\u1edfi c\u00e1c enzym kh\u00e1c ngo\u00e0i ACE, ch\u1eb3ng h\u1ea1n nh\u01b0 chymase. T\u00e1c d\u1ee5ng c\u1ee7a angiotensin II \u0111\u01b0\u1ee3c t\u1ea1o ra b\u1edfi ph\u1ea3n \u1ee9ng n\u00e0y c\u00f3 th\u1ec3 b\u1ecb \u1ee9c ch\u1ebf b\u1edfi ARB nh\u01b0ng kh\u00f4ng b\u1ecb \u1ee9c ch\u1ebf b\u1edfi ch\u1ea5t \u1ee9c ch\u1ebf men chuy\u1ec3n. Tuy nhi\u00ean, vai tr\u00f2 c\u1ee7a c\u00e1c enzym kh\u00f4ng ph\u1ea3i ACE n\u00e0y \u0111\u1ed1i v\u1edbi vi\u1ec7c t\u1ea1o ra angiotensin II in vivo , n\u1ebfu c\u00f3, l\u00e0 kh\u00f4ng ch\u1eafc ch\u1eafn.<\/li>\n<\/ul>\n

    3. Hi\u1ec7u qu\u1ea3 v\u00e0 li\u1ec1u l\u01b0\u1ee3ng<\/h2>\n

    ARB c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 t\u00e1c d\u1ee5ng \u0111\u00e3 th\u1ea5y khi \u0111\u01a1n tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng losartan , khi d\u00f9ng m\u1ed9t l\u1ea7n m\u1ed7i ng\u00e0y, kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c huy\u1ebft \u00e1p \u1edf m\u1ee9c \u0111\u1ed9 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1c thu\u1ed1c ARB kh\u00e1c (irbesartan , telmisartan , candesartan v\u00e0 valsartan). M\u1eb7t kh\u00e1c, losartan l\u00e0m gi\u1ea3m nh\u1eb9 axit uric huy\u1ebft t\u01b0\u01a1ng m\u00e0 kh\u00f4ng x\u1ea3y ra v\u1edbi c\u00e1c ARB kh\u00e1c, t\u00e1c d\u1ee5ng n\u00e0y l\u00e0 do t\u0103ng c\u01b0\u1eddng b\u00e0i ti\u1ebft axit uric. \u0110i\u1ec1u n\u00e0y d\u01b0\u1eddng nh\u01b0 \u0111\u01b0\u1ee3c trung gian \u00edt nh\u1ea5t m\u1ed9t ph\u1ea7n b\u1edfi s\u1ef1 \u1ee9c ch\u1ebf tr\u1ef1c ti\u1ebfp ch\u1ea5t trao \u0111\u1ed5i urat-anion g\u1ea7n nh\u1ea5t ch\u1ecbu tr\u00e1ch nhi\u1ec7m t\u00e1i h\u1ea5p thu urat.<\/p>\n

    Hi\u1ec7u qu\u1ea3 h\u1ea1 huy\u1ebft \u00e1p c\u1ee7a ARB d\u01b0\u1eddng nh\u01b0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n. Ngo\u00e0i ra, t\u00e1c d\u1ee5ng c\u1ee7a ARB v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n \u0111\u1ed1i v\u1edbi c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch c\u00f3 v\u1ebb t\u01b0\u01a1ng t\u1ef1 nhau.<\/p>\n

    C\u0169ng nh\u01b0 c\u00e1c t\u00e1c nh\u00e2n kh\u00e1c \u1ee9c ch\u1ebf RAS, hi\u1ec7u qu\u1ea3 c\u1ee7a ARB \u0111\u01b0\u1ee3c t\u0103ng c\u01b0\u1eddng khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi li\u1ec1u th\u1ea5p thu\u1ed1c l\u1ee3i ti\u1ec3u v\u00e0 gi\u1ea3m l\u01b0\u1ee3ng natri trong ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng. C\u0169ng nh\u01b0 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, ARB d\u01b0\u1eddng nh\u01b0 gi\u1ea3m thi\u1ec3u t\u00ecnh tr\u1ea1ng h\u1ea1 kali m\u00e1u v\u00e0 t\u0103ng axit uric m\u00e1u do \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u.<\/p>\n

    4. K\u1ebft lu\u1eadn thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/h2>\n
      \n
    • B\u1eb1ng c\u00e1ch gi\u1ea3m s\u1ea3n xu\u1ea5t angiotensin II, thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a c\u1ea3 th\u1ee5 th\u1ec3 AT1 v\u00e0 AT2;\u00a0 ARBs ch\u1ec9 ch\u1eb9n th\u1ee5 th\u1ec3 AT1.<\/li>\n
    • Trong tim, th\u1eadn v\u00e0 c\u00f3 l\u1ebd c\u1ea3 m\u1ea1ch m\u00e1u, vi\u1ec7c s\u1ea3n xu\u1ea5t angiotensin II c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00fac t\u00e1c b\u1edfi c\u00e1c enzym kh\u00e1c ngo\u00e0i ACE, ch\u1eb3ng h\u1ea1n nh\u01b0 chymase. T\u00e1c d\u1ee5ng c\u1ee7a angiotensin II \u0111\u01b0\u1ee3c t\u1ea1o ra b\u1edfi ph\u1ea3n \u1ee9ng n\u00e0y c\u00f3 th\u1ec3 b\u1ecb \u1ee9c ch\u1ebf b\u1edfi ARBs nh\u01b0ng kh\u00f4ng b\u1ecb \u1ee9c ch\u1ebf b\u1edfi thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n.<\/li>\n
    • ARB c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 khi d\u00f9ng \u0111\u01a1n tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c, bao g\u1ed3m c\u1ea3 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n.<\/li>\n
    • T\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p c\u1ee7a c\u1ea3 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 ARB \u0111\u01b0\u1ee3c t\u0103ng c\u01b0\u1eddng khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi thu\u1ed1c l\u1ee3i ti\u1ec3u li\u1ec1u th\u1ea5p v\u00e0 gi\u1ea3m l\u01b0\u1ee3ng natri trong ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng. C\u1ea3 hai lo\u1ea1i thu\u1ed1c n\u00e0y d\u01b0\u1eddng nh\u01b0 c\u0169ng gi\u1ea3m thi\u1ec3u t\u00ecnh tr\u1ea1ng h\u1ea1 kali m\u00e1u v\u00e0 t\u0103ng axit uric m\u00e1u do \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u.<\/li>\n
    • C\u1ea3 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 ARB th\u01b0\u1eddng \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c v\u1edbi 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 c\u1ea3 hai lo\u1ea1i thu\u1ed1c, bao g\u1ed3m t\u0103ng kali m\u00e1u v\u00e0 hi\u1ebfm khi ph\u00f9 m\u1ea1ch, c\u0169ng nh\u01b0 t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p t\u00ednh \u1edf b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u00edch m\u00e1u \u0111\u1ed9ng m\u1ea1ch hi\u1ec7u qu\u1ea3 th\u1ea5p (v\u00ed d\u1ee5: ti\u00eau ch\u1ea3y, n\u00f4n m\u1eeda v\u00e0 suy tim). Ho l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n. Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 ARB b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong th\u1eddi k\u1ef3 mang thai.<\/li>\n
    • Li\u1ec7u ph\u00e1p k\u1ebft h\u1ee3p v\u1edbi c\u1ea3 thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u00e0 ARB kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/li>\n<\/ul>\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 ch\u1eb9n\u00a0th\u1ee5 th\u1ec3 Angiotensin II (ARB) th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p. ARB c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 t\u00e1c d\u1ee5ng \u0111\u00e3 th\u1ea5y khi \u0111\u01a1n tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c.\u00a0 1. Thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II […]<\/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 ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II - 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 ch\u1eb9n\u00a0th\u1ee5 th\u1ec3 Angiotensin II (ARB) 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 ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Thu\u1ed1c \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng RAS, \u0111\u1eb7c bi\u1ec7t l\u00e0 thu\u1ed1c ch\u1eb9n\u00a0th\u1ee5 th\u1ec3 Angiotensin II (ARB) th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/thuoc-chen-thu-the-angiotensin-ii-trong-dieu-tri-tang-huyet-ap\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-18T07:57:25+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-18T08:41:32+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pressure-pregnant-room-young-adult-smile-2-300x200.jpg\" \/>\n<meta name=\"author\" content=\"L\u00ea Th\u1ecb \u00c1nh Kim\" \/>\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\u00ea Th\u1ecb \u00c1nh Kim\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 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\/18\/thuoc-chen-thu-the-angiotensin-ii-trong-dieu-tri-tang-huyet-ap\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/thuoc-chen-thu-the-angiotensin-ii-trong-dieu-tri-tang-huyet-ap\/\",\"name\":\"Thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 Angiotensin II - 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