{"id":22584,"date":"2023-04-17T07:56:44","date_gmt":"2023-04-17T00:56:44","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22584"},"modified":"2023-04-17T10:59:46","modified_gmt":"2023-04-17T03:59:46","slug":"statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/","title":{"rendered":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft"},"content":{"rendered":"<p><strong>Statin l\u00e0 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ea7u tay trong vi\u1ec7c ki\u1ec3m so\u00e1t lipid m\u00e1u v\u00e0 gi\u1ea3m c\u00e1c nguy c\u01a1 tim m\u1ea1ch. \u0110\u00e2y l\u00e0 nh\u00f3m thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh h\u00e0ng \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00ec c\u00e1c b\u1eb1ng ch\u1ee9ng t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y hi\u1ec7u qu\u1ea3 r\u1ea5t r\u00f5 r\u00e0ng.<\/strong><\/p>\n<h2><strong>1.L\u1ecbch s\u1eed<\/strong><\/h2>\n<ul>\n<li>Thu\u1ed1c \u1ee9c ch\u1ebf HMG-CoA reductase, hay c\u00f2n g\u1ecdi v\u1edbi c\u00e1i t\u00ean quen thu\u1ed9c l\u00e0 statin, l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ch\u00ednh d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 d\u1ef1 ph\u00f2ng c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch.<\/li>\n<li>L\u00fd thuy\u1ebft \u0111\u1ea7u ti\u00ean v\u1ec1 vi\u1ec7c cholesterol c\u00f3 li\u00ean quan \u0111\u1ebfn v\u1eefa x\u01a1 \u0111\u1ed9ng m\u1ea1ch b\u1eaft \u0111\u1ea7u t\u1eeb \u0111\u1ea7u th\u1ebf k\u1ef7 XX, tuy nhi\u00ean khi \u0111\u00f3 cholesterol ch\u01b0a \u0111\u01b0\u1ee3c ch\u00fa \u00fd nhi\u1ec1u. \u0110\u1ea7u nh\u1eefng n\u0103m 1950, John Gofman, \u0111\u1ea1i h\u1ecdc Berkeley \u2013 California \u0111\u00e3 th\u1ef1c hi\u1ec7n nh\u1eefng nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc v\u00e0 th\u1ea5y r\u1eb1ng nh\u1eefng c\u01a1n \u0111au tim li\u00ean quan \u0111\u1ebfn t\u0103ng LDL (lipoprotein t\u1ef7 tr\u1ecdng th\u1ea5p), trong khi HDL (lipoprotein t\u1ef7 tr\u1ecdng cao) t\u0103ng, c\u00e1c c\u01a1n \u0111au tim \u00edt x\u1ea3y ra h\u01a1n.<\/li>\n<li>HMG-CoA reductase l\u00e0 enzyme ki\u1ec3m so\u00e1t t\u1ed1c \u0111\u1ed9 t\u1ed5ng h\u1ee3p cholesterol t\u1ea1i gan. C\u00e1c nh\u00e0 khoa h\u1ecdc nhanh ch\u00f3ng nh\u1eadn ra s\u1ef1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1ec1 c\u1ea5u tr\u00fac gi\u1eefa compactin v\u00e0 HMG-CoA (c\u01a1 ch\u1ea5t c\u1ee7a enzyme). Do \u0111\u00f3, c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng compactin \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t l\u00e0 \u1ee9c ch\u1ebf c\u1ea1nh tranh v\u1edbi enzyme.<\/li>\n<\/ul>\n<p>Th\u00e1ng 7\/1982, Merck b\u1eaft \u0111\u1ea7u c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng quy m\u00f4 l\u1edbn v\u1ec1 lovastatin tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao v\u00e0 nghi\u00ean c\u1ee9u \u0111\u1ed9c t\u00ednh l\u00e2u d\u00e0i tr\u00ean ch\u00f3 n\u0103m 1984. Thu\u1ed1c cho th\u1ea5y t\u00e1c d\u1ee5ng h\u1ea1 cholesterol m\u00e1u \u0111\u00e1ng k\u1ec3 v\u00e0 \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t, \u0111\u1ed3ng th\u1eddi kh\u00f4ng quan s\u00e1t th\u1ea5y kh\u1ed1i u n\u00e0o tr\u00ean ch\u00f3. N\u0103m 1987,<a href=\"https:\/\/www.fda.gov\/\"> FDA<\/a> \u0111\u00e3 c\u1ea5p ph\u00e9p l\u01b0u h\u00e0nh lovastatin. Sau \u0111\u00f3, c\u00f3 th\u00eam 5 statin \u0111\u01b0\u1ee3c th\u01b0\u01a1ng m\u1ea1i h\u00f3a, bao g\u1ed3m hai statin b\u00e1n t\u1ed5ng h\u1ee3p (simvastatin v\u00e0 pravastatin), 3 statin t\u1ed5ng h\u1ee3p (Rosuvastatin, atorvastatin v\u00e0 pitavastatin).<\/p>\n<h2><strong>2.D\u01b0\u1ee3c l\u00fd h\u1ecdc<\/strong><\/h2>\n<ul>\n<li>Statin l\u00e0 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ea7u tay trong vi\u1ec7c ki\u1ec3m so\u00e1t lipid m\u00e1u v\u00e0 gi\u1ea3m c\u00e1c nguy c\u01a1 tim m\u1ea1ch. \u0110\u00e2y l\u00e0 nh\u00f3m thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh h\u00e0ng \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00ec c\u00e1c b\u1eb1ng ch\u1ee9ng t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y hi\u1ec7u qu\u1ea3 r\u1ea5t r\u00f5 r\u00e0ng.<\/li>\n<li>C\u00e1c statin m\u1ea1nh v\u1eabn l\u00e0 \u01b0u ti\u00ean l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n lipid m\u00e1u, \u0111\u1eb7c bi\u1ec7t tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n t\u0103ng lipid m\u00e1u c\u00f3 t\u00ednh ch\u1ea5t gia \u0111\u00ecnh, b\u1ec7nh nh\u00e2n nguy c\u01a1 tim m\u1ea1ch r\u1ea5t cao, nguy c\u01a1 cao, trung b\u00ecnh.<\/li>\n<li>Statin l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf c\u1ea1nh tranh c\u1ee7a enzyme kh\u1eed 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) ch\u1ecbu tr\u00e1ch nhi\u1ec7m cho chuy\u1ec3n \u0111\u1ed5i HMG-CoA th\u00e0nh mevalonate, ti\u1ec1n ch\u1ea5t c\u1ee7a sterol, bao g\u1ed3m cholesterol. S\u1ef1 \u1ee9c ch\u1ebf sinh t\u1ed5ng h\u1ee3p cholesterol trong c\u00e1c t\u1ebf b\u00e0o gan k\u00edch th\u00edch h\u01a1n n\u1eefa s\u1ef1 t\u1ed5ng h\u1ee3p c\u00e1c th\u1ee5 th\u1ec3 LDL, do \u0111\u00f3 l\u00e0m t\u0103ng s\u1ef1 h\u1ea5p thu LDL, l\u00e0m gi\u1ea3m LDL-C trong m\u00e1u.<\/li>\n<li>T\u1ea5t c\u1ea3 c\u00e1c statin \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 nhanh, t\u1ed1i \u0111a trong v\u00f2ng 4h. Tuy nhi\u00ean, th\u1eddi gian b\u00e1n h\u1ee7y c\u1ee7a c\u00e1c thu\u1ed1c thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3. Atorvastatin v\u00e0 rosuvastatin c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y d\u00e0i h\u01a1n n\u00ean hi\u1ec7u qu\u1ea3 gi\u1ea3m cholesterol k\u00e9o d\u00e0i c\u1ea3 ng\u00e0y.<\/li>\n<li>T\u1ea5t c\u1ea3 c\u00e1c statin, ngo\u1ea1i tr\u1eeb pravastatin, \u0111\u1ec1u c\u00f3 t\u1ef7 l\u1ec7 g\u1eafn protein huy\u1ebft t\u01b0\u01a1ng cao v\u00e0 c\u00e1c statin n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng thay th\u1ebf c\u00e1c thu\u1ed1c li\u00ean k\u1ebft v\u1edbi albumin, nh\u01b0 warfarin. V\u00ed d\u1ee5, d\u00f9ng chung rosuvastatin ho\u1eb7c simvastatin c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng th\u1eddi gian prothrombin<\/li>\n<li>Statin chuy\u1ec3n h\u00f3a t\u1ea1i gan th\u00f4ng qua c\u00e1c enzyme cytochrome P450 (CYP). T\u01b0\u01a1ng t\u00e1c gi\u1eefa statin v\u00e0 c\u00e1c thu\u1ed1c kh\u00e1c x\u1ea3y ra do s\u1ef1 t\u00e1c \u0111\u1ed9ng qua l\u1ea1i v\u1edbi c\u00e1c isoenzyme CYP do k\u00edch th\u00edch ho\u1eb7c \u1ee9c ch\u1ebf.<\/li>\n<li>C\u00e1c thu\u1ed1c nh\u00f3m n\u00e0y kh\u00f4ng n\u00ean d\u00f9ng qu\u00e1 g\u1ea7n b\u1eefa \u0103n v\u00e0 c\u00f3 th\u1ec3 d\u00f9ng 1 l\u1ea7n trong ng\u00e0y tr\u01b0\u1edbc khi \u0111i ng\u1ee7. C\u00e1c statin kh\u00e1c nhau c\u00f3 hi\u1ec7u l\u1ef1c gi\u1ea3m n\u1ed3ng \u0111\u1ed9 LDL-C kh\u00e1c nhau. Th\u1ef1c t\u1ebf, li\u1ec1u d\u00f9ng c\u1ee7a statin \u0111\u01b0\u1ee3c t\u00ednh d\u1ef1a tr\u00ean ho\u1ea1t l\u1ef1c v\u00e0 \u0111\u00edch \u0111i\u1ec1u tr\u1ecb c\u1ea7n \u0111\u1ea1t (LDL-C).<\/li>\n<\/ul>\n<h2><strong>3. Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n<p>Statin \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u \u0111\u1ec3 ph\u00f2ng ng\u1eeba c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch ti\u00ean ph\u00e1t v\u00e0 th\u1ee9 ph\u00e1t.<\/p>\n<p>M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean ph\u00e2n t\u1ea7ng nguy c\u01a1 v\u00e0 n\u1ed3ng \u0111\u1ed9 c\u00e1c th\u00e0nh ph\u1ea7n lipid m\u00e1u. T\u00f9y theo t\u1ea7ng nguy c\u01a1 m\u00e0 c\u00f3 m\u1ed9t \u0111\u00edch \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau. Nh\u1eefng th\u00e0nh ph\u1ea7n lipid m\u00e1u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 ch\u1ec9 s\u1ed1 x\u00e1c \u0111\u1ecbnh \u0111\u00edch \u0111i\u1ec1u tr\u1ecb nh\u01b0 sau:<\/p>\n<ul>\n<li>LDL-C l\u00e0 \u0111\u00edch \u0111i\u1ec1u tr\u1ecb ch\u00ednh.<\/li>\n<li>Cholesterol to\u00e0n ph\u1ea7n (TC) c\u00f3 th\u1ec3 coi l\u00e0 \u0111\u00edch \u0111i\u1ec1u tr\u1ecb n\u1ebfu kh\u00f4ng c\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c.<\/li>\n<li>N\u00ean \u0111\u00e1nh gi\u00e1 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 c\u00f3 k\u1ebf ho\u1ea1ch can thi\u1ec7p khi b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n lipid m\u00e1u c\u00f3 t\u0103ng triglyceride nhi\u1ec1u.<\/li>\n<li>Non-HDL-C ho\u1eb7c Apo B l\u00e0 \u0111\u00edch \u0111i\u1ec1u tr\u1ecb th\u1ee9 hai \u1edf b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n lipid m\u00e1u th\u1ec3 h\u1ed7n h\u1ee3p, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, h\u1ed9i ch\u1ee9ng chuy\u1ec3n h\u00f3a ho\u1eb7c b\u1ec7nh th\u1eadn m\u1ea1n.<\/li>\n<li>T\u1ef7 l\u1ec7 apoB\/apoA1 v\u00e0 non-HDL-C\/HDL-C kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 \u0111\u00edch \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng quy.<\/li>\n<\/ul>\n<h3><strong>3.1 M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u (theo ESC 2019): D\u1ef1 ph\u00f2ng ti\u00ean ph\u00e1t:<\/strong><\/h3>\n<ul>\n<li><strong>Nh\u00f3m nguy c\u01a1 r\u1ea5t cao:<\/strong> M\u1ee5c ti\u00eau gi\u1ea3m LDL-C \u2265 50% so v\u1edbi m\u1ee9c n\u1ec1n (khi b\u1ec7nh nh\u00e2n ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng b\u1ea5t k\u1ef3 thu\u1ed1c h\u1ea1 lipid m\u00e1u n\u00e0o) v\u00e0 \u0111\u00edch LDL-C &lt; 1,4 mmol\/L (&lt; 55 mg\/dL).<\/li>\n<li><strong>Nh\u00f3m nguy c\u01a1 cao:<\/strong> M\u1ee5c ti\u00eau gi\u1ea3m LDL-C \u2265 50% so v\u1edbi m\u1ee9c n\u1ec1n (khi b\u1ec7nh nh\u00e2n ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng b\u1ea5t k\u1ef3 thu\u1ed1c h\u1ea1 lipid m\u00e1u n\u00e0o) v\u00e0 \u0111\u00edch LDL-C d\u01b0\u1edbi 1,8 mmol\/L (&lt; 100 mg\/dL).<\/li>\n<li><strong>Nh\u00f3m nguy c\u01a1 v\u1eeba:<\/strong> M\u1ee9c LDL-C t\u1ed1t nh\u1ea5t d\u01b0\u1edbi 2,6 mmol\/L (&lt; 115 mg\/dL). Nh\u00f3m nguy c\u01a1 th\u1ea5p: M\u1ee9c LDL-C t\u1ed1t nh\u1ea5t d\u01b0\u1edbi 3,0 mmol\/L (&lt; 116 mg\/dL). M\u1ee5c ti\u00eau ph\u1ee5 bao g\u1ed3m: Non \u2013 HDL; apo-B. Trong \u0111\u00f3 m\u1ee5c ti\u00eau c\u1ee7a non-HDL t\u01b0\u01a1ng \u1ee9ng v\u1edbi m\u1ee5c ti\u00eau LDL-C + 0,8 mmol\/L cho t\u1eebng nh\u00f3m nguy c\u01a1 n\u00f3i tr\u00ean. M\u1ee5c ti\u00eau c\u1ee7a apo-B cho c\u00e1c nh\u00f3m b\u1ec7nh nh\u00e2n nguy c\u01a1 r\u1ea5t cao, cao v\u00e0 trung b\u00ecnh l\u1ea7n l\u01b0\u1ee3t l\u00e0 65,80 v\u00e0 100 mg\/dL.<\/li>\n<\/ul>\n<h3><strong>3.2 D\u1ef1 ph\u00f2ng th\u1ee9 ph\u00e1t:<\/strong><\/h3>\n<ul>\n<li><strong>Nguy c\u01a1 r\u1ea5t cao:<\/strong> M\u1ee5c ti\u00eau gi\u1ea3m LDL-C \u2265 50% so v\u1edbi m\u1ee9c n\u1ec1n (khi b\u1ec7nh nh\u00e2n ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng b\u1ea5t k\u1ef3 thu\u1ed1c h\u1ea1 lipid m\u00e1u n\u00e0o) v\u00e0 \u0111\u00edch LDL-C &lt; 1,4 mmol\/L (&lt; 55 mg\/dL).<\/li>\n<li>N\u1ebfu b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb li\u1ec1u statin t\u1ed1i \u0111a dung n\u1ea1p \u0111\u01b0\u1ee3c x\u1ea3y ra bi\u1ebfn c\u1ed1 tim m\u1ea1ch l\u1ea7n 2 (kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i c\u00f9ng m\u1ed9t lo\u1ea1i bi\u1ebfn c\u1ed1 tim m\u1ea1ch l\u1ea7n \u0111\u1ea7u) trong v\u00f2ng 2 n\u0103m, c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc thay \u0111\u1ed5i m\u1ee5c ti\u00eau LDL-C th\u00e0nh 1,0 mmol\/L.<\/li>\n<\/ul>\n<h2><strong>4. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n<ul>\n<li>Ph\u1ee5 n\u1eef \u0111ang mang thai v\u00e0 cho con b\u00fa do \u1ea3nh h\u01b0\u1edfng t\u1edbi thai nhi.<\/li>\n<li>B\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh gan giai \u0111o\u1ea1n ho\u1ea1t \u0111\u1ed9ng ho\u1eb7c t\u0103ng men gan k\u00e9o d\u00e0i kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c.<\/li>\n<li>B\u1ec7nh nh\u00e2n qu\u00e1 m\u1eabn c\u1ea3m v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c.<\/li>\n<li>Simvastatin v\u00e0 lovastatin b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh khi s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf CYP3A4 m\u1ea1nh (v\u00ed d\u1ee5: itraconazole, ketoconazole, posaconazole, voriconazole, \u1ee9c ch\u1ebf HIV protease, boceprevir, telaprevir, kh\u00e1ng sinh macrolid erythromycin v\u00e0 clarithromycin, kh\u00e1ng sinh ketolid telithromycin, thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m nefazodone s\u1ea3n ph\u1ea9m ch\u1ee9a cobicistat). Simvastatin ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng, cyclosporin ho\u1eb7c danazol. Pitavastatin ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong khi d\u00f9ng \u0111\u1ed3ng th\u1eddi cyclosporine.<\/li>\n<\/ul>\n<h3><strong>5. T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n<\/strong><\/h3>\n<h3>5.1 T\u1ed5n th\u01b0\u01a1ng c\u01a1<\/h3>\n<p>L\u00e0 m\u1ed9t t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n ph\u1ed5 bi\u1ebfn khi s\u1eed d\u1ee5ng statin. T\u1ed5n th\u01b0\u01a1ng c\u01a1 c\u00f3 th\u1ec3 \u1edf d\u1ea1ng ti\u00eau c\u01a1 v\u00e2n c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p. S\u1eed d\u1ee5ng statin v\u1edbi c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf CYP l\u00e0m t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng c\u01a1 v\u00e0 n\u00ean ng\u1eebng s\u1eed d\u1ee5ng n\u1ebfu n\u1ed3ng \u0111\u1ed9 CK t\u0103ng cao r\u00f5 r\u1ec7t ho\u1eb7c b\u1ec7nh c\u01a1 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ho\u1eb7c nghi ng\u1edd.<\/p>\n<p>Ch\u1ec9nh li\u1ec1u statin \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o khi s\u1eed d\u1ee5ng c\u00f9ng, cyclosporin ho\u1eb7c thu\u1ed1c \u1ee9c ch\u1ebf CYP3A4. C\u1ea7n th\u1eadn tr\u1ecdng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 y\u1ebfu t\u1ed1 d\u1ec5 g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u01a1: Tr\u00ean 65 tu\u1ed5i, n\u1eef, suy gi\u00e1p ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ho\u1eb7c suy th\u1eadn. C\u00e1c tri\u1ec7u ch\u1ee9ng t\u1ea1i c\u01a1 th\u01b0\u1eddng h\u1ebft trong v\u00f2ng 2 th\u00e1ng sau khi ng\u1eebng thu\u1ed1c.<\/p>\n<p>N\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng t\u1eeb nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh, c\u00f3 th\u1ec3 t\u1ea1m ng\u1eebng statin cho \u0111\u1ebfn khi c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u1ea1i. N\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111au c\u01a1 h\u1ebft v\u00e0 n\u1ebfu kh\u00f4ng c\u00f2n ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng li\u1ec1u ban \u0111\u1ea7u ho\u1eb7c li\u1ec1u th\u1ea5p h\u01a1n \u0111\u1ec3 t\u00ecm m\u1ed1i li\u00ean quan gi\u1eefa c\u00e1c tri\u1ec7u ch\u1ee9ng t\u1ea1i c\u01a1 v\u00e0 li\u1ec7u ph\u00e1p statin. N\u1ebfu \u0111au c\u01a1 xu\u1ea5t hi\u1ec7n tr\u1edf l\u1ea1i n\u00ean ng\u1eebng s\u1eed d\u1ee5ng statin cho \u0111\u1ebfn khi c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111au c\u01a1 h\u1ebft, b\u1eaft \u0111\u1ea7u d\u00f9ng li\u1ec1u l\u1ea1i v\u00e0 \u0111\u1ed5i sang statin kh\u00e1c.<\/p>\n<p>C\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid kh\u00e1c (nh\u01b0 ezetimibe, ch\u1ea5t c\u00f4 l\u1eadp acid m\u1eadt (BAS) v\u00e0 niacin) l\u00e0 thu\u1ed1c thay th\u1ebf \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng dung n\u1ea1p statin.<\/p>\n<h3>5.2 T\u1ed5n th\u01b0\u01a1ng gan:<\/h3>\n<p>V\u1edbi m\u1ee9c t\u0103ng alanine aminotransferase (ALT) nh\u1ecf h\u01a1n 1,2% v\u00e0 t\u0103ng l\u00ean 2,3% v\u1edbi li\u1ec1u cao. T\u0103ng men gan th\u01b0\u1eddng x\u1ea3y ra trong 3 th\u00e1ng \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb (c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn thay \u0111\u1ed5i th\u00e0nh ph\u1ea7n lipid c\u1ee7a m\u00e0ng t\u1ebf b\u00e0o gan, d\u1eabn \u0111\u1ebfn t\u0103ng t\u00ednh th\u1ea5m). N\u00ean ki\u1ec3m tra n\u1ed3ng \u0111\u1ed9 AST v\u00e0 ALT tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. T\u1ed5n th\u01b0\u01a1ng gan n\u1eb7ng do statin l\u00e0 r\u1ea5t hi\u1ebfm. Tuy nhi\u00ean, n\u1ebfu c\u00f3 t\u1ed5n th\u01b0\u01a1ng gan v\u00e0 kh\u00f4ng t\u00ecm th\u1ea5y nguy\u00ean nh\u00e2n kh\u00e1c, c\u1ea7n gi\u1ea3m li\u1ec1u ho\u1eb7c \u0111\u1ed5i sang thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u kh\u00e1c.<\/p>\n<h3>5.3 Gi\u1ea3m tr\u00ed nh\u1edb v\u00e0 nh\u1ea7m l\u1eabn<\/h3>\n<p>C\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi s\u1eed d\u1ee5ng statin; tuy nhi\u00ean, nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00e0y r\u1ea5t hi\u1ebfm g\u1eb7p, th\u01b0\u1eddng kh\u00f4ng nghi\u00eam tr\u1ecdng, kh\u00f4ng d\u1eabn \u0111\u1ebfn suy gi\u1ea3m nh\u1eadn th\u1ee9c v\u00e0 th\u01b0\u1eddng ph\u1ee5c h\u1ed3i sau khi ng\u1eebng s\u1eed d\u1ee5ng statin. Th\u1eddi gian kh\u1edfi ph\u00e1t r\u1ea5t thay \u0111\u1ed5i, t\u1eeb m\u1ed9t ng\u00e0y \u0111\u1ebfn nhi\u1ec1u n\u0103m sau khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/p>\n<h3>5.4 T\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng:<\/h3>\n<p>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng statin c\u00f3 li\u00ean quan \u0111\u1ebfn t\u0103ng t\u1ef7 l\u1ec7 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1edbi xu\u1ea5t hi\u1ec7n. Trong m\u1ed9t ph\u00e2n t\u00edch t\u1ed5ng h\u1ee3p tr\u00ean 13 nghi\u00ean c\u1ee9u tr\u00ean 91.140 b\u1ec7nh nh\u00e2n, nh\u00f3m s\u1eed d\u1ee5ng statin t\u0103ng 9% nguy c\u01a1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea. Nguy c\u01a1 n\u00e0y cao h\u01a1n \u1edf nh\u00f3m ng\u01b0\u1eddi cao tu\u1ed5i.<\/p>\n<p>Ph\u00e2n t\u00edch k\u1ebft qu\u1ea3 c\u1ee7a nghi\u00ean c\u1ee9u JUPITER cho th\u1ea5y nguy c\u01a1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng cao h\u01a1n \u1edf nh\u1eefng nh\u00f3m b\u1ec7nh nh\u00e2n c\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u h\u01a1n c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. C\u00e1c b\u1eb1ng ch\u1ee9ng kh\u00e1c c\u0169ng \u1ee7ng h\u1ed9 quan \u0111i\u1ec3m n\u00e0y li\u00ean quan \u0111\u1ebfn nhi\u1ec1u thu\u1ed1c thu\u1ed9c nh\u00f3m statin nh\u01b0 rosuvastatin, atorvastatin, pravastatin. C\u01a1 ch\u1ebf c\u1ee7a hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng gi\u1ea3m ti\u1ebft insulin \u1edf t\u1ee5y v\u00e0 gi\u1ea3m nh\u1ea1y c\u1ea3m c\u1ee7a insulin \u1edf ngo\u1ea1i bi\u00ean.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Statin l\u00e0 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ea7u tay trong vi\u1ec7c ki\u1ec3m so\u00e1t lipid m\u00e1u v\u00e0 gi\u1ea3m c\u00e1c nguy c\u01a1 tim m\u1ea1ch. \u0110\u00e2y l\u00e0 nh\u00f3m thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh h\u00e0ng \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00ec c\u00e1c b\u1eb1ng ch\u1ee9ng t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":22585,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft<\/title>\n<meta name=\"description\" content=\"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. T\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng\" \/>\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=\"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft\" \/>\n<meta property=\"og:description\" content=\"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. T\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-17T00:56:44+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-17T03:59:46+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/images_medium_figure1.gif\" \/>\n\t<meta property=\"og:image:width\" content=\"500\" \/>\n\t<meta property=\"og:image:height\" content=\"425\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/gif\" \/>\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=\"9 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\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/\",\"name\":\"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-17T00:56:44+00:00\",\"dateModified\":\"2023-04-17T03:59:46+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. T\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft\"}]},{\"@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":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft","description":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. T\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng","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":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft","og_description":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. T\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/","og_site_name":"Vinmec","article_published_time":"2023-04-17T00:56:44+00:00","article_modified_time":"2023-04-17T03:59:46+00:00","og_image":[{"width":500,"height":425,"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/images_medium_figure1.gif","type":"image\/gif"}],"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":"9 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/","name":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-17T00:56:44+00:00","dateModified":"2023-04-17T03:59:46+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c cung c\u1ea5p trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. T\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/statin-trong-dieu-tri-roi-loan-lipid-mau-va-cac-van-de-can-biet\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Statin trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n lipid m\u00e1u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ea7n bi\u1ebft"}]},{"@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\/22584"}],"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=22584"}],"version-history":[{"count":2,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22584\/revisions"}],"predecessor-version":[{"id":22589,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22584\/revisions\/22589"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media\/22585"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=22584"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=22584"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=22584"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}