{"id":22613,"date":"2023-04-17T07:55:09","date_gmt":"2023-04-17T00:55:09","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22613"},"modified":"2023-04-17T11:01:31","modified_gmt":"2023-04-17T04:01:31","slug":"thuoc-gan-acid-mat-tu-co-che-den-chi-dinh-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/thuoc-gan-acid-mat-tu-co-che-den-chi-dinh-lam-sang\/","title":{"rendered":"Thu\u1ed1c g\u1eafn acid m\u1eadt: t\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng"},"content":{"rendered":"

Thu\u1ed1c g\u1eafn acid m\u1eadt l\u00e0 c\u00e1c polyme l\u1edbn li\u00ean k\u1ebft c\u00e1c acid m\u1eadt t\u00edch \u0111i\u1ec7n \u00e2m v\u00e0 mu\u1ed1i m\u1eadt trong ru\u1ed9t non, l\u00e0m m\u1ea5t vai tr\u00f2 c\u1ee7a c\u00e1c ch\u1ea5t n\u00e0y. Trong qu\u00e1 tr\u00ecnh ti\u00eau h\u00f3a b\u00ecnh th\u01b0\u1eddng, acid m\u1eadt \u0111\u01b0\u1ee3c ti\u1ebft ra trong m\u1eadt t\u1eeb gan v\u00e0 t\u00fai m\u1eadt v\u00e0o ru\u1ed9t. C\u00e1c acid m\u1eadt l\u00e0m nh\u0169 h\u00f3a c\u00e1c ch\u1ea5t b\u00e9o v\u00e0 lipid c\u00f3 trong th\u1ef1c ph\u1ea9m, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho vi\u1ec7c h\u1ea5p th\u1ee5 ch\u1ea5t b\u00e9o v\u00e0 vitamin h\u00f2a tan trong m\u1ee1 t\u1eeb ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng.<\/strong><\/p>\n

1.C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/strong><\/h2>\n
    \n
  • Thu\u1ed1c g\u1eafn acid m\u1eadt l\u00e0 c\u00e1c polyme l\u1edbn li\u00ean k\u1ebft c\u00e1c acid m\u1eadt t\u00edch \u0111i\u1ec7n \u00e2m v\u00e0 mu\u1ed1i m\u1eadt trong ru\u1ed9t non, l\u00e0m m\u1ea5t vai tr\u00f2 c\u1ee7a c\u00e1c ch\u1ea5t n\u00e0y.<\/li>\n
  • Trong qu\u00e1 tr\u00ecnh ti\u00eau h\u00f3a b\u00ecnh th\u01b0\u1eddng, acid m\u1eadt \u0111\u01b0\u1ee3c ti\u1ebft ra trong m\u1eadt t\u1eeb gan v\u00e0 t\u00fai m\u1eadt v\u00e0o ru\u1ed9t. C\u00e1c acid m\u1eadt l\u00e0m nh\u0169 h\u00f3a c\u00e1c ch\u1ea5t b\u00e9o v\u00e0 lipid c\u00f3 trong th\u1ef1c ph\u1ea9m, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho vi\u1ec7c h\u1ea5p th\u1ee5 ch\u1ea5t b\u00e9o v\u00e0 vitamin h\u00f2a tan trong m\u1ee1 t\u1eeb ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng. M\u1ed9t ph\u1ea7n ch\u00ednh c\u1ee7a acid m\u1eadt \u0111\u01b0\u1ee3c ti\u1ebft ra \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu t\u1eeb ru\u1ed9t v\u00e0 tr\u1edf v\u1ec1 gan th\u00f4ng qua tu\u1ea7n ho\u00e0n c\u1eeda, t\u1ea1o n\u00ean chu k\u1ef3 ru\u1ed9t gan. Tuy nhi\u00ean, kho\u1ea3ng 5% kh\u00f4ng \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu v\u00e0 acid m\u1eadt b\u1ed5 sung \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p t\u1eeb cholesterol c\u1ee7a gan.<\/li>\n
  • Khi acid m\u1eadt gi\u1ea3m, cholesterol trong gan \u0111\u01b0\u1ee3c chuy\u1ec3n th\u00e0nh acid m\u1eadt v\u00e0 c\u00f3 s\u1ef1 t\u0103ng b\u00f9 tr\u1eeb c\u00e1c th\u1ee5 th\u1ec3 LDL. \u0110\u01a1n tr\u1ecb li\u1ec7u v\u1edbi thu\u1ed1c g\u1eafn acid m\u1eadt l\u00e0m gi\u1ea3m LDL xu\u1ed1ng 5-30% ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u.<\/li>\n
  • Vi\u1ec7c gi\u1ea3m h\u00e0m l\u01b0\u1ee3ng cholesterol trong t\u1ebf b\u00e0o gan th\u00fac \u0111\u1ea9y s\u1ef1 gia t\u0103ng c\u00e1c th\u1ee5 th\u1ec3 LDL v\u00e0 t\u0103ng thanh th\u1ea3i LDL kh\u1ecfi tu\u1ea7n ho\u00e0n.<\/li>\n
  • Gi\u1ea3m LDL-C th\u01b0\u1eddng th\u1ea5y r\u00f5 trong v\u00f2ng 2 tu\u1ea7n v\u1edbi colesevelam v\u00e0 1 th\u00e1ng v\u1edbi colestipol v\u00e0 cholestyramine.<\/li>\n<\/ul>\n

    2.Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n

    C\u00e1c thu\u1ed1c g\u1eafn acid m\u1eadt \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 gi\u1ea3m LDL khi d\u00f9ng \u0111\u01a1n tr\u1ecb li\u1ec7u ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi statin \u0111\u1ec3 gi\u1ea3m LDL-C t\u0103ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb t\u0103ng lipid m\u00e1u nguy\u00ean ph\u00e1t.<\/p>\n

    3.Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n
      \n
    • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed t\u1eafc ru\u1ed9t, t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt ho\u00e0n to\u00e0n, t\u0103ng triglyceride l\u1edbn h\u01a1n 500 mg\/dL v\u00e0 c\u00f3 ti\u1ec1n s\u1eed vi\u00eam t\u1ee5y do triglyceride ho\u1eb7c qu\u00e1 m\u1eabn.<\/li>\n
    • Cholestyramine v\u00e0 colestipol l\u00e0 thu\u1ed1c nh\u00f3m C \u0111\u1ed1i v\u1edbi ph\u1ee5 n\u1eef mang thai. Vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c trong khi mang thai ho\u1eb7c cho con b\u00fa ho\u1eb7c b\u1edfi ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh \u0111\u1ebb \u0111\u00f2i h\u1ecfi c\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch ti\u1ec1m n\u0103ng v\u1edbi nguy c\u01a1 \u0111\u1ed1i v\u1edbi m\u1eb9 ho\u1eb7c con.<\/li>\n
    • Colesevelam l\u00e0 thu\u1ed1c lo\u1ea1i B d\u00e0nh cho b\u1ec7nh nh\u00e2n c\u00f3 thai v\u00e0 c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng trong thai k\u1ef3 n\u1ebfu c\u1ea7n thi\u1ebft.<\/li>\n<\/ul>\n

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

      4.1. Cholestyramine<\/h3>\n

      Li\u1ec1u kh\u1edfi \u0111\u1ea7u \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb l\u00e0 4 g, m\u1ed9t ho\u1eb7c hai l\u1ea7n m\u1ed7i ng\u00e0y. Li\u1ec1u duy tr\u00ec h\u1eb1ng ng\u00e0y l\u00e0 8-16 g, chia l\u00e0m 2 l\u1ea7n. C\u00e2n nh\u1eafc t\u0103ng li\u1ec1u thu\u1ed1c n\u1ebfu m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c sau th\u1eddi gian 4 tu\u1ea7n. Li\u1ec1u t\u1ed1i \u0111a h\u1eb1ng ng\u00e0y l\u00e0 24 g, n\u00ean d\u00f9ng thu\u1ed1c c\u00f9ng b\u1eefa \u0103n. M\u1eb7c d\u00f9 thu\u1ed1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o d\u00f9ng hai l\u1ea7n m\u1ed9t ng\u00e0y, cholestyramine c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng chia li\u1ec1u 1-6 l\u1ea7n trong ng\u00e0y.<\/p>\n

      4.2. Colestipol<\/h3>\n

      Li\u1ec1u kh\u1edfi \u0111\u1ea7u n\u00ean l\u00e0 5 g d\u1ea1ng h\u1ea1t nh\u1ecf m\u1ed9t ho\u1eb7c hai l\u1ea7n m\u1ed7i ng\u00e0y ho\u1eb7c hai vi\u00ean 1g m\u1ed9t l\u1ea7n ho\u1eb7c hai l\u1ea7n m\u1ed7i ng\u00e0y. T\u0103ng li\u1ec1u 5 g d\u1ea1ng h\u1ea1t nh\u1ecf\/24h ho\u1eb7c 2 g d\u1ea1ng vi\u00ean\/24h c\u1ee9 sau 1 \u2013 2 th\u00e1ng. Li\u1ec1u th\u01b0\u1eddng d\u00f9ng l\u00e0 5 \u2013 30 g\/24h d\u1ea1ng h\u1ea1t nh\u1ecf ho\u1eb7c 2-16 g d\u1ea1ng vi\u00ean\/24h m\u1ed9t l\u1ea7n ho\u1eb7c chia li\u1ec1u.<\/p>\n

      4.3. Colesevelam<\/h3>\n

      Li\u1ec1u d\u00f9ng l\u00e0 s\u00e1u vi\u00ean 625 mg m\u1ed7i ng\u00e0y m\u1ed9t l\u1ea7n ho\u1eb7c chia l\u00e0m hai l\u1ea7n. Thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng c\u00f9ng v\u1edbi b\u1eefa \u0103n v\u00e0 u\u1ed1ng nhi\u1ec1u n\u01b0\u1edbc.Thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng c\u00f9ng l\u00fac v\u1edbi statin ho\u1eb7c hai lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 d\u00f9ng c\u00e1ch nhau. Colesevelam c\u00f3 kh\u1ea3 n\u0103ng v\u00e0 \u00e1i l\u1ef1c v\u1edbi acid m\u1eadt l\u1edbn h\u01a1n so v\u1edbi cholestyramine ho\u1eb7c colestipol, v\u00ec v\u1eady thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf li\u1ec1u th\u1ea5p h\u01a1n. Sau khi b\u1eaft \u0111\u1ea7u, n\u00ean ki\u1ec3m tra lipid m\u00e1u sau 4-6 tu\u1ea7n. Kh\u00f4ng c\u00f3 khuy\u1ebfn c\u00e1o c\u1ee5 th\u1ec3 ho\u1eb7c c\u00e1ch \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u khi d\u00f9ng colesevelam cho b\u1ec7nh nh\u00e2n suy gan.<\/p>\n

      5.T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n<\/strong><\/h2>\n

      Ch\u1ea5t g\u1eafn acid m\u1eadt c\u00f3 th\u1ec3 g\u00e2y ra ho\u1eb7c l\u00e0m n\u1eb7ng th\u00eam ch\u1ee9ng t\u00e1o b\u00f3n t\u1eeb tr\u01b0\u1edbc. \u0110\u1ec3 gi\u1ea3m thi\u1ec3u t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n l\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a khi d\u00f9ng thu\u1ed1c g\u1eafn acid m\u1eadt n\u00ean d\u00f9ng li\u1ec1u ban \u0111\u1ea7u th\u1ea5p. Khi b\u1ecb t\u00e1o b\u00f3n, t\u0103ng l\u01b0\u1ee3ng ch\u1ea5t l\u1ecfng v\u00e0 ch\u1ea5t x\u01a1 trong kh\u1ea9u ph\u1ea7n \u0103n. T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n \u00edt g\u1eb7p h\u01a1n bao g\u1ed3m kh\u00f3 ch\u1ecbu \u1edf b\u1ee5ng, \u0111au b\u1ee5ng, \u0111\u1ea7y h\u01a1i, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n.<\/p>\n

      Thu\u1ed1c g\u1eafn acid m\u1eadt kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam d\u1ea1 d\u00e0y, r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a kh\u00e1c, \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 ph\u1eabu thu\u1eadt \u0111\u01b0\u1eddng ti\u00eau h\u00f3a l\u1edbn ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 b\u1ecb t\u1eafc ru\u1ed9t v\u00e0 nh\u1eefng ng\u01b0\u1eddi b\u1ecb t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt ho\u00e0n to\u00e0n.<\/p>\n

      Ch\u1ea5t g\u1eafn acid m\u1eadt c\u00f3 th\u1ec3 l\u00e0m t\u0103ng triglyceride. V\u00ed d\u1ee5, colesevelam c\u00f3 th\u1ec3 l\u00e0m t\u0103ng triglyceride l\u00ean 5% \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb t\u0103ng lipid m\u00e1u nguy\u00ean ph\u00e1t; tuy nhi\u00ean, m\u1ee9c t\u0103ng trung b\u00ecnh c\u1ee7a triglyceride l\u00e0 18-22% \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. X\u00e9t nghi\u1ec7m n\u1ed3ng \u0111\u1ed9 lipid l\u00fac \u0111\u00f3i n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb thu\u1ed1c g\u1eafn acid m\u1eadt, 3 th\u00e1ng sau khi b\u1eaft \u0111\u1ea7u, v\u00e0 c\u1ee9 sau 6 \u2013 12 th\u00e1ng sau \u0111\u00f3. N\u00ean ng\u1eebng d\u00f9ng thu\u1ed1c g\u1eafn acid m\u1eadt n\u1ebfu triglyceride v\u01b0\u1ee3t qu\u00e1 400 mg\/dL.<\/p>\n

      S\u1eed d\u1ee5ng thu\u1ed1c g\u1eafn acid m\u1eadt k\u00e9o d\u00e0i c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u0103ng kh\u1ea3 n\u0103ng ch\u1ea3y m\u00e1u do gi\u1ea3m prothrombin m\u00e1u v\u00e0 thi\u1ebfu vitamin K. Ngo\u00e0i ra, t\u00ecnh tr\u1ea1ng gi\u1ea3m folate huy\u1ebft thanh ho\u1eb7c h\u1ed3ng c\u1ea7u \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi s\u1eed d\u1ee5ng cholestyramine v\u00e0 colestipol gi\u1ea3m folate huy\u1ebft thanh ho\u1eb7c h\u1ed3ng c\u1ea7u m\u1ea1n t\u00ednh \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o\u2026 C\u00e1c ch\u1ea5t g\u1eafn acid m\u1eadt c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 h\u1ea5p thu c\u00e1c vitamin tan trong ch\u1ea5t b\u00e9o. B\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb vitamin n\u00ean u\u1ed1ng vitamin \u00edt nh\u1ea5t 4h tr\u01b0\u1edbc khi d\u00f9ng c\u00e1c thu\u1ed1c g\u1eafn acid m\u1eadt<\/p>\n","protected":false},"excerpt":{"rendered":"

      Thu\u1ed1c g\u1eafn acid m\u1eadt l\u00e0 c\u00e1c polyme l\u1edbn li\u00ean k\u1ebft c\u00e1c acid m\u1eadt t\u00edch \u0111i\u1ec7n \u00e2m v\u00e0 mu\u1ed1i m\u1eadt trong ru\u1ed9t non, l\u00e0m m\u1ea5t vai tr\u00f2 c\u1ee7a c\u00e1c ch\u1ea5t n\u00e0y. Trong qu\u00e1 tr\u00ecnh ti\u00eau h\u00f3a b\u00ecnh th\u01b0\u1eddng, acid m\u1eadt \u0111\u01b0\u1ee3c ti\u1ebft ra trong m\u1eadt t\u1eeb gan v\u00e0 t\u00fai m\u1eadt v\u00e0o ru\u1ed9t. C\u00e1c acid m\u1eadt l\u00e0m […]<\/p>\n","protected":false},"author":7,"featured_media":22615,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"\nThu\u1ed1c g\u1eafn acid m\u1eadt t\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c g\u1eafn acid m\u1eadt t\u1eeb c\u01a1 ch\u1ebf \u0111\u1ebfn ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng s\u1ebd c\u00f3 trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. 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