{"id":22655,"date":"2023-04-16T23:22:48","date_gmt":"2023-04-16T16:22:48","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22655"},"modified":"2023-04-17T14:54:16","modified_gmt":"2023-04-17T07:54:16","slug":"tang-tieu-cau-nguyen-phat","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/tang-tieu-cau-nguyen-phat\/","title":{"rendered":"T\u1ed5ng quan v\u1ec1 b\u1ec7nh t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t"},"content":{"rendered":"

T\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t (Essential thrombocythemia -ET) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd trong nh\u00f3m b\u1ec7nh t\u0103ng sinh t\u1ee7y \u00e1c t\u00ednh. B\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 gia t\u0103ng b\u1ea5t th\u01b0\u1eddng s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u ngo\u1ea1i vi, s\u1ed1 l\u01b0\u1ee3ng m\u1eabu ti\u1ec3u c\u1ea7u trong t\u1ee7y x\u01b0\u01a1ng. Ti\u1ebfn tri\u1ec3n l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi xu\u1ea5t huy\u1ebft ho\u1eb7c huy\u1ebft kh\u1ed1i. Ch\u1ea9n \u0111o\u00e1n ET l\u00e0 m\u1ed9t ch\u1ea9n \u0111o\u00e1n lo\u1ea1i tr\u1eeb.<\/strong><\/p>\n

1. Gi\u1edbi thi\u1ec7u<\/h2>\n

T\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t (ET) l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh l\u00fd m\u00e1u hi\u1ebfm g\u1eb7p, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u0103ng s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nguy c\u01a1 cao cho c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn m\u00e1u, bao g\u1ed3m h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng (thrombosis) ho\u1eb7c xu\u1ea5t huy\u1ebft.<\/p>\n

\"tang-tieu-cau-nguyen-phat-anh-huong-den-dong-mau\"
T\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111\u00f4ng m\u00e1u<\/a><\/figcaption><\/figure>\n

2. Nguy\u00ean nh\u00e2n t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t<\/h2>\n

Nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a ET v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c r\u00f5 r\u00e0ng, tuy nhi\u00ean, c\u00e1c thay \u0111\u1ed5i di truy\u1ec1n trong t\u1ebf b\u00e0o g\u1ed1c t\u1ea1o m\u00e1u \u0111\u01b0\u1ee3c cho l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng. M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 kh\u00e1c c\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng t\u1edbi nguy c\u01a1 m\u1eafc b\u1ec7nh, bao g\u1ed3m tu\u1ed5i t\u00e1c, gi\u1edbi t\u00ednh, l\u1ecbch s\u1eed gia \u0111\u00ecnh v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng nh\u01b0 h\u00fat thu\u1ed1c.<\/p>\n

3. Tri\u1ec7u ch\u1ee9ng t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t<\/h2>\n

Tri\u1ec7u ch\u1ee9ng c\u1ee7a t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t c\u00f3 th\u1ec3 kh\u00f4ng r\u00f5 r\u00e0ng ho\u1eb7c kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n

3.1. Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/h3>\n

B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 than phi\u1ec1n \u0111au \u0111\u1ea7u, tri\u1ec7u ch\u1ee9ng th\u1ecb gi\u00e1c, \u0111au ng\u1ef1c kh\u00f4ng \u0111i\u1ec3n h\u00ecnh, r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c \u0111\u1ea7u chi v\u00e0 \u0111au \u0111\u1ecf chi.<\/p>\n

3.2. Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/h3>\n

L\u00e1ch to nh\u1eb9 trong 20-50% tr\u01b0\u1eddng h\u1ee3p<\/p>\n

Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y s\u1ea9y thai 3 th\u00e1ng \u0111\u1ea7u<\/p>\n

Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft: t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1c b\u1ec7nh l\u00fd ti\u1ec3u c\u1ea7u v\u00e0 m\u1ea1ch m\u00e1u kh\u00e1c,x\u1ea3y ra \u1edf v\u1ecb tr\u00ed n\u00f4ng v\u00e0 t\u1ef1 ph\u00e1t ho\u1eb7c sau ch\u1ea5n th\u01b0\u01a1ng nh\u1eb9.<\/p>\n

Bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i: th\u01b0\u1eddng g\u1eb7p h\u01a1n xu\u1ea5t huy\u1ebft, huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch hay g\u1eb7p h\u01a1n t\u0129nh m\u1ea1ch. Huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch hay g\u1eb7p \u1edf tim, n\u00e3o v\u00e0 m\u1ea1ch m\u00e1u ngo\u1ea1i vi. Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch th\u01b0\u1eddng h\u1ec7 th\u1ed1ng t\u0129nh m\u1ea1ch s\u00e2u chi d\u01b0\u1edbi, h\u1ec7 th\u1ed1ng n\u1ed9i t\u1ea1ng-m\u1ea1c treo tr\u00e0ng v\u00e0 xoang t\u0129nh m\u1ea1ch n\u00e3o.<\/p>\n

4. Ch\u1ea9n \u0111o\u00e1n t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t<\/h2>\n

Ch\u1ea9n \u0111o\u00e1n t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t l\u00e0 m\u1ed9t ch\u1ea9n \u0111o\u00e1n lo\u1ea1i tr\u1eeb.<\/p>\n

Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n \u0111\u00f2i h\u1ecfi ph\u1ea3i k\u1ebft h\u1ee3p nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nhau. C\u00e1c b\u00e1c s\u0129 s\u1ebd th\u0103m kh\u00e1m l\u00e2m s\u00e0ng \u0111\u1ec3 ki\u1ec3m tra c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 t\u00ecnh tr\u1ea1ng chung c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

Sau \u0111\u00f3, c\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u. N\u1ebfu s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u c\u1ee7a b\u1ec7nh nh\u00e2n cao h\u01a1n m\u1ee9c b\u00ecnh th\u01b0\u1eddng, c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c s\u1ebd \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nh\u01b0 sinh thi\u1ebft t\u1ee7y x\u01b0\u01a1ng, x\u00e9t nghi\u1ec7m c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh l\u00fd m\u00e1u kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y ra t\u00ecnh tr\u1ea1ng t\u0103ng ti\u1ec3u c\u1ea7u.<\/p>\n

Ngo\u00e0i ra, \u0111\u1ec3 g\u00f3p ph\u1ea7n ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c c\u1ee7a ET, c\u00e1c x\u00e9t nghi\u1ec7m di truy\u1ec1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 t\u00ecm ki\u1ebfm c\u00e1c thay \u0111\u1ed5i di truy\u1ec1n trong t\u1ebf b\u00e0o c\u1ee7a b\u1ec7nh nh\u00e2n, \u0111\u1ed9t bi\u1ebfn gen JAK2 V617F c\u00f3 th\u1ec3 g\u1eb7p trong kho\u1ea3ng 50% tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh.<\/p>\n

Theo h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t c\u1ee7a T\u1ed5 ch\u1ee9c Y t\u1ebf Th\u1ebf gi\u1edbi: sinh thi\u1ebft t\u1ee7y x\u01b0\u01a1ng v\u1edbi t\u0103ng sinh ch\u1ee7 y\u1ebfu d\u00f2ng m\u1eabu ti\u1ec3u c\u1ea7u v\u1edbi t\u0103ng s\u1ed1 l\u01b0\u1ee3ng c\u00e1c m\u1eabu ti\u1ec3u c\u1ea7u kh\u1ed5ng l\u1ed3 v\u00e0 tr\u01b0\u1edfng th\u00e0nh l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh nh\u01b0ng ti\u00eau chu\u1ea9n n\u00e0y ch\u01b0a bao gi\u1edd \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn v\u1ec1 m\u1eb7t ti\u1ec1n c\u1ee9u, v\u00e0 x\u00e9t nghi\u1ec7m t\u1ee7y s\u1ebd kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c b\u1ec7nh t\u0103ng ti\u1ec3u c\u1ea7u c\u01a1 b\u1ea3n v\u1edbi b\u1ec7nh \u0111a h\u1ed3ng c\u1ea7u, ngo\u00e0i ra vi\u1ec7c ph\u00e1t hi\u1ec7n c\u00e1c \u0111\u1ed9t bi\u1ebfn JAK2 V617F v\u00e0 t\u1ed5 h\u1ee3p gen BCR\/ABL s\u1ebd gi\u00fap ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t ET v\u1edbi t\u0103ng ti\u1ec3u c\u1ea7u trong b\u1ec7nh b\u1ea1ch c\u1ea7u m\u1ea1n d\u00f2ng t\u1ee7y.<\/p>\n

T\u1ed5ng h\u1ee3p c\u00e1c k\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c x\u00e9t nghi\u1ec7m tr\u00ean s\u1ebd gi\u00fap b\u00e1c s\u0129 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c v\u00e0 \u0111\u1ec1 xu\u1ea5t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u00e1c \u0111\u1ed9ng c\u1ee7a b\u1ec7nh v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

5. \u0110i\u1ec1u tr\u1ecb t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t<\/h2>\n

\u0110i\u1ec1u tr\u1ecb t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t nh\u1eb1m gi\u1ea3m thi\u1ec3u c\u00e1c tri\u1ec7u ch\u1ee9ng, bi\u1ebfn ch\u1ee9ng v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Tuy nhi\u00ean, \u0111i\u1ec1u tr\u1ecb ET l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh ph\u1ee9c t\u1ea1p v\u00e0 \u0111\u00f2i h\u1ecfi s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u ti\u00ean th\u01b0\u1eddng l\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng ti\u1ec3u c\u1ea7u \u0111\u1ec3 gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u. C\u00e1c lo\u1ea1i thu\u1ed1c nh\u01b0 hydroxyurea v\u00e0 interferon alpha \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u v\u00e0 ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn m\u00e1u. Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng ti\u1ec3u c\u1ea7u c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch, m\u1ec7t m\u1ecfi v\u00e0 r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a.<\/p>\n

Ngo\u00e0i ra, vi\u1ec7c th\u1ef1c hi\u1ec7n c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba nh\u01b0 t\u1eadp th\u1ec3 d\u1ee5c \u0111\u1ec1u \u0111\u1eb7n, ki\u1ec3m so\u00e1t c\u00e2n n\u1eb7ng v\u00e0 gi\u1ea3m stress c\u0169ng c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m thi\u1ec3u c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a ET v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn m\u00e1u c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

Vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p cho t\u1eebng b\u1ec7nh nh\u00e2n l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u00e1c \u0111\u1ed9ng c\u1ee7a b\u1ec7nh v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1edfi c\u00e1c b\u00e1c s\u0129 chuy\u00ean khoa \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb.<\/p>\n

6. K\u1ebft lu\u1eadn<\/h2>\n

T\u0103ng ti\u1ec3u c\u1ea7u ti\u00ean ph\u00e1t essential thrombocythemia (ET) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd m\u00e1u hi\u1ebfm g\u1eb7p, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u00ecnh tr\u1ea1ng t\u0103ng s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u. Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh \u0111\u00f2i h\u1ecfi s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nhau, bao g\u1ed3m c\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u, x\u00e9t nghi\u1ec7m di truy\u1ec1n, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thu\u1ed1c.<\/p>\n","protected":false},"excerpt":{"rendered":"

T\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t (Essential thrombocythemia -ET) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd trong nh\u00f3m b\u1ec7nh t\u0103ng sinh t\u1ee7y \u00e1c t\u00ednh. B\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 gia t\u0103ng b\u1ea5t th\u01b0\u1eddng s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u ngo\u1ea1i vi, s\u1ed1 l\u01b0\u1ee3ng m\u1eabu ti\u1ec3u c\u1ea7u trong t\u1ee7y x\u01b0\u01a1ng. Ti\u1ebfn tri\u1ec3n l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi xu\u1ea5t huy\u1ebft […]<\/p>\n","protected":false},"author":70,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"\nT\u1ed5ng quan v\u1ec1 b\u1ec7nh t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t (ET) l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh l\u00fd m\u00e1u hi\u1ebfm g\u1eb7p, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u0103ng s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u trong m\u00e1u\" \/>\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=\"T\u1ed5ng quan v\u1ec1 b\u1ec7nh t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t - 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