{"id":22805,"date":"2023-04-18T15:29:49","date_gmt":"2023-04-18T08:29:49","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22805"},"modified":"2023-04-18T15:41:55","modified_gmt":"2023-04-18T08:41:55","slug":"thuoc-giam-dau-nguc-benh-mach-vanh-man","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/thuoc-giam-dau-nguc-benh-mach-vanh-man\/","title":{"rendered":"S\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n"},"content":{"rendered":"

Thu\u1ed1c gi\u1ea3m \u0111au\u00a0 ng\u1ef1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n. Thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c c\u00f3 th\u1ec3 gi\u00fap gi\u00e3n c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 gi\u1ea3m s\u1ef1 co th\u1eaft c\u1ee7a c\u01a1 tim, gi\u00fap cung c\u1ea5p oxy\u00a0 \u0111\u1ebfn tim\u00a0 v\u00e0 gi\u1ea3m \u0111au ng\u1ef1c.\u00a0<\/strong><\/p>\n

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

B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd v\u1ec1 tim m\u1ea1ch ph\u1ed5 bi\u1ebfn, n\u00f3 \u0111\u01b0\u1ee3c xem l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn tim m\u1ea1ch. B\u1ec7nh n\u00e0y x\u1ea3y ra khi c\u00e1c \u0111\u1ed9ng m\u1ea1ch chuy\u00ean ch\u1edf m\u00e1u \u0111\u1ebfn tim m\u1ea1ch b\u1ecb h\u1eb9p ho\u1eb7c b\u1ecb t\u1eafc \u0111\u1ed9t ng\u1ed9t, g\u00e2y ra s\u1ef1 suy gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn tim m\u1ea1ch v\u00e0 d\u1eabn \u0111\u1ebfn c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au ng\u1ef1c, kh\u00f3 th\u1edf v\u00e0 m\u1ec7t m\u1ecfi.<\/p>\n

Tri\u1ec7u ch\u1ee9ng ch\u00ednh c\u1ee7a b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n l\u00e0 \u0111au th\u1eaft ng\u1ef1c<\/a>, th\u01b0\u1eddng \u0111\u01b0\u1ee3c mi\u00eau t\u1ea3 l\u00e0 c\u1ea3m gi\u00e1c n\u1eb7ng n\u1ec1 ho\u1eb7c \u00e1p l\u1ef1c trong v\u00f9ng ng\u1ef1c. \u0110au th\u01b0\u1eddng x\u1ea3y ra khi ng\u01b0\u1eddi b\u1ec7nh v\u1eadn \u0111\u1ed9ng ho\u1eb7c khi g\u1eb7p t\u00ecnh hu\u1ed1ng c\u0103ng th\u1eb3ng t\u00e2m l\u00fd. \u0110au ng\u1ef1c c\u00f3 th\u1ec3 k\u00e9o d\u00e0i v\u00e0 lan r\u1ed9ng \u0111\u1ebfn v\u00f9ng l\u01b0ng, c\u1ed5, tay tr\u00e1i ho\u1eb7c c\u1ea3 hai tay.<\/p>\n

Thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n.C\u00f3 nhi\u1ec1u lo\u1ea1i thu\u1ed1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c nhanh ch\u00f3ng c\u0169ng nh\u01b0 l\u00e2u d\u00e0i, l\u1ef1a ch\u1ecdn v\u00e0 ph\u1ed1i h\u1ee3p thu\u1ed1c l\u00e0 kh\u00e1c nhau gi\u1eefa c\u00e1c c\u00e1 nh\u00e2n.<\/p>\n

2. C\u00e1c thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c<\/h2>\n

C\u00e1c lo\u1ea1i thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n bao g\u1ed3m: nitrat, beta-blocker v\u00e0 calcium-channel blocker.<\/p>\n

    \n
  • Nitrat Gi\u00e3n h\u1ec7 \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0 h\u1ec7 t\u0129nh m\u1ea1ch, gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c d\u1ef1a tr\u00ean c\u01a1 ch\u1ebf gi\u1ea3i ph\u00f3ng nitric oxide (NO) v\u00e0 gi\u1ea3m ti\u1ec1n g\u00e1nh.<\/li>\n
  • Beta-blocker: Ch\u1eb9n beta giao c\u1ea3m l\u00e0 thu\u1ed1c kh\u1edfi \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au ng\u1ef1c \u1edf h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n. Gi\u1ea3m ti\u00eau th\u1ee5 oxy c\u01a1 tim do gi\u1ea3m nh\u1ecbp tim, gi\u1ea3m co b\u00f3p c\u01a1 tim v\u00e0 gi\u1ea3m h\u1eadu g\u00e1nh. Gi\u1ea3m t\u00e1i c\u1ea5u tr\u00fac c\u01a1 tim do gi\u1ea3m s\u1ee9c c\u0103ng th\u00e0nh th\u1ea5t tr\u00e1i. K\u00e9o d\u00e0i th\u1eddi k\u1ef3 t\u00e2m tr\u01b0\u01a1ng, t\u0103ng t\u01b0\u1edbi m\u00e1u \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, l\u00e0m t\u0103ng cung c\u1ea5p oxy c\u01a1 tim.L\u1ee3i \u00edch c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ch\u1eb9n beta giao c\u1ea3m l\u00e2u d\u00e0i \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh tr\u00ean b\u1ec7nh nh\u00e2n h\u1ed9i ch\u1ee9ng \u0110MV m\u1ea1n t\u00ednh do gi\u1ea3m g\u00e1nh n\u1eb7ng thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, c\u1ea3i thi\u1ec7n s\u1ed1ng c\u00f2n \u1edf b\u1ec7nh nh\u00e2n c\u00f3 gi\u1ea3m ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i ho\u1eb7c ti\u1ec1n s\u1eed nh\u1ed3i m\u00e1u c\u01a1 tim<\/li>\n
  • Ch\u1eb9n k\u00eanh canxi c\u00f3 vai tr\u00f2 trong c\u1ea3i thi\u1ec7n cung c\u1ea5p oxy cho tim\u00a0<\/strong>do gi\u1ea3m s\u1ee9c c\u1ea3n m\u1ea1ch v\u00e0nh, t\u0103ng d\u00f2ng ch\u1ea3y \u0111\u1ed9ng m\u1ea1ch h\u1ec7 th\u1ed1ng. L\u00e0m gi\u1ea3m nhu c\u1ea7u oxy c\u01a1 tim\u00a0<\/strong>b\u1eb1ng c\u00e1ch gi\u1ea3m co b\u00f3p c\u01a1 tim, gi\u1ea3m s\u1ee9c c\u1ea3n m\u1ea1ch h\u1ec7 th\u1ed1ng v\u00e0 gi\u1ea3m huy\u1ebft \u00e1p. Tuy nhi\u00ean, c\u00e1c thu\u1ed1c ch\u1eb9n k\u00eanh canxi ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 m\u1eafc b\u1ec7nh tr\u00ean b\u1ec7nh nh\u00e2n h\u1ed9i ch\u1ee9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n.G\u1ed3m 2 nh\u00f3m dihydropyridine (amlodipine, felodipine, lacidipine, nifedipine) v\u00e0 nondihydropyridine (diltiazem v\u00e0 verapamil).<\/li>\n<\/ul>\n

    C\u00e1c nh\u00f3m thu\u1ed1c kh\u00e1c:<\/p>\n

      \n
    • Ivabradine: C\u00f3 vai tr\u00f2 trong ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 tim v\u00e0 tri\u1ec7u ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c. C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p c\u00f9ng ho\u1eb7c thay th\u1ebf thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m khi kh\u00f4ng dung n\u1ea1p v\u1edbi thu\u1ed1c ch\u1eb9n beta.<\/li>\n
    • Nicorandil: L\u00e0 m\u1ed9t d\u1eabn xu\u1ea5t nitrat c\u1ee7a nicotinamide \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111au th\u1eaft ng\u1ef1c l\u00e2u d\u00e0i, c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m.<\/li>\n
    • Trimetazidine: L\u00e0 thu\u1ed1c \u0111i\u1ec1u ch\u1ec9nh chuy\u1ec3n h\u00f3a n\u0103ng l\u01b0\u1ee3ng c\u01a1 tim, gi\u1ea3m nhu c\u1ea7u oxy c\u01a1 tim, gi\u00fap c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng \u0111au ng\u1ef1c<\/li>\n<\/ul>\n

      3. Chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb thu\u1ed1c gi\u1ea3m \u0111au th\u1eaft ng\u1ef1c b\u1eb1ng thu\u1ed1c<\/h2>\n

      Chi\u1ebfn l\u01b0\u1ee3c ti\u1ebfp c\u1eadn t\u1eebng b\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111au th\u1eaft ng\u1ef1c trong h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh m\u1ea1n \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ed9t s\u1ed1 \u0111\u1eb7c \u0111i\u1ec3m ban \u0111\u1ea7u c\u1ee7a b\u1ec7nh nh\u00e2n . \u0110\u00e1p \u1ee9ng kh\u00f4ng ho\u00e0n to\u00e0n ho\u1eb7c dung n\u1ea1p k\u00e9m \u1edf m\u1ed7i b\u01b0\u1edbc c\u1ea7n chuy\u1ec3n sang b\u01b0\u1edbc ti\u1ebfp theo. Chi\u1ebfn l\u01b0\u1ee3c ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo \u0111\u1eb7c \u0111i\u1ec3m v\u00e0 s\u1ef1 \u01b0a th\u00edch c\u1ee7a m\u1ed7i b\u1ec7nh nh\u00e2n v\u00e0 kh\u00f4ng nh\u1ea5t thi\u1ebft theo c\u00e1c b\u01b0\u1edbc \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb.<\/p>\n

      Thu\u1ed1c\u00a0 Nitrat t\u00e1c d\u1ee5ng ng\u1eafn\u00a0 \u0111\u01b0\u1ee3c d\u00f9ng c\u1eaft c\u01a1n \u0111au ng\u1ef1c g\u1eafng s\u1ee9c.
      \nThu\u1ed1c nh\u00f3m 1 :Beta-blocker, Ch\u1eb9n k\u00eanh canxi.
      \nThu\u1ed1c nh\u00f3m 2 : Nitrat t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i, Ivabradine, Nicorandil, Trimetazidine.
      \n<\/span><\/p>\n\n\n\n\n\n\n\n
      <\/td>\nLi\u1ec7u ph\u00e1p chu\u1ea9n<\/td>\nNh\u1ecbp tim nhanh (> 80 l\/p)<\/td>\nNh\u1ecbp tim ch\u1eadm ( < 50 l\/p)<\/td>\nRLCNTT ho\u1eb7c suy tim<\/td>\nHuy\u1ebft \u00e1p th\u1ea5p<\/td>\n<\/tr>\n
      B\u01b0\u1edbc 1<\/td>\nCB ho\u1eb7c CC<\/td>\nCB ho\u1eb7c CC Non- DHP<\/td>\nCC DHP<\/td>\nCB<\/td>\nCB li\u1ec1u th\u1ea5p ho\u1eb7c CC Non- DHP li\u1ec1u th\u1ea5p<\/td>\n<\/tr>\n
      B\u01b0\u1edbc 2<\/td>\nCB + CC DHP<\/td>\nCB v\u00e0 CC Non- DHP<\/td>\nNTDD<\/td>\nTh\u00eam NTDD ho\u1eb7c IVAB<\/td>\nTh\u00eam NTDD li\u1ec1u th\u1ea5p<\/td>\n<\/tr>\n
      B\u01b0\u1edbc 3<\/td>\nTh\u00eam thu\u1ed1c h\u00e0ng th\u1ee9 2<\/td>\nTh\u00eam IVAB<\/td>\nCC DHP+ NTDD<\/td>\nTh\u00eam thu\u1ed1c h\u00e0ng th\u1ee9 2 kh\u00e1c<\/td>\nTh\u00eam IVAB ho\u1eb7c TMZ<\/td>\n<\/tr>\n
      B\u01b0\u1edbc 4<\/td>\n <\/p>\n

      Th\u00eam nicorandil ho\u1eb7c TMZ<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

      B\u1ea3ng 1:\u00a0 C\u00e1c b\u01b0\u1edbc d\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au th\u1eaft ng\u1ef1c. RLCNTT: r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i, CB: ch\u1eb9n beeta, CC: ch\u1eb9n k\u00eanh canxi, DHP: DIHYPROPYRIDIN,\u00a0 NTDD: nitrat t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i, IVAB: Ivabradine, TMZ: Trimetazidine.<\/p>\n

      4. Nh\u1eefng l\u01b0u \u00fd<\/h2>\n

      C\u1ea7n l\u01b0u \u00fd nh\u1eefng \u0111i\u1ec3m sau \u0111\u00e2y:<\/p>\n

        \n
      • Kh\u00f4ng t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c m\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 h\u01b0\u1edbng d\u1eabn c\u1ee7a b\u00e1c s\u0129: Thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c l\u00e0 nh\u1eefng lo\u1ea1i thu\u1ed1c m\u1ea1nh v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng \u0111\u1ebfn h\u1ec7 th\u1ed1ng tim m\u1ea1ch, v\u00ec th\u1ebf c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u00fang li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian ch\u1ec9 \u0111\u1ecbnh. Vi\u1ec7c t\u1ef1 \u00fd s\u1eed d\u1ee5ng thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng.<\/li>\n
      • Th\u00f4ng b\u00e1o cho b\u00e1c s\u0129 v\u1ec1 b\u1ea5t k\u1ef3 t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0o khi s\u1eed d\u1ee5ng thu\u1ed1c: N\u1ebfu s\u1eed d\u1ee5ng thu\u1ed1c g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, bu\u1ed3n n\u00f4n ho\u1eb7c kh\u00f3 th\u1edf, b\u1ec7nh nh\u00e2n c\u1ea7n th\u00f4ng b\u00e1o ngay cho b\u00e1c s\u0129 \u0111\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn k\u1ecbp th\u1eddi.<\/li>\n
      • Ki\u1ec3m so\u00e1t li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian s\u1eed d\u1ee5ng thu\u1ed1c: Vi\u1ec7c s\u1eed d\u1ee5ng qu\u00e1 li\u1ec1u ho\u1eb7c d\u00f9ng thu\u1ed1c qu\u00e1 l\u00e2u c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb. Do \u0111\u00f3, b\u1ec7nh nh\u00e2n c\u1ea7n ki\u1ec3m so\u00e1t li\u1ec1u l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian s\u1eed d\u1ee5ng thu\u1ed1c theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

        Thu\u1ed1c gi\u1ea3m \u0111au\u00a0 ng\u1ef1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n. Thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c c\u00f3 th\u1ec3 gi\u00fap gi\u00e3n c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 gi\u1ea3m s\u1ef1 co th\u1eaft c\u1ee7a c\u01a1 tim, gi\u00fap cung c\u1ea5p oxy\u00a0 \u0111\u1ebfn tim\u00a0 v\u00e0 gi\u1ea3m \u0111au ng\u1ef1c.\u00a0 1. Gi\u1edbi thi\u1ec7u B\u1ec7nh \u0111\u1ed9ng […]<\/p>\n","protected":false},"author":25,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nS\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n -<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c gi\u1ea3m \u0111au ng\u1ef1c gi\u00fap gi\u00e3n c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 gi\u1ea3m s\u1ef1 co th\u1eaft c\u1ee7a c\u01a1 tim, gi\u00fap cung c\u1ea5p oxy\u00a0 \u0111\u1ebfn tim\u00a0 v\u00e0 gi\u1ea3m \u0111au ng\u1ef1c b\u1ec7nh m\u1ea1ch v\u00e0nh m\u1ea1n\" \/>\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=\"S\u1eed d\u1ee5ng 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