{"id":23481,"date":"2023-04-28T19:44:12","date_gmt":"2023-04-28T12:44:12","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=23481"},"modified":"2023-04-28T19:44:28","modified_gmt":"2023-04-28T12:44:28","slug":"phan-ung-viem","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/28\/phan-ung-viem\/","title":{"rendered":"Ph\u1ea3n \u1ee9ng vi\u00eam: Qu\u00e1 tr\u00ecnh b\u1ea3o v\u1ec7 \u0111\u1ea7y ph\u1ee9c t\u1ea1p c\u01a1 th\u1ec3"},"content":{"rendered":"<p>Vi\u00eam l\u00e0 m\u1ed9t ph\u1ea3n \u1ee9ng b\u1ea3o v\u1ec7 t\u1ef1 nhi\u00ean c\u1ee7a c\u01a1 th\u1ec3 ch\u1ed1ng l\u1ea1i s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i. Qu\u00e1 tr\u00ecnh vi\u00eam \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi c\u00e1c ch\u1ea5t cytokine, chemokine v\u00e0 c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch, c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au, s\u01b0ng, n\u00f3ng v\u00e0 \u0111\u1ecf, qu\u00e1 tr\u00ecnh vi\u00eam qu\u00e1 m\u1ee9c c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/p>\n<h2>1. Gi\u1edbi thi\u1ec7u v\u1ec1 ph\u1ea3n \u1ee9ng vi\u00eam<\/h2>\n<p>Vi\u00eam l\u00e0 ph\u1ea3n \u1ee9ng t\u1ef1 nhi\u00ean c\u1ee7a c\u01a1 th\u1ec3 tr\u01b0\u1edbc s\u1ef1 t\u1ed5n th\u01b0\u01a1ng m\u00f4 do vi sinh v\u1eadt, ch\u1ea5n th\u01b0\u01a1ng v\u1eadt l\u00fd ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i kh\u00e1c. Ph\u1ea3n \u1ee9ng vi\u00eam l\u00e0 qu\u00e1 tr\u00ecnh ph\u1ee9c t\u1ea1p bao g\u1ed3m nhi\u1ec1u s\u1ef1 ki\u1ec7n trong m\u1ea1ch m\u00e1u v\u00e0 t\u1ebf b\u00e0o kh\u00e1c nhau, nh\u1eb1m lo\u1ea1i b\u1ecf c\u00e1c vi sinh v\u1eadt v\u00e0 kh\u1edfi \u0111\u1ed9ng qu\u00e1 tr\u00ecnh t\u00e1i t\u1ea1o m\u00f4.<\/p>\n<figure id=\"attachment_24991\" aria-describedby=\"caption-attachment-24991\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-24991 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/57b49d47-2e47-469f-8663-5dadbf1bc0eb-300x300.jpg\" alt=\"Tong-quan-phan-ung-viem\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/57b49d47-2e47-469f-8663-5dadbf1bc0eb-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/57b49d47-2e47-469f-8663-5dadbf1bc0eb-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/57b49d47-2e47-469f-8663-5dadbf1bc0eb-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/57b49d47-2e47-469f-8663-5dadbf1bc0eb.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-24991\" class=\"wp-caption-text\">T\u1ed5ng quan ph\u1ea3n \u1ee9ng vi\u00eam<\/figcaption><\/figure>\n<h2>2. S\u1ef1 ki\u1ec7n di\u1ec5n ra trong m\u1ea1ch m\u00e1u<\/h2>\n<p>S\u1ef1 gi\u1ea3i ph\u00f3ng histamin, serotonin, prostaglandin, bradykinin v\u00e0 leukotrien t\u1eeb c\u00e1c m\u00f4 t\u1ed5n th\u01b0\u01a1ng, t\u1ebf b\u00e0o n\u1ed9i m\u1ea1c, ti\u1ec3u c\u1ea7u, basophils v\u00e0 mast cells k\u00edch ho\u1ea1t m\u1ed9t lo\u1ea1t chu\u1ed7i c\u00e1c s\u1ef1 ki\u1ec7n trong ph\u1ea3n \u1ee9ng vi\u00eam. Chu\u1ed7i n\u00e0y bao g\u1ed3m s\u1ef1 gi\u00e3n m\u1ea1ch, t\u0103ng t\u00ednh th\u1ea5m th\u00e0nh m\u1ea1ch, b\u1ed9c l\u1ed9 nh\u1eefng ph\u00e2n t\u1eed b\u00e1m d\u00ednh, s\u1ef1 di chuy\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u (WBCs) v\u00e0o h\u01b0\u1edbng v\u1ec1 ph\u00eda vi sinh v\u1eadt (ho\u00e1 h\u01b0\u1edbng \u0111\u1ed9ng).<\/p>\n<ul>\n<li><strong>S\u1ef1 gi\u00e3n m\u1ea1ch<\/strong> d\u1eabn \u0111\u1ebfn t\u0103ng d\u00f2ng m\u00e1u \u0111\u1ebfn v\u00f9ng b\u1ecb vi sinh v\u1eadt x\u00e2m nh\u1eadp, g\u00e2y ra s\u1ef1 \u0111\u1ecf v\u00e0 n\u00f3ng.<\/li>\n<li><strong>T\u0103ng t\u00ednh th\u1ea5m th\u00e0nh m\u1ea1ch<\/strong> t\u0103ng c\u01b0\u1eddng cho ph\u00e9p protein huy\u1ebft thanh v\u00e0 WBCs ra kh\u1ecfi m\u1ea1ch m\u00e1u v\u00e0 v\u00e0o m\u00f4, g\u00e2y ra s\u01b0ng v\u00e0 \u0111au.<\/li>\n<li><strong>B\u1ed9c l\u1ed9 nh\u1eefng ph\u00e2n t\u1eed b\u00e1m d\u00ednh <\/strong>cho ph\u00e9p WBCs r\u1eddi kh\u1ecfi m\u1ea1ch m\u00e1u v\u00e0 v\u00e0o m\u00f4 n\u01a1i vi sinh v\u1eadt \u0111ang c\u00f3 m\u1eb7t.<br \/>\n+ <em>Giai \u0111o\u1ea1n \u0111\u1ea7u qu\u00e1 tr\u00ecnh vi\u00eam: P-selectins: <\/em>G\u1eafn v\u1edbi ph\u00e2n t\u1eed Sialyl-Lewis tr\u00ean WBCs v\u00e0 gi\u1eef ch\u00fang g\u1ea7n v\u1edbi th\u00e0nh m\u1ea1ch (margination); <em>PE-cams: <\/em>Cho ph\u00e9p WBCs di chuy\u1ec3n gi\u1eefa c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 c\u1ee7a th\u00e0nh m\u1ea1ch (diapedesis).<br \/>\n+ <em>Giai \u0111o\u1ea1n mu\u1ed9n qu\u00e1 tr\u00ecnh vi\u00eam:<\/em> Sau khi WBCs \u0111\u1ebfn v\u00f9ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng, ch\u00fang ti\u1ebft IL-1, IL-8, TNF-alpha. T\u1eeb \u0111\u00f3, ti\u1ebfp t\u1ee5c b\u1ed9c l\u1ed9 c\u1ee7a c\u00e1c ph\u00e2n t\u1eed b\u00e1m d\u00ednh \u1edf gian \u0111o\u1ea1n mu\u1ed9n <em>E-<\/em>selectins (t\u01b0\u01a1ng t\u1ef1\u00a0<em>P-selectins<\/em>); <em>PE-cams;<\/em>\u00a0<em>I-Cams, V-Cams:<\/em> G\u1eafn v\u1edbi c\u00e1c integrin tr\u00ean WBCs tr\u00ean th\u00e0nh m\u1ea1ch v\u00e0 gi\u1eef ch\u00fang ch\u1eb7t v\u00e0o th\u00e0nh (Tight Binding)<\/li>\n<li><strong>Ho\u00e1 h\u01b0\u1edbng \u0111\u1ed9ng: <\/strong>S\u1ef1 di chuy\u1ec3n c\u1ee7a WBCs v\u1ec1 h\u01b0\u1edbng vi sinh v\u1eadt \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi leukotrien, C5a, IL-8 v\u00e0 y\u1ebfu t\u1ed1 k\u00edch ho\u1ea1t ti\u1ec3u c\u1ea7u, c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y \u0111\u00f3ng vai tr\u00f2 nh\u01b0 t\u00edn hi\u1ec7u \u0111\u1ec3 h\u01b0\u1edbng d\u1eabn WBCs \u0111\u1ebfn vi sinh v\u1eadt. C\u00e1c WBCs \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t s\u1ebd gi\u1ea3i ph\u00f3ng th\u00eam IL-1,TNF-alpha, k\u00edch th\u00edch c\u00e1c c\u01a1 quan:<br \/>\n+ <em>Gan:<\/em> Ph\u00f3ng th\u00edch c\u00e1c protein \u0111\u00e1p \u1ee9ng v\u1edbi ph\u1ea3n \u1ee9ng vi\u00eam c\u1ea5p: IL-6, Ferritin, Fibrinogen, Haptoglobin, CRP, Ceruloplasmin,&#8230;<br \/>\n+ <em>N\u00e3o:<\/em> K\u00edch th\u00edch h\u1ea1 \u0111\u1ed3i l\u00e0m t\u0103ng nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3 g\u00e2y ra s\u1ed1t.<br \/>\n+<em> T\u1ee7y \u0111\u1ecf:<\/em> D\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a IL-1, TNF alpha, IL-3, IL-5,&#8230; g\u00e2y t\u0103ng sinh WBCs.<\/li>\n<\/ul>\n<h2>3. S\u1ef1 ki\u1ec7n t\u1ebf b\u00e0o trong ph\u1ea3n \u1ee9ng vi\u00eam<\/h2>\n<p>WBCs r\u1eddi kh\u1ecfi m\u1ea1ch m\u00e1u v\u00e0 \u0111i v\u00e0o m\u00f4 n\u01a1i vi sinh v\u1eadt \u0111ang c\u00f3 m\u1eb7t, d\u1eabn \u0111\u1ebfn c\u00e1c s\u1ef1 ki\u1ec7n t\u1ebf b\u00e0o kh\u00e1c nhau, bao g\u1ed3m th\u1ef1c b\u00e0o (phagocytosis) v\u00e0 ti\u00eau di\u1ec7t vi sinh v\u1eadt kh\u00f4ng \u0111\u1eb7c hi\u1ec7u.<\/p>\n<ul>\n<li><strong>Hi\u1ec7n t\u01b0\u1ee3ng th\u1ef1c b\u00e0o<\/strong> ch\u1ee7 y\u1ebfu b\u1edfi neutrophils v\u00e0 macrophages. Neutrophils v\u00e0 macrophages th\u1ef1c b\u00e0o vi sinh v\u1eadt, \u0111\u01b0a n\u00f3 v\u00e0o t\u1ebf b\u00e0o, t\u1ea1o th\u00e0nh phagosome, k\u1ebft h\u1ee3p v\u1edbi lysosomes \u0111\u1ec3 t\u1ea1o th\u00e0nh phagolysosome. C\u00e1c enzyme lysosome ph\u00e2n h\u1ee7y c\u00e1c ph\u00e2n t\u1eed l\u1edbn c\u1ee7a vi sinh v\u1eadt th\u00e0nh c\u00e1c m\u1ea3nh nh\u1ecf v\u00e0 mang \u0111\u1ebfn c\u00e1c h\u1ea1ch b\u1ea1ch huy\u1ebft g\u1ea7n \u0111\u00f3. Neutrophils c\u0169ng ti\u00eau di\u1ec7t c\u00e1c vi sinh v\u1eadt n\u00e0y trong phagolysosome th\u00f4ng qua s\u1ef1 \u201cb\u00f9ng n\u1ed5 h\u00f4 h\u1ea5p\u201d\u00a0 (respiratory burst), trong khi macrophages bi\u1ec3u hi\u1ec7n kh\u00e1ng nguy\u00ean tr\u00ean c\u00e1c ph\u00e2n t\u1eed MHC II tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o, t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c t\u1ebf b\u00e0o T-helper.<\/li>\n<li><strong>Ti\u00eau di\u1ec7t vi sinh v\u1eadt kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/strong> \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi c\u00e1c t\u1ebf b\u00e0o ti\u00eau di\u1ec7t t\u1ef1 nhi\u00ean (Natural killer cell), \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t th\u00f4ng qua ph\u1ee9c h\u1ee3p MHC I ho\u1eb7c qua qu\u00e1 tr\u00ecnh g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o qua kh\u00e1ng th\u1ec3 ph\u1ee5 thu\u1ed9c (ADCC &#8211; Antibody dependent cell mediated cytotoxicity):<br \/>\n+ <em>Ph\u1ee9c h\u1ee3p MHC I: <\/em>Khi virus x\u00e2m nh\u1eadp v\u00e0o t\u1ebf b\u00e0o m\u00f4, virus s\u1ebd l\u00e0m bi\u1ec3u l\u1ed9 MHC I b\u1ea5t th\u01b0\u1eddng ho\u1eb7c \u1ee9c ch\u1ebf vi\u1ec7c h\u00ecnh th\u00e0nh MHC I b\u00ecnh th\u01b0\u1eddng c\u1ee7a t\u1ebf b\u00e0o. T\u1eeb \u0111\u00f3, k\u00edch ho\u1ea1t c\u00e1c t\u1ebf b\u00e0o NK ph\u00f3ng th\u00edch perforin v\u00e0 granzymes, k\u00edch ho\u1ea1t qu\u00e1 tr\u00ecnh ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh (apoptotic) c\u1ee7a c\u00e1c t\u1ebf b\u00e0o b\u1ecb nhi\u1ec5m virus.<br \/>\n+ <em>G\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o qua kh\u00e1ng th\u1ec3 ph\u1ee5 thu\u1ed9c:<\/em> Kh\u00e1ng th\u1ec3 IgG \u0111\u01b0\u1ee3c t\u1ea1o b\u1edfi t\u01b0\u01a1ng b\u00e0o (plasma cells) s\u1ebd g\u1eafn v\u1edbi kh\u00e1ng nguy\u00ean c\u1ee7a virus \u0111\u00e3 \u0111\u01b0\u1ee3c b\u1ed9c l\u1ed9 tr\u00ean ph\u1ee9c h\u1ee3p MHC I c\u1ee7a t\u1ebf b\u00e0o nhi\u1ec5m virus. C\u00e1c t\u1ebf b\u00e0o NK \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t th\u00f4ng qua g\u1eafn v\u1edbi ph\u1ea7n Fc c\u1ee7a kh\u00e1ng th\u1ec3 IgG qua protein CD-16. Ti\u1ebfp t\u1ee5c ph\u00f3ng th\u00edch perforin v\u00e0 granzymes nh\u1eb1m k\u00edch ho\u1ea1t qu\u00e1 tr\u00ecnh ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh (apoptotic) c\u1ee7a c\u00e1c t\u1ebf b\u00e0o b\u1ecb nhi\u1ec5m virus.<\/li>\n<\/ul>\n<h2>4. K\u1ebft lu\u1eadn<\/h2>\n<p>Vi\u00eam l\u00e0 qu\u00e1 tr\u00ecnh quan tr\u1ecdng trong ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 tr\u01b0\u1edbc s\u1ef1 t\u1ed5n th\u01b0\u01a1ng m\u00f4 do vi sinh v\u1eadt ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i kh\u00e1c. C\u00e1c s\u1ef1 ki\u1ec7n m\u1ea1ch m\u00e1u v\u00e0 t\u1ebf b\u00e0o trong vi\u00eam nh\u1eb1m lo\u1ea1i b\u1ecf c\u00e1c vi sinh v\u1eadt v\u00e0 kh\u1edfi \u0111\u1ed9ng qu\u00e1 tr\u00ecnh t\u00e1i t\u1ea1o m\u00f4. Hi\u1ec3u r\u00f5 c\u00e1c qu\u00e1 tr\u00ecnh ph\u1ee9c t\u1ea1p li\u00ean quan \u0111\u1ebfn vi\u00eam l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 c\u00f3 m\u1ed9t th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed h\u1edbp l\u00ed \u0111\u1ed1i v\u1edbi ph\u1ea3n \u1ee9ng vi\u00eam: T\u0103ng c\u01b0\u1eddng \u0111\u1ec1 kh\u00e1ng, lo\u1ea1i b\u1ecf y\u1ebfu t\u1ed1 g\u00e2y vi\u00eam, gi\u1ea3i quy\u1ebft k\u1ecbp th\u1eddi bi\u1ebfn ch\u1ee9ng c\u00f3 h\u1ea1i trong qu\u00e1 tr\u00ecnh vi\u00eam.<\/p>\n<p>C\u00e1c \u0111\u1ed9c gi\u1ea3 c\u00f3 th\u1ec3 truy c\u1eadp v\u00e0o trang web <a href=\"https:\/\/vinmecdr.com\/\">vinmecdr.com<\/a>, \u0111\u1ec3 tham kh\u1ea3o th\u00eam nh\u1eefng b\u00e0i vi\u1ebft chuy\u00ean s\u00e2u v\u1ec1 h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 con ng\u01b0\u1eddi.<br \/>\n<strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><br \/>\nAbul K Abbas, Andrew H. Lichtman, and Shiv Oillai. 2021. Cellular and Molecular Immunology. 10th ed.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam l\u00e0 m\u1ed9t ph\u1ea3n \u1ee9ng b\u1ea3o v\u1ec7 t\u1ef1 nhi\u00ean c\u1ee7a c\u01a1 th\u1ec3 ch\u1ed1ng l\u1ea1i s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i. Qu\u00e1 tr\u00ecnh vi\u00eam \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi c\u00e1c ch\u1ea5t cytokine, chemokine v\u00e0 c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch, c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au, [&hellip;]<\/p>\n","protected":false},"author":55,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[73,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ph\u1ea3n \u1ee9ng vi\u00eam: Qu\u00e1 tr\u00ecnh b\u1ea3o v\u1ec7 \u0111\u1ea7y ph\u1ee9c t\u1ea1p c\u01a1 th\u1ec3 - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam l\u00e0 ph\u1ea3n \u1ee9ng t\u1ef1 nhi\u00ean c\u1ee7a c\u01a1 th\u1ec3 tr\u01b0\u1edbc s\u1ef1 t\u1ed5n th\u01b0\u01a1ng m\u00f4 do vi sinh v\u1eadt, ch\u1ea5n th\u01b0\u01a1ng v\u1eadt l\u00fd ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 b\u00ean ngo\u00e0i kh\u00e1c.\" \/>\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=\"Ph\u1ea3n \u1ee9ng vi\u00eam: Qu\u00e1 tr\u00ecnh b\u1ea3o v\u1ec7 \u0111\u1ea7y ph\u1ee9c t\u1ea1p c\u01a1 th\u1ec3 - 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