{"id":257,"date":"2023-04-15T16:26:06","date_gmt":"2023-04-15T09:26:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=257"},"modified":"2023-04-18T15:39:47","modified_gmt":"2023-04-18T08:39:47","slug":"thuoc-chong-ket-tap-tieu-cau-trong-benh-mach-vanh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/thuoc-chong-ket-tap-tieu-cau-trong-benh-mach-vanh\/","title":{"rendered":"Thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u trong b\u1ec7nh m\u1ea1ch v\u00e0nh"},"content":{"rendered":"

B\u1ec7nh m\u1ea1ch v\u00e0nh l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd tim m\u1ea1ch ph\u1ed5 bi\u1ebfn, g\u00e2y ra do k\u1ebft t\u1ee5 ch\u1ea5t b\u00e9o v\u00e0 c\u00e1c t\u1ebf b\u00e0o trong m\u1ea1ch m\u00e1u, g\u00e2y ra h\u1eb9p c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0ng v\u00e0 gi\u1ea3m l\u01b0u th\u00f4ng m\u00e1u \u0111\u1ebfn tim.<\/strong>\u0110\u1ec3 ng\u0103n ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng m\u00e1u trong b\u1ec7nh m\u1ea1ch v\u00e0nh<\/a>, c\u00e1c thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i.<\/strong><\/p>\n

\"Ch\u1ed1ng
Ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u<\/figcaption><\/figure>\n

1. Gi\u1edbi thi\u1ec7u v\u1ec1 b\u1ec7nh tim m\u1ea1ch v\u00e0 t\u00ecnh tr\u1ea1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u<\/h2>\n

B\u1ec7nh tim m\u1ea1ch l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd c\u1ee7a tim v\u00e0 m\u1ea1ch m\u00e1u, bao g\u1ed3m nhi\u1ec1u lo\u1ea1i b\u1ec7nh nh\u01b0 \u0111au th\u1eaft ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim, suy tim, nh\u1ecbp tim kh\u00f4ng \u0111\u1ec1u, v\u00e0 \u0111\u1ed9t qu\u1ef5. B\u1ec7nh tim m\u1ea1ch l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.<\/p>\n

K\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u l\u00e0 t\u00ecnh tr\u1ea1ng m\u00e0 c\u00e1c ti\u1ec3u c\u1ea7u trong m\u00e1u d\u00ednh v\u00e0o nhau \u0111\u1ec3 t\u1ea1o th\u00e0nh m\u1ed9t c\u1ee5c m\u00e1u \u0111\u00f4ng. K\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u l\u00e0 m\u1ed9t trong c\u00e1c y\u1ebfu t\u1ed1 g\u00f3p ph\u1ea7n g\u00e2y ra b\u1ec7nh tim m\u1ea1ch, b\u1edfi v\u00ec n\u00f3 l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn c\u00e1c b\u1ed9 ph\u1eadn c\u1ee7a c\u01a1 th\u1ec3 v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1eafc ngh\u1ebdn c\u00e1c m\u1ea1ch m\u00e1u, g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m nh\u01b0 \u0111au th\u1eaft ng\u1ef1c, nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 \u0111\u1ed9t qu\u1ef5.<\/p>\n

C\u01a1 ch\u1ebf h\u00ecnh th\u00e0nh k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u b\u1eaft \u0111\u1ea7u b\u1eb1ng s\u1ef1 k\u00edch th\u00edch c\u1ee7a m\u1ed9t ch\u1ea5t g\u1ecdi l\u00e0 thromboxane A2 (TXA2), \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi c\u00e1c t\u1ebf b\u00e0o ti\u1ec3u c\u1ea7u v\u00e0 t\u1ebf b\u00e0o m\u1ea1ch m\u00e1u khi b\u1ecb t\u1ed5n th\u01b0\u01a1ng. TXA2 k\u00edch th\u00edch c\u00e1c ti\u1ec3u c\u1ea7u k\u1ebft d\u00ednh v\u1edbi nhau v\u00e0 v\u1edbi c\u00e1c th\u00e0nh t\u1ebf b\u00e0o kh\u00e1c \u0111\u1ec3 t\u1ea1o th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y ra k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u bao g\u1ed3m: h\u00fat thu\u1ed1c l\u00e1, ti\u1ec3u \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p, m\u1ee1 m\u00e1u cao, b\u00e9o ph\u00ec, tu\u1ed5i t\u00e1c, v\u00e0 di truy\u1ec1n.<\/p>\n

\u0110\u1ec3 ng\u0103n ng\u1eeba t\u00ecnh tr\u1ea1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u trong b\u1ec7nh tim m\u1ea1ch, c\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 s\u1ea3n xu\u1ea5t c\u1ee7a TXA2 v\u00e0 gi\u1ea3m s\u1ef1 k\u1ebft d\u00ednh c\u1ee7a c\u00e1c ti\u1ec3u c\u1ea7u. C\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y bao g\u1ed3m Aspirin, Clopidogrel, Ticagrelor v\u00e0 Prasugrel.<\/p>\n

2.C\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng<\/h2>\n

2.1 Aspirin:<\/h3>\n
    \n
  • C\u01a1 ch\u1ebf: Aspirin \u1ee9c ch\u1ebf enzyme cyclooxygenase (COX) trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t prostaglandin v\u00e0 tromboxan A2, l\u00e0 hai ch\u1ea5t g\u00e2y ra \u0111au v\u00e0 vi\u00eam, c\u0169ng nh\u01b0 k\u00edch ho\u1ea1t ti\u1ec3u c\u1ea7u. B\u1eb1ng c\u00e1ch n\u00e0y, aspirin gi\u1ea3m s\u1ef1 k\u00edch ho\u1ea1t c\u1ee7a ti\u1ec3u c\u1ea7u, l\u00e0m gi\u1ea3m nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng trong c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 v\u00e0 c\u01a1n \u0111au tim.<\/li>\n
  • T\u00e1c d\u1ee5ng ph\u1ee5: T\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a aspirin bao g\u1ed3m \u0111au d\u1ea1 d\u00e0y, bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, ti\u00eau ch\u1ea3y v\u00e0 vi\u00eam \u0111\u1ea1i tr\u00e0ng. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 s\u1eed d\u1ee5ng aspirin v\u1edbi li\u1ec1u th\u1ea5p \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 ch\u1ea3y m\u00e1u d\u1ea1 d\u00e0y v\u00e0 \u0111\u1ed9ng m\u1ea1ch n\u00e3o.<\/li>\n
  • Li\u1ec1u d\u00f9ng: Li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng l\u00e0 75-100mg\/ng\u00e0y<\/li>\n<\/ul>\n

    2.2 Clopidogrel:<\/h3>\n
      \n
    • C\u01a1 ch\u1ebf: Clopidogrel \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c th\u1ee5 th\u1ec3 ADP tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ti\u1ec3u c\u1ea7u, gi\u00fap ng\u0103n ch\u1eb7n s\u1ef1 k\u00edch ho\u1ea1t v\u00e0 li\u00ean k\u1ebft c\u00e1c ti\u1ec3u c\u1ea7u v\u1edbi nhau. B\u1eb1ng c\u00e1ch n\u00e0y, clopidogrel gi\u1ea3m nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng trong c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 v\u00e0 c\u01a1n \u0111au tim.<\/li>\n
    • T\u00e1c d\u1ee5ng ph\u1ee5: T\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a clopidogrel bao g\u1ed3m ch\u1ea3y m\u00e1u, \u0111au \u0111\u1ea7u, bu\u1ed3n n\u00f4n v\u00e0 d\u1ec5 b\u1ea7m t\u00edm. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 ch\u1ea3y m\u00e1u n\u1ed9i t\u1ea1ng v\u00e0 r\u1ed1i lo\u1ea1n ti\u1ec3u c\u1ea7u c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra.<\/li>\n
    • Li\u1ec1u d\u00f9ng: Li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng l\u00e0 75mg\/ng\u00e0y.<\/li>\n<\/ul>\n

      2.3 Ticagrelor:<\/h3>\n
        \n
      • C\u01a1 ch\u1ebf: Ticagrelor kh\u00e1ng k\u00edch th\u00edch c\u1ee7a th\u1ee5 th\u1ec3 P2Y12 tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ti\u1ec3u c\u1ea7u, gi\u00fap ng\u0103n ch\u1eb7n s\u1ef1 k\u00edch ho\u1ea1t v\u00e0 li\u00ean k\u1ebft c\u00e1c ti\u1ec3u c\u1ea7u v\u1edbi nhau. B\u1eb1ng c\u00e1ch n\u00e0y, ticagrelor gi\u1ea3m nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng trong c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 v\u00e0 c\u01a1n \u0111au tim.<\/li>\n
      • T\u00e1c d\u1ee5ng ph\u1ee5: T\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a ticagrelor bao g\u1ed3m \u0111au \u0111\u1ea7u, bu\u1ed3n n\u00f4n, ti\u00eau ch\u1ea3y v\u00e0 kh\u00f3 ng\u1ee7. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 ch\u1ea3y m\u00e1u n\u1ed9i t\u1ea1ng v\u00e0 r\u1ed1i lo\u1ea1n ti\u1ec3u c\u1ea7u c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra.<\/li>\n
      • Li\u1ec1u d\u00f9ng: Li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng l\u00e0 90mg x 2 l\u1ea7n\/ng\u00e0y trong 1 n\u0103m \u0111\u1ea7u ti\u00ean sau ph\u1eabu thu\u1eadt \u0111\u1eb7t stent, sau \u0111\u00f3 gi\u1ea3m li\u1ec1u xu\u1ed1ng c\u00f2n 60mg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n<\/ul>\n

        2.4 Prasugrel:<\/h3>\n
          \n
        • C\u01a1 ch\u1ebf: Prasugrel kh\u00e1ng k\u00edch th\u00edch c\u1ee7a th\u1ee5 th\u1ec3 P2Y12 tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ti\u1ec3u c\u1ea7u, gi\u00fap ng\u0103n ch\u1eb7n s\u1ef1 k\u00edch ho\u1ea1t v\u00e0 li\u00ean k\u1ebft c\u00e1c ti\u1ec3u c\u1ea7u v\u1edbi nhau. B\u1eb1ng c\u00e1ch n\u00e0y, prasugrel gi\u1ea3m nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng trong c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 v\u00e0 c\u01a1n \u0111au tim.<\/li>\n
        • T\u00e1c d\u1ee5ng ph\u1ee5: T\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p c\u1ee7a prasugrel bao g\u1ed3m ch\u1ea3y m\u00e1u, \u0111au \u0111\u1ea7u, bu\u1ed3n n\u00f4n v\u00e0 d\u1ec5 b\u1ea7m t\u00edm. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng nh\u01b0 ch\u1ea3y m\u00e1u n\u1ed9i t\u1ea1ng v\u00e0 r\u1ed1i lo\u1ea1n ti\u1ec3u c\u1ea7u c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra.<\/li>\n
        • Li\u1ec1u d\u00f9ng: Li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng l\u00e0 10mg\/ng\u00e0y. Tuy nhi\u00ean, n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 tr\u1ecdng l\u01b0\u1ee3ng d\u01b0\u1edbi 60kg, li\u1ec1u d\u00f9ng \u0111\u01b0\u1ee3c gi\u1ea3m xu\u1ed1ng c\u00f2n 5mg\/ng\u00e0y.
          \n

          3.So s\u00e1nh gi\u1eefa c\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u<\/h2>\n<\/li>\n<\/ul>\n
            \n
          • Aspirin l\u00e0 lo\u1ea1i thu\u1ed1c r\u1ebb ti\u1ec1n v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng t\u1ed1t trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh m\u1ea1ch v\u00e0nh \u1ed5n \u0111\u1ecbnh, trong khi clopidogrel, ticagrelor v\u00e0 prasugrel th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb sau khi \u0111\u00e3 ph\u1eabu thu\u1eadt \u0111\u1eb7t stent.<\/li>\n
          • Clopidogrel, ticagrelor v\u00e0 prasugrel c\u00f3 t\u00e1c d\u1ee5ng ng\u0103n ch\u1eb7n s\u1ef1 k\u00edch ho\u1ea1t v\u00e0 li\u00ean k\u1ebft c\u00e1c ti\u1ec3u c\u1ea7u v\u1edbi nhau nhanh h\u01a1n v\u00e0 m\u1ea1nh h\u01a1n so v\u1edbi aspirin, nh\u01b0ng c\u0169ng c\u00f3 nguy c\u01a1 t\u0103ng cao h\u01a1n v\u1ec1 ch\u1ea3y m\u00e1u.<\/li>\n
          • Ticagrelor c\u00f3 t\u00e1c d\u1ee5ng nhanh h\u01a1n v\u00e0 m\u1ea1nh h\u01a1n so v\u1edbi clopidogrel v\u00e0 prasugrel, nh\u01b0ng c\u0169ng c\u00f3 nguy c\u01a1 t\u0103ng cao h\u01a1n v\u1ec1 ch\u1ea3y m\u00e1u.<\/li>\n
          • Prasugrel c\u00f3 t\u00e1c d\u1ee5ng nhanh h\u01a1n v\u00e0 m\u1ea1nh h\u01a1n so v\u1edbi clopidogrel, nh\u01b0ng c\u0169ng c\u00f3 nguy c\u01a1 t\u0103ng cao h\u01a1n v\u1ec1 ch\u1ea3y m\u00e1u.
            \n

            4.K\u1ebft lu\u1eadn<\/h2>\n<\/li>\n<\/ul>\n
              \n
            • C\u00e1c thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u \u0111\u1ec1u c\u00f3 t\u00e1c d\u1ee5ng ng\u0103n ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng m\u00e1u trong b\u1ec7nh m\u1ea1ch v\u00e0nh.<\/li>\n
            • Aspirin l\u00e0 lo\u1ea1i thu\u1ed1c r\u1ebb ti\u1ec1n v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng t\u1ed1t trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh m\u1ea1ch v\u00e0nh \u1ed5n \u0111\u1ecbnh, trong khi clopidogrel, ticagrelor v\u00e0 prasugrel th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb sau khi \u0111\u00e3 ph\u1eabu thu\u1eadt \u0111\u1eb7t stent.<\/li>\n
            • Tuy nhi\u00ean, c\u00e1c thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u c\u0169ng c\u00f3 nguy c\u01a1 t\u0103ng cao h\u01a1n v\u1ec1 ch\u1ea3y m\u00e1u, do \u0111\u00f3 c\u1ea7n th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng v\u00e0 theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n

              \u00a0<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

              B\u1ec7nh m\u1ea1ch v\u00e0nh l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd tim m\u1ea1ch ph\u1ed5 bi\u1ebfn, g\u00e2y ra do k\u1ebft t\u1ee5 ch\u1ea5t b\u00e9o v\u00e0 c\u00e1c t\u1ebf b\u00e0o trong m\u1ea1ch m\u00e1u, g\u00e2y ra h\u1eb9p c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0ng v\u00e0 gi\u1ea3m l\u01b0u th\u00f4ng m\u00e1u \u0111\u1ebfn tim.\u0110\u1ec3 ng\u0103n ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng m\u00e1u trong b\u1ec7nh m\u1ea1ch v\u00e0nh, c\u00e1c thu\u1ed1c […]<\/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":"\nThu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u trong b\u1ec7nh m\u1ea1ch v\u00e0nh -<\/title>\n<meta name=\"description\" content=\"\u0110\u1ec3 ng\u0103n ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng 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