{"id":26241,"date":"2023-04-27T15:46:50","date_gmt":"2023-04-27T08:46:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26241"},"modified":"2023-04-27T15:46:50","modified_gmt":"2023-04-27T08:46:50","slug":"nhiem-covid-19","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/27\/nhiem-covid-19\/","title":{"rendered":"C\u01a1 ch\u1ebf th\u00fac \u0111\u1ea9y nhi\u1ec5m COVID 19 \u1edf b\u1ec7nh nh\u00e2n COPD"},"content":{"rendered":"

B\u1ec7nh nh\u00e2n COPD (Chronic Obstructive Pulmonary Disease) l\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 h\u1ec7 th\u1ed1ng h\u00f4 h\u1ea5p y\u1ebfu v\u00e0 th\u01b0\u1eddng xuy\u00ean g\u1eb7p kh\u00f3 kh\u0103n trong vi\u1ec7c th\u1edf. V\u00ec v\u1eady, khi b\u1ecb nhi\u1ec5m COVID 19, b\u1ec7nh nh\u00e2n COPD c\u00f3 nguy c\u01a1 cao h\u01a1n \u0111\u1ec3 ph\u00e1t tri\u1ec3n ra c\u00e1c tri\u1ec7u ch\u1ee9ng nghi\u00eam tr\u1ecdng v\u00e0 t\u1eed vong. Tuy nhi\u00ean, trong b\u00e0i vi\u1ebft n\u00e0y s\u1ebd \u0111\u01b0a ra c\u01a1 ch\u1ebf th\u00fac \u0111\u1ea9y nhi\u1ec5m COVID 19 c\u1ee7a b\u1ec7nh nh\u00e2n COPD.<\/strong><\/p>\n

1. T\u1ed5ng quan<\/strong><\/h1>\n

\u0110\u1ea1i d\u1ecbch b\u1ec7nh virus corona 2019 (COVID 19) \u0111\u00e3 \u00a0g\u00e2y ra h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh n\u1eb7ng. Lo\u1ea1i virus c\u00f3 kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n cao n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra b\u1ec7nh virus nh\u1eb9, trong khi c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng h\u01a1n c\u00f3 bi\u1ec3u hi\u1ec7n vi\u00eam to\u00e0n th\u00e2n, vi\u00eam ph\u1ed5i v\u00e0 suy h\u00f4 h\u1ea5p n\u1eb7ng c\u1ea5p t\u00ednh. Suy h\u00f4 h\u1ea5p do COVID 19 th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn \u0111\u1ed9 gi\u00e3n n\u1edf c\u1ee7a ph\u1ed5i, cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u v\u00e0 co m\u1ea1ch l\u00e0 c\u01a1 ch\u1ebf trung t\u00e2m c\u1ee7a suy h\u00f4 h\u1ea5p. Vi\u00eam ph\u1ed5i do COVID 19 d\u01b0\u1eddng nh\u01b0 l\u00e0 do d\u1ecbch ti\u1ebft ph\u1ed5i do t\u1ed5n th\u01b0\u01a1ng vi m\u1ea1ch. C\u00e1c bi\u1ec3u hi\u1ec7n to\u00e0n th\u00e2n th\u01b0\u1eddng g\u1eb7p \u1edf COVID 19 n\u1eb7ng, v\u1edbi t\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u00f4 g\u00e2y bi\u1ebfn ch\u1ee9ng tim, th\u1eadn v\u00e0 th\u1ea7n kinh.<\/p>\n

B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u00e3n t\u00ednh (COPD) x\u1ea3y ra \u1edf nh\u1eefng ng\u01b0\u1eddi l\u1edbn tu\u1ed5i do li\u00ean t\u1ee5c h\u00edt ph\u1ea3i c\u00e1c h\u1ea1t \u0111\u1ed9c h\u1ea1i, th\u01b0\u1eddng l\u00e0 do h\u00fat thu\u1ed1c l\u00e1. B\u1ec7nh ph\u1ed5i bao g\u1ed3m vi\u00eam v\u00e0 t\u00e1i t\u1ea1o \u0111\u01b0\u1eddng th\u1edf, v\u1edbi s\u1ef1 ph\u00e1 h\u1ee7y ph\u1ebf nang (kh\u00ed ph\u1ebf th\u0169ng). B\u1ec7nh nh\u00e2n COPD b\u1ecb kh\u00f3 th\u1edf, ho v\u00e0 kh\u1ea1c \u0111\u1eddm, v\u00e0 c\u00f3 th\u1ec3 \u0111\u1ed9t ng\u1ed9t x\u1ea5u \u0111i (\u0111\u1ee3t c\u1ea5p) th\u01b0\u1eddng do nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p g\u00e2y ra. Ngo\u00e0i ra, COPD c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 m\u1eafc c\u00e1c b\u1ec7nh \u0111i k\u00e8m cao nh\u01b0 b\u1ec7nh tim m\u1ea1ch v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Do \u0111\u00f3, COPD v\u00e0 COVID 19 c\u00f3 nhi\u1ec1u m\u1ed1i t\u01b0\u01a1ng quan x\u1ea5u ti\u1ec1m \u1ea9n, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 t\u1ed3i t\u1ec7 h\u01a1n t\u1eeb COVID 19, bao g\u1ed3m suy gi\u1ea3m ch\u1ee9c n\u0103ng ph\u1ed5i, tu\u1ed5i gi\u00e0 v\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c b\u1ec7nh \u0111i k\u00e8m \u1edf b\u1ec7nh nh\u00e2n COPD. H\u01a1n n\u1eefa, b\u1ec7nh nh\u00e2n COPD c\u0169ng c\u00f3 th\u1ec3 d\u1ec5 b\u1ecb nhi\u1ec5m virus h\u01a1n bao g\u1ed3m c\u1ea3 SARS-CoV-2.<\/p>\n

2. C\u01a1 ch\u1ebf nhi\u1ec5m COVID 19 \u1edf b\u1ec7nh nh\u00e2n COPD<\/strong><\/h2>\n

T\u00ednh h\u01b0\u1edbng t\u1ebf b\u00e0o c\u1ee7a nhi\u1ec5m SARS-CoV-2 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi s\u1ef1 bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c th\u1ee5 th\u1ec3 \u0111\u1ed1i v\u1edbi virus, bao g\u1ed3m c\u1ea3 men chuy\u1ec3n angiotensin 2 (ACE2). C\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 ph\u1ebf qu\u1ea3n v\u00e0 ph\u1ebf nang c\u0169ng nh\u01b0 c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 ph\u1ed5i bi\u1ec3u hi\u1ec7n ACE2 v\u00e0 d\u1ec5 b\u1ecb nhi\u1ec5m virus trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p COVID 19.<\/p>\n

C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 bi\u1ec3u hi\u1ec7n gen v\u00e0 protein \u0111\u00e3 b\u00e1o c\u00e1o s\u1ef1 gia t\u0103ng\u00a0 bi\u1ec3u hi\u1ec7n c\u1ee7a ACE2 trong c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 COPD so v\u1edbi nh\u00f3m ch\u1ee9ng, v\u1edbi bi\u1ec3u hi\u1ec7n gia t\u0103ng \u1edf b\u1ec7nh nh\u00e2n COPD c\u00f3 ch\u1ec9 s\u1ed1 BMI cao h\u01a1n v\u00e0 c\u00e1c \u0111\u1ee3t c\u1ea5p th\u01b0\u1eddng xuy\u00ean h\u01a1n c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn. C\u00f3 nh\u1eefng ph\u00e1t hi\u1ec7n kh\u00f4ng r\u00f5 r\u00e0ng v\u1ec1 nh\u1eefng thay \u0111\u1ed5i trong bi\u1ec3u hi\u1ec7n protein ph\u1ee5, bao g\u1ed3m Protease Serine xuy\u00ean m\u00e0ng 2 (TMPRSS2) v\u00e0 Furin.<\/p>\n

Bi\u1ec3u hi\u1ec7n c\u1ee7a ph\u00e2n t\u1eed b\u00e1m d\u00ednh n\u1ed9i b\u00e0o 1 (ICAM-1) c\u0169ng t\u0103ng l\u00ean trong ph\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n COPD.<\/p>\n

Nh\u00ecn chung, nh\u1eefng ph\u00e1t hi\u1ec7n n\u00e0y cho th\u1ea5y c\u00f3 s\u1ef1 t\u1ef7 l\u1ec7 gia t\u0103ng virus x\u00e2m nh\u1eadp v\u00e0o ph\u1ed5i b\u1ec7nh nh\u00e2n COPD.<\/p>\n

C\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y c\u00e1c ph\u1ea3n \u1ee9ng kh\u00e1ng virus c\u1ee7a v\u1eadt ch\u1ee7, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c Interferon, b\u1ecb suy gi\u1ea3m \u1edf b\u1ec7nh nh\u00e2n COPD. Trong qu\u00e1 tr\u00ecnh nhi\u1ec5m virus, vi\u1ec7c s\u1ea3n xu\u1ea5t Interferon (IFN) \u03b1, \u03b2 v\u00e0 \u03bb t\u1eeb c\u00e1c t\u1ebf b\u00e0o d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang \u1edf b\u1ec7nh nh\u00e2n COPD th\u1ea5p h\u01a1n so v\u1edbi nh\u00f3m ch\u1ee9ng, m\u1eb7c d\u00f9 ch\u1ec9 c\u00f3 \u00fd ngh\u0129a \u0111\u1ed1i v\u1edbi IFN-\u03b2.<\/p>\n

B\u1ec7nh nh\u00e2n COPD g\u1eb7p nhi\u1ec1u tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p h\u01a1n, \u0111\u1ed3ng th\u1eddi c\u0169ng c\u00f3 t\u1ea3i l\u01b0\u1ee3ng virus cao h\u01a1n v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u vi\u00eam nhi\u1ec5m gia t\u0103ng. M\u1ed9t nghi\u00ean c\u1ee9u h\u00f3a m\u00f4 mi\u1ec5n d\u1ecbch cho th\u1ea5y bi\u1ec3u hi\u1ec7n ph\u1ebf qu\u1ea3n v\u00e0 \u0111\u1ea1i th\u1ef1c b\u00e0o bi\u1ec3u m\u00f4 ph\u1ebf nang c\u1ee7a IFN-\u03b2 \u1edf b\u1ec7nh nh\u00e2n COPD th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi nh\u00f3m ch\u1ee9ng.<\/p>\n

H\u01a1n n\u1eefa, n\u1ed3ng \u0111\u1ed9 IFN-\u03b2 v\u00e0 IFN-\u03bb trong \u0111\u00e0m th\u1ea5p h\u01a1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n COPD c\u00f3 nhi\u1ec1u \u0111\u1ee3t c\u1ea5p h\u01a1n, cho th\u1ea5y r\u1eb1ng vi\u1ec7c gi\u1ea3m kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 c\u1ee7a v\u1eadt ch\u1ee7 ch\u1ed1ng l\u1ea1i nhi\u1ec5m virus c\u00f3 li\u00ean quan \u0111\u1ebfn k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng t\u1ed3i t\u1ec7 h\u01a1n.<\/p>\n

Gi\u1ea3m s\u1ea3n xu\u1ea5t IFN c\u00f3 th\u1ec3 do gi\u1ea3m t\u00edn hi\u1ec7u b\u1edfi c\u00e1c th\u1ee5 th\u1ec3 nh\u1eadn d\u1ea1ng; bi\u1ec3u hi\u1ec7n bi\u1ec3u m\u00f4 ph\u1ebf qu\u1ea3n c\u1ee7a gen 5 li\u00ean quan \u0111\u1ebfn bi\u1ec7t h\u00f3a kh\u1ed1i u \u00e1c t\u00ednh (MDA-5) v\u00e0 gen 1 c\u1ea3m \u1ee9ng Axit Retinoic (RIG-1) gi\u1ea3m \u1edf b\u1ec7nh nh\u00e2n COPD so v\u1edbi nh\u00f3m ch\u1ee9ng, cho th\u1ea5y r\u1eb1ng c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 ph\u1ebf qu\u1ea3n c\u1ee7a COPD k\u00e9m hi\u1ec7u qu\u1ea3 h\u01a1n khi g\u1eafn k\u1ebft c\u00e1c ph\u1ea3n \u1ee9ng ch\u1ed1ng virus.<\/p>\n

Veerati et al \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng vi\u1ec7c s\u1ea3n xu\u1ea5t IFN-\u03b2 v\u00e0 bi\u1ec3u hi\u1ec7n gen kh\u00e1ng virus b\u1edfi c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 COPD \u0111\u00e3 b\u1ecb tr\u00ec ho\u00e3n sau khi nhi\u1ec5m virus. M\u1eb7c d\u00f9 c\u00e1c ph\u1ea3n \u1ee9ng kh\u00e1ng virus s\u1eed d\u1ee5ng c\u00e1c t\u1ebf b\u00e0o ph\u1ed5i COPD ti\u1ebfp x\u00fac v\u1edbi SARS-CoV-2 ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u, nh\u01b0ng b\u1eb1ng ch\u1ee9ng s\u1eed d\u1ee5ng c\u00e1c m\u00f4 h\u00ecnh ph\u01a1i nhi\u1ec5m virus kh\u00e1c cho th\u1ea5y s\u1ef1 \u0111i\u1ec1u ch\u1ec9nh gi\u1ea3m c\u1ee7a c\u00e1c c\u01a1 ch\u1ebf b\u1ea3o v\u1ec7 Interferon.<\/p>\n

Gi\u1ea3m b\u1ea1ch huy\u1ebft v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o T c\u00f3 li\u00ean quan \u0111\u1ebfn k\u1ebft qu\u1ea3 x\u1ea5u h\u01a1n \u1edf COVID 19. C\u00e1c t\u1ebf b\u00e0o T trong ph\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n COPD bi\u1ec3u hi\u1ec7n gia t\u0103ng bi\u1ec3u hi\u1ec7n c\u1ee7a protein ch\u1ebft t\u1ebf b\u00e0o \u0111\u01b0\u1ee3c l\u1eadp tr\u00ecnh 1 (m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a s\u1ef1 c\u1ea1n ki\u1ec7t t\u1ebf b\u00e0o T), trong khi bi\u1ec3u hi\u1ec7n c\u1ee7a th\u1ee5 th\u1ec3 t\u1ebf b\u00e0o T (TCR) gi\u1ea3m so v\u1edbi nh\u00f3m ch\u1ee9ng.<\/p>\n

Nh\u1eefng quan s\u00e1t n\u00e0y ch\u1ec9 ra r\u1eb1ng c\u00e1c t\u1ebf b\u00e0o T c\u1ee7a COPD b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng; \u0111i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1edfi c\u00e1c b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c gi\u1ea3m tho\u00e1i h\u00f3a b\u1edfi c\u00e1c t\u1ebf b\u00e0o T ph\u1ed5i COPD \u0111\u1ec3 \u0111\u00e1p \u1ee9ng v\u1edbi nhi\u1ec5m c\u00fam v\u00e0 gi\u1ea3m s\u1ea3n xu\u1ea5t Cytokine t\u1eeb c\u00e1c t\u1ebf b\u00e0o T m\u00e1u COPD sau khi k\u00edch ho\u1ea1t TCR. R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o T \u1edf b\u1ec7nh nh\u00e2n COPD c\u00f3 th\u1ec3 g\u00e2y ra ph\u1ea3n \u1ee9ng b\u1ea3o v\u1ec7 v\u1eadt ch\u1ee7 d\u01b0\u1edbi m\u1ee9c t\u1ed1i \u01b0u \u0111\u1ed1i v\u1edbi nhi\u1ec5m SARS-CoV-2.<\/p>\n

\"\"
Ngu\u1ed3n<\/strong>: Janice M. Leung, Masahiro Niikura, Cheng Wei Tony Yang, Don D. Sin, “COVID-19 and\u00a0 \u00a0 COPD”,<\/strong> European Respiratory Journal<\/em>, 2020.<\/figcaption><\/figure>\n

Ngu\u1ed3n tham kh\u1ea3o<\/strong>: Singh, Dave, Mathioudakis, Alexander G, Higham, Andrew, \u201cChronic obstructive pulmonary disease and COVID-19: interrelationships\u201d, Current Opinion in Pulmonary Medicine, <\/em>2022.<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u1ec7nh nh\u00e2n COPD (Chronic Obstructive Pulmonary Disease) l\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 h\u1ec7 th\u1ed1ng h\u00f4 h\u1ea5p y\u1ebfu v\u00e0 th\u01b0\u1eddng xuy\u00ean g\u1eb7p kh\u00f3 kh\u0103n trong vi\u1ec7c th\u1edf. V\u00ec v\u1eady, khi b\u1ecb nhi\u1ec5m COVID 19, b\u1ec7nh nh\u00e2n COPD c\u00f3 nguy c\u01a1 cao h\u01a1n \u0111\u1ec3 ph\u00e1t tri\u1ec3n ra c\u00e1c tri\u1ec7u ch\u1ee9ng nghi\u00eam tr\u1ecdng v\u00e0 t\u1eed vong. Tuy nhi\u00ean, trong […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"\nC\u01a1 ch\u1ebf th\u00fac \u0111\u1ea9y nhi\u1ec5m COVID 19 \u1edf b\u1ec7nh nh\u00e2n COPD<\/title>\n<meta name=\"description\" content=\"Khi b\u1ecb nhi\u1ec5m COVID 19, b\u1ec7nh nh\u00e2n COPD c\u00f3 nguy c\u01a1 cao h\u01a1n \u0111\u1ec3 ph\u00e1t tri\u1ec3n ra c\u00e1c tri\u1ec7u ch\u1ee9ng nghi\u00eam tr\u1ecdng v\u00e0 t\u1eed vong. 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