{"id":27152,"date":"2023-04-28T19:43:03","date_gmt":"2023-04-28T12:43:03","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27152"},"modified":"2023-04-28T19:43:20","modified_gmt":"2023-04-28T12:43:20","slug":"glucocorticoids-co-che-tac-dong-len-he-mien-dich","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/28\/glucocorticoids-co-che-tac-dong-len-he-mien-dich\/","title":{"rendered":"Glucocorticoids: C\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng l\u00ean h\u1ec7 mi\u1ec5n d\u1ecbch"},"content":{"rendered":"<p>Glucocorticoid, c\u00f3 kh\u1ea3 n\u0103ng ch\u1ed1ng vi\u00eam v\u00e0 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch m\u1ed9t c\u00e1ch m\u1ea1nh m\u1ebd. Ch\u00fang \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n vi\u00eam v\u00e0 t\u1ef1 mi\u1ec5n m\u00e3n c\u1ea5p t\u00ednh v\u00e0 m\u00e3n t\u00ednh. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a glucocorticosteroid \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch v\u00e0 c\u00f3 th\u1ec3 \u0111i\u1ec1u ch\u1ec9nh c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch kh\u00e1c nhau.<\/p>\n<h2>1. Gi\u1edbi thi\u1ec7u<\/h2>\n<p>Glucocorticoids, c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 corticosteroids, c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng vi\u00eam v\u00e0 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch m\u1ea1nh m\u1ebd. Ch\u00fang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n vi\u00eam v\u00e0 t\u1ef1 mi\u1ec5n m\u00e3n t\u00ednh v\u00e0 c\u1ea5p t\u00ednh. Glucocorticoids t\u00e1c \u0111\u1ed9ng l\u00ean nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch v\u00e0 c\u00f3 th\u1ec3 \u0111i\u1ec1u ho\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch kh\u00e1c nhau. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd xem x\u00e9t c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a glucocorticoids tr\u00ean h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u01a1 th\u1ec3 ng\u01b0\u1eddi.<\/p>\n<h2>2. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a glucocorticoids<\/h2>\n<p>Glucocorticoids c\u00f3 kh\u1ea3 n\u0103ng khu\u1ebfch t\u00e1n qua m\u00e0ng t\u1ebf b\u00e0o v\u00e0 g\u1eafn v\u1edbi v\u1edbi th\u1ee5 th\u1ec3 glucocorticoid n\u1eb1m \u1edf b\u00ean trong t\u1ebf b\u00e0o. Sau \u0111\u00f3, ch\u00fang s\u1ebd di chuy\u1ec3n v\u00e0o nh\u00e2n, n\u01a1i m\u00e0 ch\u00fang c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u00e1c tr\u1ef1c ti\u1ebfp v\u1edbi c\u00e1c chu\u1ed7i DNA \u0111\u1eb7c hi\u1ec7u (y\u1ebfu t\u1ed1 ph\u1ea3n \u1ee9ng glucocorticoid &#8211; GRE) v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 phi\u00ean m\u00e3 kh\u00e1c (transcription factors).<\/p>\n<h3><strong>2.1. T\u00e1c \u0111\u1ed9ng \u0111\u1ebfn qu\u00e1 tr\u00ecnh phi\u00ean m\u00e3 gen<\/strong><\/h3>\n<p>Vi\u1ec7c g\u1eafn c\u00e1c th\u1ee5 th\u1ec3 v\u1edbi GRE c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng ho\u1eb7c gi\u1ea3m qu\u00e1 tr\u00ecnh phi\u00ean m\u00e3 c\u1ee7a gen. C\u00e1c h\u1ec7 qu\u1ea3 \u0111\u01b0\u1ee3c l\u01b0u \u00fd c\u1ee7a t\u00e1c \u0111\u1ed9ng c\u1ee7a GCs \u0111\u1ebfn qu\u00e1 tr\u00ecnh phi\u00ean m\u00e3 gen g\u00f3p ph\u1ea7n h\u00ecnh th\u00e0nh t\u00e1c d\u1ee5ng ch\u1ed1ng vi\u00eam c\u1ee7a n\u00f3, bao g\u1ed3m:<\/p>\n<ul>\n<li>G\u1eafn v\u00e0 kho\u00e1 c\u00e1c v\u1ecb tr\u00ed kh\u1edfi \u0111\u1ea7u c\u1ee7a c\u00e1c gen ti\u1ec1n vi\u00eam, ch\u1eb3ng h\u1ea1n nh\u01b0 interleukin (IL)-1-alpha v\u00e0 IL-1-beta.<\/li>\n<li>\u0110\u01b0a c\u00e1c y\u1ebfu t\u1ed1 phi\u00ean m\u00e3 \u0111\u1ebfn v\u00f9ng gen kh\u1edfi \u0111\u1ed9ng (promoter sequences) c\u00e1c gen m\u00e3 h\u00f3a c\u00e1c s\u1ea3n ph\u1ea9m ch\u1ed1ng vi\u00eam bao g\u1ed3m: I-kappa-B-alpha, IL-1, receptor-II, lipocortin-1 (annexin 1), IL-10, alpha-2-macroglobulin v\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u ti\u1ebft ra protease.<\/li>\n<li>\u1ee8c ch\u1ebf t\u1ed5ng h\u1ee3p h\u1ea7u h\u1ebft c\u00e1c cytokine g\u00e2y vi\u00eam. \u0110i\u1ec1u n\u00e0y ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c \u0111\u1ea1t nh\u1edd s\u1ef1 c\u1ea1nh tranh ho\u1eb7c \u1ee9c ch\u1ebf c\u00e1c ch\u1ee9c n\u0103ng c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 phi\u00ean m\u00e3, ch\u1eb3ng h\u1ea1n nh\u01b0 y\u1ebfu t\u1ed1 nh\u00e2n kappa-B (NF-kB) v\u00e0 protein k\u00edch ho\u1ea1t-1 (AP-1). Nh\u1eefng y\u1ebfu t\u1ed1 tr\u00ean \u0111\u1ec1u c\u1ea7n thi\u1ebft cho vi\u1ec7c phi\u00ean m\u00e3 c\u1ee7a c\u00e1c ch\u1ea5t trung gian g\u00e2y vi\u00eam. \u0110i\u1ec1u n\u00e0y c\u00f2n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00f4ng qua t\u00e1c d\u1ee5ng k\u00edch ho\u1ea1t c\u1ee7a glucocorticoids \u0111\u1ebfn c\u00e1c protein kinase mitogen-1 (MAPK) g\u00e2y s\u1ef1 gi\u1ea3m phosphoryl ho\u00e1 c\u1ee7a nhi\u1ec1u protein tham gia trong t\u00edn hi\u1ec7u n\u1ed9i b\u00e0o. Nh\u1eefng protein n\u00e0y bao g\u1ed3m Jun N-terminal kinase (can thi\u1ec7p v\u00e0o s\u1ea3n xu\u1ea5t c-Jun v\u00e0 AP-1), ERK1\/2 v\u00e0 p38 MAPK. Glucocorticoids c\u00f2n gi\u00fap t\u0103ng c\u01b0\u1eddng t\u1ed5ng h\u1ee3p c\u1ee7a I-kappa-B-alpha, m\u1ed9t protein l\u00e0m gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng c\u1ee7a NF-kB.<\/li>\n<\/ul>\n<h3><strong>2.2. T\u00e1c \u0111\u1ed9ng \u0111\u1ebfn c\u00e1c qu\u00e1 tr\u00ecnh sau khi d\u1ecbch m\u00e3\u00a0<\/strong><\/h3>\n<p>Ngo\u00e0i t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u00fang \u0111\u1ebfn phi\u00ean m\u00e3 c\u1ee7a gen, Glucocorticoids c\u0169ng \u1ee9c ch\u1ebf vi\u1ec7c b\u00e0i ti\u1ebft c\u00e1c cytokine vi\u00eam b\u1eb1ng c\u00e1ch t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn c\u00e1c qu\u00e1 tr\u00ecnh sau khi d\u1ecbch m\u00e3. S\u1ef1 \u1ed5n \u0111\u1ecbnh c\u1ee7a mRNA m\u00e3 h\u00f3a IL-1, IL-2, IL-6, IL-8, y\u1ebfu t\u1ed1 ho\u1ea1i t\u1eed kh\u1ed1i u v\u00e0 y\u1ebfu t\u1ed1 k\u00edch th\u00edch d\u00f2ng b\u1ea1ch c\u1ea7u h\u1ea1t-\u0111\u1ea1i th\u1ef1c b\u00e0o (GM-CSF) b\u1ecb gi\u1ea3m trong m\u00f4i tr\u01b0\u1eddng c\u00f3 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a Glucocorticoids. C\u00e1c t\u00e1c d\u1ee5ng c\u1ee7a glucocorticoids \u1edf c\u00e1c qu\u00e1 tr\u00ecnh sau d\u1ecbch m\u00e3 bao g\u1ed3m:<\/p>\n<ul>\n<li>T\u0103ng t\u1ed5ng h\u1ee3p c\u00e1c enzyme chuy\u1ec3n ho\u00e1 angiotensin v\u00e0 neutral-endopeptidase gi\u00fap ph\u00e2n hu\u1ef7 bradykinin, \u0111\u00e2y l\u00e0 m\u1ed9t peptid gi\u00e3n m\u1ea1ch trung t\u00e2m g\u00f3p ph\u1ea7n v\u00e0o qu\u00e1 tr\u00ecnh ph\u00f9 n\u1ec1.<\/li>\n<li>Gi\u1ea3m s\u1ea3n xu\u1ea5t c\u00e1c ch\u1ea5t trung gian g\u00e2y vi\u00eam h\u1ecd\u00a0<em>eicosanoid<\/em> \u1edf c\u00e1c t\u1ebf b\u00e0o th\u1ef1c b\u00e0o b\u1eb1ng c\u00e1ch k\u00edch ho\u1ea1t t\u1ed5ng h\u1ee3p c\u1ee7a lipocortin-1 (annexin 1), macrocortin +\/- lipomodulin, t\u1ea5t c\u1ea3 \u0111\u1ec1u \u1ee9c ch\u1ebf s\u1ef1 gi\u1ea3i ph\u00f3ng c\u1ee7a axit arachidonic \u0111\u01b0\u1ee3c g\u1eafn li\u1ec1n v\u1edbi phospholipid m\u00e0ng t\u1ebf b\u00e0o do phospholipase A2 trung gian.<\/li>\n<li>Gi\u1ea3m t\u1ed5ng h\u1ee3p c\u1ee7a cyclooxygenase (COX)-2 ch\u1ecbu tr\u00e1ch nhi\u1ec7m ch\u00ednh cho s\u1ef1 s\u1ea3n xu\u1ea5t prostaglandin t\u1ea1i c\u00e1c v\u1ecb tr\u00ed ch\u1ea5n th\u01b0\u01a1ng v\u00e0 vi\u00eam. Qu\u00e1 tr\u00ecnh n\u00e0y ch\u1ee7 y\u1ebfu l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 \u1ee9c ch\u1ebf NF-kB c\u1ee7a Glucocorticoids. Glucocorticoids d\u01b0\u1eddng nh\u01b0 kh\u00f4ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p c\u1ee7a COX-1.<\/li>\n<\/ul>\n<div class=\"flex-1 overflow-hidden\">\n<div class=\"react-scroll-to-bottom--css-gvehe-79elbk h-full dark:bg-gray-800\">\n<div class=\"react-scroll-to-bottom--css-gvehe-1n7m0yu\">\n<div class=\"flex flex-col items-center text-sm dark:bg-gray-800\">\n<div class=\"group w-full text-gray-800 dark:text-gray-100 border-b border-black\/10 dark:border-gray-900\/50 bg-gray-50 dark:bg-[#444654]\">\n<div class=\"text-base gap-4 md:gap-6 md:max-w-2xl lg:max-w-xl xl:max-w-3xl p-4 md:py-6 flex lg:px-0 m-auto\">\n<div class=\"relative flex w-[calc(100%-50px)] flex-col gap-1 md:gap-3 lg:w-[calc(100%-115px)]\">\n<div class=\"flex flex-grow flex-col gap-3\">\n<div class=\"min-h-[20px] flex flex-col items-start gap-4 whitespace-pre-wrap\">\n<div class=\"markdown prose w-full break-words dark:prose-invert dark\">\n<h2>3. Kho\u1ea3ng li\u1ec1u s\u1eed d\u1ee5ng Glucocorticoids<\/h2>\n<div class=\"flex-1 overflow-hidden\">\n<div class=\"react-scroll-to-bottom--css-bhioe-79elbk h-full dark:bg-gray-800\">\n<div class=\"react-scroll-to-bottom--css-bhioe-1n7m0yu\">\n<div class=\"flex flex-col items-center text-sm dark:bg-gray-800\">\n<div class=\"group w-full text-gray-800 dark:text-gray-100 border-b border-black\/10 dark:border-gray-900\/50 bg-gray-50 dark:bg-[#444654]\">\n<div class=\"text-base gap-4 md:gap-6 md:max-w-2xl lg:max-w-xl xl:max-w-3xl p-4 md:py-6 flex lg:px-0 m-auto\">\n<div class=\"relative flex w-[calc(100%-50px)] flex-col gap-1 md:gap-3 lg:w-[calc(100%-115px)]\">\n<div class=\"flex flex-grow flex-col gap-3\">\n<div class=\"min-h-[20px] flex flex-col items-start gap-4 whitespace-pre-wrap\">\n<div class=\"markdown prose w-full break-words dark:prose-invert dark\">\n<p>M\u1ed9t s\u1ed1 t\u00e1c \u0111\u1ed9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u00e1c glucocorticoids ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng v\u00e0 ph\u1ee5 thu\u1ed9c ch\u00ednh v\u00e0o \u00e1i l\u1ef1c c\u1ee7a ph\u1ee9c h\u1ee3p glucocorticoids v\u00e0 th\u1ee5 th\u1ec3 c\u1ee7a ch\u00fang t\u00e1c \u0111\u1ed9ng l\u00ean c\u00e1c v\u00f9ng gen kh\u00e1c nhau. C\u00e1c v\u00f9ng gen c\u00f3 \u00e1i l\u1ef1c cao c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi c\u00e1c n\u1ed3ng \u0111\u1ed9 glucocorticoid th\u1ea5p, t\u0103ng n\u1ed3ng \u0111\u1ed9c glucocorticoids s\u1ebd t\u0103ng m\u1ee9c \u0111\u1ed9 \u1ea3nh h\u01b0\u1edfng l\u00ean v\u00f9ng gen tr\u00ean. Vi\u1ec7c s\u1eed d\u1ee5ng glucocorticoids t\u0129nh m\u1ea1ch li\u00ea\u0300u cao c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 ph\u00e1 v\u1ee1 qu\u00e1 tr\u00ecnh phi\u00ean m\u00e3 c\u1ee7a gen. Ngo\u00e0i ra, glucocorticoids t\u0129nh m\u1ea1ch li\u00ea\u0300u cao c\u00f3 th\u1ec3 c\u00f3 t\u00e1c \u0111\u1ed9ng nhanh h\u01a1n \u0111\u1ebfn qu\u00e1 tr\u00ecnh &#8220;k\u00eau g\u1ecdi&#8221; b\u1ea1ch c\u1ea7u, \u0111\u1ed3ng th\u1eddi c\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng l\u00ean s\u1ef1 bi\u1ec3u hi\u1ec7n c\u1ee7a ph\u00e2n t\u1eed k\u1ebft d\u00ednh b\u1ea1ch c\u1ea7u (leukocyte-adhesion).<\/p>\n<p>M\u1ed7i ng\u01b0\u1eddi kh\u00e1c nhau v\u1ec1 m\u1ee9c \u0111\u1ed9 nh\u1ea1y c\u1ea3m v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a glucocorticoids l\u00ean c\u01a1 th\u1ec3. C\u00e1c c\u01a1 ch\u1ebf \u0111\u1ec1 xu\u1ea5t g\u00e2y ra s\u1ef1 \u0111a d\u1ea1ng n\u00e0y:<\/p>\n<ul>\n<li><strong>C\u00e1c li\u1ec1u th\u1ea5p \u0111\u1ebfn trung b\u00ecnh: <\/strong>Li\u1ec1u th\u1ea5p \u0111\u1ebfn trung b\u00ecnh c\u1ee7a prednisone c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 li\u1ec1u l\u01b0\u1ee3ng l\u00ean \u0111\u1ebfn 1 mg \/ kg m\u1ed7i ng\u00e0y prednisone \u1edf tr\u1ebb em ho\u1eb7c 40 mg m\u1ed7i ng\u00e0y \u1edf ng\u01b0\u1eddi l\u1edbn, v\u00ec \u0111\u00e2y l\u00e0 ng\u01b0\u1ee1ng x\u1ea5p x\u1ec9 m\u00e0 c\u00e1c \u0111\u1ed9c t\u00ednh \u0111\u00e1ng k\u1ec3 b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng k\u00e9o d\u00e0i \u1edf h\u1ea7u h\u1ebft c\u00e1c c\u00e1 th\u1ec3. C\u00e1c li\u1ec1u t\u01b0\u01a1ng \u0111\u01b0\u01a1ng c\u1ee7a c\u00e1c glucocorticoid kh\u00e1c \u0111\u01b0\u1ee3c hi\u1ec3n th\u1ecb trong b\u1ea3ng 1 d\u01b0\u1edbi \u0111\u00e2y.<\/li>\n<li><strong>Li\u1ec1u cao:<\/strong> Li\u1ec1u &gt;1 mg\/kg\/ng\u00e0y \u1edf tr\u1ebb em ho\u1eb7c &gt;40 mg m\u1ed7i ng\u00e0y \u1edf ng\u01b0\u1eddi l\u1edbn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 li\u1ec1u cao cho m\u1ee5c ti\u00eau v\u1ec1 mi\u1ec5n d\u1ecbch. T\u00e1c \u0111\u1ed9ng mi\u1ec5n d\u1ecbch c\u1ee7a Glucocorticoids \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch li\u1ec1u cao, ng\u1eafn h\u1ea1n c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. \u1ea2nh h\u01b0\u1edfng c\u1ea5p t\u00ednh c\u1ee7a 1 gam methylprednisolone t\u0129nh m\u1ea1ch \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 trong m\u1ed9t nghi\u00ean c\u1ee9u nh\u1ecf tr\u00ean b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh 1 ho\u1eb7c 3 li\u1ec1u methylprednisolone h\u00e0ng ng\u00e0y (1 g\/li\u1ec1u). Gi\u1ea3m b\u1ea1ch c\u1ea7u lympho (lymphopenia) ph\u00e1t tri\u1ec3n trong v\u00f2ng 2 gi\u1edd sau khi s\u1eed d\u1ee5ng thu\u1ed1c, \u0111\u1ea1t \u0111\u1ec9nh trong 6 gi\u1edd v\u00e0 gi\u1ea3i quy\u1ebft v\u00e0o th\u1eddi \u0111i\u1ec3m 24 gi\u1edd v\u1edbi c\u1ea3 hai li\u1ec1u. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c theo d\u00f5i trong 16 tu\u1ea7n, trong \u0111\u00f3 k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh c\u1ee7a x\u00e9t nghi\u1ec7m da \u0111\u1ed1i v\u1edbi ch\u1ea5t d\u1eabn xu\u1ea5t protein tinh khi\u1ebft (purified protein derivative) kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng, m\u1ee9c \u0111\u1ed9 kh\u00e1ng th\u1ec3 mi\u1ec5n d\u1ecbch trong huy\u1ebft thanh kh\u00f4ng thay \u0111\u1ed5i v\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng kh\u00e1ng th\u1ec3 \u0111\u1ed1i v\u1edbi kh\u00e1ng nguy\u00ean l\u00e0 b\u00ecnh th\u01b0\u1eddng. X\u00e9t nghi\u1ec7m in vitro (trong \u1ed1ng nghi\u1ec7m), s\u1ef1 t\u0103ng sinh c\u00e1c t\u1ebf b\u00e0o lympho \u0111\u1ed1i v\u1edbi c\u00e1c ch\u1ea5t k\u00edch th\u00edch mitogens \u0111\u1ec1u \u0111\u01b0\u1ee3c \u1ee9c ch\u1ebf t\u1ed1i \u0111a \u1edf n\u1ed3ng \u0111\u1ed9 glucocorticoids t\u01b0\u01a1ng \u1ee9ng v\u1edbi 1 g methylprednisolone \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch.\n<p><figure id=\"attachment_29144\" aria-describedby=\"caption-attachment-29144\" style=\"width: 372px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\" wp-image-29144\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-24-175449-2-300x83.png\" alt=\"Lieu-tuong-duong-cac-lo\u1ea1i-Glucocorticoids\" width=\"372\" height=\"103\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-24-175449-2-300x83.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-24-175449-2-1024x283.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-24-175449-2-768x212.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-24-175449-2.png 1227w\" sizes=\"(max-width: 372px) 100vw, 372px\" \/><figcaption id=\"caption-attachment-29144\" class=\"wp-caption-text\">Li\u1ec1u t\u01b0\u01a1ng \u0111\u01b0\u01a1ng c\u00e1c lo\u1ea1i Glucocorticoids<\/figcaption><\/figure><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h2>4. K\u1ebft lu\u1eadn<\/h2>\n<p>Glucocorticoids c\u00f3 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c chu\u1ed7i DNA \u0111\u1eb7c hi\u1ec7u (y\u1ebfu t\u1ed1 ph\u1ea3n \u1ee9ng glucocorticoids &#8211; GRE) v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 phi\u00ean m\u00e3 kh\u00e1c (transcription factors). T\u1eeb \u0111\u00f3, t\u1ea1o n\u00ean c\u00e1c t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn qu\u00e1 tr\u00ecnh phi\u00ean m\u00e3 gen v\u00e0 c\u00e1c qu\u00e1 tr\u00ecnh sau d\u1ecbch m\u00e3, g\u00f3p ph\u1ea7n h\u00ecnh th\u00e0nh t\u00e1c d\u1ee5ng ch\u1ed1ng vi\u00eam c\u1ee7a ch\u00fang. Hi\u1ec3u r\u00f5 v\u1ec1 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng glucocorticoids tr\u00ean h\u1ec7 mi\u1ec5n d\u1ecbch ng\u01b0\u1eddi r\u1ea5t h\u1eefu \u00edch cho c\u00e1c chuy\u00ean gia y t\u1ebf trong qu\u00e1 tr\u00ecnh s\u1eed d\u1ee5ng ch\u00fang.<\/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 Glucocorticoids v\u00e0 h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 con ng\u01b0\u1eddi.<\/p>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o: <\/strong>Uptodate<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Glucocorticoid, c\u00f3 kh\u1ea3 n\u0103ng ch\u1ed1ng vi\u00eam v\u00e0 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch m\u1ed9t c\u00e1ch m\u1ea1nh m\u1ebd. Ch\u00fang \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n vi\u00eam v\u00e0 t\u1ef1 mi\u1ec5n m\u00e3n c\u1ea5p t\u00ednh v\u00e0 m\u00e3n t\u00ednh. C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a glucocorticosteroid \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch v\u00e0 c\u00f3 th\u1ec3 \u0111i\u1ec1u ch\u1ec9nh [&hellip;]<\/p>\n","protected":false},"author":55,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[73,12,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Glucocorticoids: C\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng l\u00ean h\u1ec7 mi\u1ec5n d\u1ecbch - Vinmec<\/title>\n<meta name=\"description\" content=\"Glucocorticoids \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n vi\u00eam v\u00e0 t\u1ef1 mi\u1ec5n m\u00e3n t\u00ednh v\u00e0 c\u1ea5p t\u00ednh. 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