{"id":27430,"date":"2023-04-23T21:44:42","date_gmt":"2023-04-23T14:44:42","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27430"},"modified":"2023-04-25T19:28:41","modified_gmt":"2023-04-25T12:28:41","slug":"chen-beta-suy-tim-man","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/","title":{"rendered":"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n"},"content":{"rendered":"

Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n t\u00ednh.<\/span>Qu\u00e1 tr\u00ecnh suy tim m\u1ea1ng di\u1ec5n ra khi tr\u00e1i tim kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng hi\u1ec7u qu\u1ea3 \u0111\u1ec3 truy\u1ec1n m\u00e1u ra kh\u1ecfi c\u01a1 th\u1ec3. <\/span>\u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 kh\u00f3 th\u1edf, m\u1ec7t m\u1ecfi v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1edf. <\/span>Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m<\/a> gi\u00fap gi\u1ea3m t\u1ed1c \u0111\u1ed9, gi\u1ea3m \u00e1p l\u1ef1c tr\u00ean tr\u00e1i tim v\u00e0 gi\u1ea3m m\u1ee9c ti\u00eau th\u1ee5 oxy c\u1ee7a tim, t\u1eeb \u0111\u00f3 gi\u00fap ti\u1ebft ki\u1ec7m n\u0103ng l\u01b0\u1ee3ng v\u00e0 gi\u1ea3m c\u0103ng th\u1eb3ng tr\u00ean tr\u00e1i tim. <\/span>\u0110i\u1ec1u n\u00e0y gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng tim m\u1ea1ch, gi\u1ea3m tri\u1ec7u ch\u1ee9ng v\u00e0 t\u0103ng c\u01b0\u1eddng s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/span><\/span><\/strong><\/p>\n

\"suy
\u00a0 \u00a0\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Suy tim m\u1ea1n<\/strong><\/span><\/span><\/figcaption><\/figure>\n

 <\/p>\n

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

Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n t\u00ednh. <\/span>Thu\u1ed1c ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch gi\u1edbi h\u1ea1n ch\u1ebf \u0111\u1ed9 k\u00edch th\u00edch th\u00e1i \u0111\u1ed9 c\u1ee7a h\u1ec7 th\u1ed1ng th\u1ea7n kinh giao c\u1ea3m, m\u1ed9t c\u01a1 ch\u1ebf \u0111i\u1ec1u h\u00f2a ng\u01b0\u1ee3c trong suy tim m\u1ea1n t\u00ednh. <\/span>Vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n s\u1ef1 s\u1ed1ng c\u00f2n, gi\u1ea3m t\u00e1i sinh nh\u1eadp vi\u1ec7n l\u00e0m \u0111\u1ee3t c\u1ea5p v\u00e0 gi\u1ea3m nh\u1ecbp tim.<\/span><\/span><\/p>\n

Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb suy tim, bao g\u1ed3m carvedilol, metoprolol, bisoprolol v\u00e0 nebivolol. <\/span>Tuy nhi\u00ean, l\u1ee3i \u00edch c\u1ee7a ch\u1eb9n beta giao c\u1ea3m xu\u1ea5t hi\u1ec7n ch\u1eadm v\u00e0 l\u00e2u d\u00e0i, do \u0111\u00f3, c\u1ea7n s\u1eed d\u1ee5ng m\u1ee9c th\u1ea5p nh\u1ea5t khi kh\u1edfi \u0111\u1ed9ng, sau \u0111\u00f3 t\u0103ng d\u1ea7n \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee9c t\u1ed1i \u01b0u v\u00e0 gi\u1ea3m thi\u1ec3u t\u00e1c d\u1ee5ng ph\u1ee5.<\/span><\/span><\/p>\n

Tuy nhi\u00ean, thu\u1ed1c ch\u1eb9n beta ch\u1ed1ng giao c\u1ea3m c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 ch\u1ec9 \u0111\u1ecbnh. <\/span>\u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh \u0111ang trong giai \u0111o\u1ea1n m\u1ea5t b\u00f9, nh\u1ecbp ch\u1eadm ho\u1eb7c b\u1ecb hen ph\u1ebf qu\u1ea3n th\u00ec kh\u00f4ng n\u00ean d\u00f9ng thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m. <\/span>Tr\u01b0\u1edbc khi d\u00f9ng thu\u1ed1c, b\u1ec7nh nh\u00e2n n\u00ean tham kh\u1ea3o \u00fd ki\u1ebfn \u200b\u200bc\u1ee7a b\u00e1c s\u0129 \u0111\u1ec3 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u00e0 gi\u00e1m s\u00e1t t\u00ecnh h\u00ecnh s\u1ee9c kh\u1ecfe.<\/span><\/span><\/p>\n

 <\/p>\n

2. Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m trong suy tim m\u1ea1n<\/span><\/span><\/h2>\n
    \n
  • Bisoprolol: Li\u1ec1u kh\u1edfi \u0111\u1ea7u l\u00e0 1,25 mg m\u1ed7i ng\u00e0y, u\u1ed1ng m\u1ed9t l\u1ea7n. <\/span>N\u1ebfu c\u1ea7n thi\u1ebft, m\u1ec7nh l\u1ec7nh c\u00f3 th\u1ec3 t\u0103ng d\u1ea7n l\u00ean 10 mg m\u1ed7i ng\u00e0y, u\u1ed1ng m\u1ed9t l\u1ea7n.<\/span><\/span><\/li>\n
  • Carvedilol: Carvedilol l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m v\u00e0 \u0111\u1ed3ng th\u1eddi c\u00f3 t\u00e1c d\u1ee5ng ch\u1eb9n alpha trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n v\u00e0 c\u00e1c b\u1ec7nh tim m\u1ea1ch kh\u00e1c. <\/span>Thu\u1ed1c ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch gi\u1ea3m t\u1ed1c \u0111\u1ed9 th\u1eddi gian, gi\u1ea3m \u00e1p l\u1ef1c b\u00ean tr\u00e1i th\u1eddi gian v\u00e0 gi\u1ea3m m\u1ee9c ti\u00eau th\u1ee5 oxy c\u1ee7a th\u1eddi gian. <\/span>Ngo\u00e0i ra, Carvedilol c\u00f2n c\u00f3 kh\u1ea3 n\u0103ng gi\u1ea3m huy\u1ebft \u00e1p, gi\u1ea3m s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a t\u1ebf b\u00e0o c\u01a1 tim v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng oxy h\u00f3a. <\/span>Kh\u1edfi \u0111\u1ed9ng l\u1ea1i l\u00e0 3,125 mg hai l\u1ea7n m\u1ed7i ng\u00e0y. <\/span>N\u1ebfu c\u1ea7n thi\u1ebft, m\u1ec7nh l\u1ec7nh c\u00f3 th\u1ec3 t\u0103ng d\u1ea7n l\u00ean 25 mg hai l\u1ea7n m\u1ed7i ng\u00e0y.<\/span><\/span><\/li>\n
  • Metoprolol succinate (CR\/XL): Metoprolol succinate (CR\/XL) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m, c\u00f3 d\u1ea1ng thu\u1ed1c ch\u1ed1ng gi\u00e3n trong th\u1eddi gian k\u00e9o d\u00e0i, v\u1edbi t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i trong 24 gi\u1edd. <\/span>Thu\u1ed1c \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 t\u1ed1t th\u00f4ng qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0 c\u00f3 th\u1ec3 u\u1ed1ng \u0111\u01b0\u1ee3c ho\u1eb7c kh\u00f4ng c\u00f3 th\u1ef1c ph\u1ea9m. <\/span>Sau khi u\u1ed1ng, metoprolol succinate CR\/XL s\u1ebd \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng li\u00ean t\u1ee5c trong su\u1ed1t 24 gi\u1edd. <\/span>\u0110i\u1ec1u n\u00e0y gi\u00fap duy tr\u00ec t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c trong m\u1ed9t kho\u1ea3ng th\u1eddi gian d\u00e0i h\u01a1n so v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c ch\u1eb9n beta th\u00f4ng th\u01b0\u1eddng. <\/span>Li\u1ec1u kh\u1edfi \u0111\u1ea7u l\u00e0 12,5-25 mg m\u1ed7i ng\u00e0y, u\u1ed1ng m\u1ed9t l\u1ea7n. <\/span>N\u1ebfu c\u1ea7n thi\u1ebft, m\u1ec7nh l\u1ec7nh c\u00f3 th\u1ec3 t\u0103ng d\u1ea7n l\u00ean 200 mg m\u1ed7i ng\u00e0y, u\u1ed1ng m\u1ed9t l\u1ea7n.<\/span><\/span><\/li>\n
  • Nebivolol: Nebivolol l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb huy\u1ebft \u00e1p cao v\u00e0 suy tim m\u1ea1n t\u00ednh. <\/span>Thu\u1ed1c ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n t\u00e1c d\u1ee5ng c\u1ee7a hormone adrenaline v\u00e0 noradrenaline, gi\u00fap gi\u1ea3m t\u1ed1c \u0111\u1ed9 tim v\u00e0 t\u00e1c d\u1ee5ng l\u1ef1c l\u00ean tr\u00e1i tim. Nebivolol c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m gi\u00e3n m\u1ea1ch v\u00e0 t\u0103ng l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn tim, gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng tim v\u00e0 gi\u1ea3m nguy c\u01a1 engine death do tim. <\/span>Ngo\u00e0i ra, nebivolol c\u00f2n c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng oxy h\u00f3a v\u00e0 gi\u1ea3m s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a t\u1ebf b\u00e0o c\u01a1 tim. Li\u1ec1u kh\u1edfi \u0111\u1ea7u l\u00e0 1,25 mg m\u1ed7i ng\u00e0y, u\u1ed1ng m\u1ed9t l\u1ea7n. <\/span>N\u1ebfu c\u1ea7n thi\u1ebft, m\u1ec7nh l\u1ec7nh c\u00f3 th\u1ec3 t\u0103ng d\u1ea7n l\u00ean 10 mg m\u1ed7i ng\u00e0y, u\u1ed1ng m\u1ed9t l\u1ea7n.<\/span><\/span><\/li>\n<\/ul>\n

     <\/p>\n

    3. Nh\u1eefng l\u01b0u \u00fd khi s\u1eed d\u1ee5ng ch\u1eb9n beta trong b\u1ec7nh suy tim m\u1ea1n t\u00ednh<\/span><\/span><\/h2>\n

    S\u1eed d\u1ee5ng khi b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ec1n (l\u1ee3i ti\u1ec3u, UCMC, digoxin…) v\u00e0 kh\u00f4ng c\u00f2n c\u00e1c d\u1ea5u hi\u1ec7u \u1ee9ng d\u1ecbch (ph\u00f9, gan to, tr\u00e0n d\u1ecbch c\u00e1c ngo\u1ea1i l\u1ec7…). <\/span>khi s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb suy tim, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ec1n tr\u01b0\u1edbc \u0111\u00f3 bao g\u1ed3m c\u00e1c lo\u1ea1i thu\u1ed1c l\u1ee3i ti\u1ec3u nh\u01b0 furosemide, c\u00e1c lo\u1ea1i thu\u1ed1c ch\u1ed1ng co th\u1eaft m\u1ea1ch v\u00e0 gi\u00e3n m\u1ea1ch nh\u01b0 ACE-I ho\u1eb7c ARB, v\u00e0 digoxin (n\u1ebfu c\u1ea7n thi\u1ebft). <\/span>Thu\u1ed1c ch\u1eb9n beta th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t ph\u1ea7n c\u1ee7a \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p \u0111\u1ec3 gi\u1ea3m t\u1ed1c \u0111\u1ed9, gi\u1ea3m \u00e1p l\u1ef1c tr\u00ean tr\u00e1i tim v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng th\u1eddi gian.<\/span><\/span><\/p>\n

    Ngo\u00e0i ra, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c ki\u1ec3m tra \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh kh\u00f4ng c\u00f2n c\u00e1c d\u1ea5u hi\u1ec7u d\u1ecbch nh\u01b0 ph\u00f9, gan, tr\u00e0n d\u1ecbch c\u00e1c ngo\u1ea1i quan, v\u00ec nh\u1eefng d\u1ea5u hi\u1ec7u n\u00e0y c\u00f3 th\u1ec3 cho th\u1ea5y b\u1ec7nh nh\u00e2n \u0111ang trong t\u00ecnh tr\u1ea1ng suy tim n\u1eb7ng v\u00e0 c\u1ea7n thi\u1ebft endurance value. <\/span>N\u1ebfu b\u1ec7nh nh\u00e2n v\u1eabn c\u00f2n c\u00e1c d\u1ea5u hi\u1ec7u n\u00e0y, thu\u1ed1c ch\u1eb9n beta kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c v\u00e0 b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung \u0111\u1ec3 ki\u1ec3m tra c\u00e1c d\u1ea5u hi\u1ec7u suy tim nghi\u00eam tr\u1ecdng. <\/span>Tuy nhi\u00ean, quy\u1ebft \u0111\u1ecbnh d\u00f9ng thu\u1ed1c ch\u1eb9n beta v\u00e0 \u0111i\u1ec1u tr\u1ecb suy tim ph\u1ea3i \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129 chuy\u00ean khoa tim m\u1ea1ch.<\/span><\/span><\/p>\n

    Nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ea7n l\u01b0u \u00fd khi th\u00eam \u1ee9c ch\u1ebf beta: Suy tim n\u1eb7ng, sau bi\u1ebfn c\u1ed1 tim m\u1ea1ch do suy n\u1ea1p, sau bi\u1ebfn ch\u1ee9ng c\u01a1 h\u1ecdc c\u1ee7a nh\u1ed3i m\u00e1u c\u01a1 tim, NYHA IV, nh\u1ecbp ban \u0111\u1ea7u kh\u00f4ng nhanh ( <70l\/p ), suy tim do c\u01a1 ch\u1ee7, b\u1ec7nh c\u01a1 tim do \u0111\u1ed9c t\u00ednh trong giai \u0111o\u1ea1n ch\u01b0a ph\u1ee5c h\u1ed3i. <\/span>Nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc c\u00e1c b\u1ec7nh l\u00fd sau \u0111\u00e2y n\u00ean s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta m\u1ed9t c\u00e1ch th\u1eadn tr\u1ecdng ho\u1eb7c tr\u00e1nh s\u1eed d\u1ee5ng:<\/span><\/span><\/p>\n

      \n
    • D\u00e3n th\u1ea5t tr\u00e1i n\u1eb7ng<\/span><\/span><\/li>\n
    • Sau bi\u1ebfn c\u1ed1 tim m\u1ea1ch do suy b\u01a1m<\/span><\/span><\/li>\n
    • Sau bi\u1ebfn ch\u1ee9ng c\u01a1 h\u1ecdc c\u1ee7a nh\u1ed3i m\u00e1u c\u01a1 tim kh\u00f4ng c\u1ea5p<\/span><\/span><\/li>\n
    • suy tim NYHA \u0111\u1ed9 IV<\/span><\/span><\/li>\n
    • Nh\u1ecbp tim ban \u0111\u1ea7u ch\u1eadm h\u01a1n 70 nh\u1ecbp\/ph\u00fat<\/span><\/span><\/li>\n
    • Suy tim do h\u1eb9p ch\u1ee7<\/span><\/span><\/li>\n
    • B\u1ec7nh c\u01a1 tim do nhi\u1ec5m \u0111\u1ed9c trong giai \u0111o\u1ea1n ch\u01b0a h\u1ed3i ph\u1ee5c<\/span><\/span><\/li>\n<\/ul>\n

      Vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 x\u1ea3y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 suy tim c\u1ea5p, gi\u1ea3m huy\u1ebft \u00e1p, t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft, suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn, suy gi\u1ea3m ch\u1ee9c n\u0103ng gan v\u00e0 m\u1ea5t c\u00e2n. b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i. <\/span>Do \u0111\u00f3, tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 nghi ng\u1edd ch\u00ednh x\u00e1c b\u1ec7nh l\u00fd c\u1ee7a m\u00ecnh, v\u00e0 thu\u1ed1c ch\u1eb9n beta only n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129 chuy\u00ean khoa tim m\u1ea1ch.<\/span><\/span><\/p>\n

      Kh\u00f4ng d\u00f9ng cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3: Hen ph\u1ebf qu\u1ea3n, \u0111\u1ee3t c\u1ea5p COPD, nh\u1ecbp tim ch\u1eadm, suy n\u00fat xoang. <\/span>c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c b\u1ec7nh l\u00fd sau \u0111\u00e2y th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta:<\/span><\/span><\/p>\n

        \n
      • Hen ph\u1ebf qu\u1ea3n: Thu\u1ed1c ch\u1eb9n beta c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 th\u1eaft l\u01b0ng qu\u1ea3n v\u00e0 l\u00e0m t\u0103ng t\u00ecnh tr\u1ea1ng kh\u00f3 th\u1edf, do \u0111\u00f3 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb hen ph\u1ebf qu\u1ea3n.<\/span><\/span><\/li>\n
      • Gi\u1ea3m c\u1ea5p c\u1ee7a b\u1ec7nh t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD): Trong \u0111\u1ee3t c\u1ea5p c\u1ee7a b\u1ec7nh t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh, thu\u1ed1c ch\u1eb9n beta c\u00f3 th\u1ec3 g\u00e2y t\u0103ng huy\u1ebft \u00e1p ph\u1ea3n v\u1ec7 v\u00e0 l\u00e0m t\u0103ng nguy c\u01a1 th\u1eaft l\u01b0ng qu\u1ea3n l\u00fd, \u0111i\u1ec1u \u0111\u00f3 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/span><\/span><\/li>\n
      • Nh\u1ecbp tim ch\u1eadm: Thu\u1ed1c ch\u1eb9n beta c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u1ed1c \u0111\u1ed9 nh\u1ecbp tim v\u00e0 l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t hi\u1ec7n nh\u1ecbp tim ch\u1eadm h\u01a1n, do \u0111\u00f3 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nh\u1ecbp tim ch\u1eadm.<\/span><\/span><\/li>\n
      • Suy n\u00fat xoang: Thu\u1ed1c ch\u1eb9n beta c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ch\u1ee9c n\u0103ng c\u1ee7a n\u00fat xoang v\u00e0 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 truy\u1ec1n d\u1eabn \u0111i\u1ec7n tim, do \u0111\u00f3 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 suy n\u00fat xoang.<\/span><\/span><\/li>\n<\/ul>\n

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

        Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n t\u00ednh.Qu\u00e1 tr\u00ecnh suy tim m\u1ea1ng di\u1ec5n ra khi tr\u00e1i tim kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng hi\u1ec7u qu\u1ea3 \u0111\u1ec3 truy\u1ec1n m\u00e1u ra kh\u1ecfi c\u01a1 th\u1ec3. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 kh\u00f3 th\u1edf, m\u1ec7t m\u1ecfi v\u00e0 […]<\/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":[],"yoast_head":"\nThu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n - Vinmec<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n.Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng.\" \/>\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=\"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n.Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-23T14:44:42+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-25T12:28:41+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/20190802_055225_843340_kiem-tra-tim-mach.max-1800x1800-2-300x200.jpg\" \/>\n<meta name=\"author\" content=\"Thinh Nguyen Hoang\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Thinh Nguyen Hoang\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/\",\"name\":\"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-23T14:44:42+00:00\",\"dateModified\":\"2023-04-25T12:28:41+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/68301644e785034fdd8106b4c392fa5d\"},\"description\":\"Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n.Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/68301644e785034fdd8106b4c392fa5d\",\"name\":\"Thinh Nguyen Hoang\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/2.gravatar.com\/avatar\/eda1569ca1057e665d34a18ba4468cb1?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/2.gravatar.com\/avatar\/eda1569ca1057e665d34a18ba4468cb1?s=96&d=mm&r=g\",\"caption\":\"Thinh Nguyen Hoang\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/nguyenhoangthinh1902gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n - Vinmec","description":"Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n.Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n - Vinmec","og_description":"Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n.Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/","og_site_name":"Vinmec","article_published_time":"2023-04-23T14:44:42+00:00","article_modified_time":"2023-04-25T12:28:41+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/20190802_055225_843340_kiem-tra-tim-mach.max-1800x1800-2-300x200.jpg"}],"author":"Thinh Nguyen Hoang","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Thinh Nguyen Hoang","Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/","name":"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-23T14:44:42+00:00","dateModified":"2023-04-25T12:28:41+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/68301644e785034fdd8106b4c392fa5d"},"description":"Thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n.Hi\u1ec7n nay, c\u00f3 4 lo\u1ea1i thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m c\u00f3 th\u1ec3 d\u00f9ng.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chen-beta-suy-tim-man\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Thu\u1ed1c ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim m\u1ea1n"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/68301644e785034fdd8106b4c392fa5d","name":"Thinh Nguyen Hoang","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/2.gravatar.com\/avatar\/eda1569ca1057e665d34a18ba4468cb1?s=96&d=mm&r=g","contentUrl":"http:\/\/2.gravatar.com\/avatar\/eda1569ca1057e665d34a18ba4468cb1?s=96&d=mm&r=g","caption":"Thinh Nguyen Hoang"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/nguyenhoangthinh1902gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/27430"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/25"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=27430"}],"version-history":[{"count":5,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/27430\/revisions"}],"predecessor-version":[{"id":28391,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/27430\/revisions\/28391"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=27430"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=27430"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=27430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}