{"id":27841,"date":"2023-04-26T16:51:38","date_gmt":"2023-04-26T09:51:38","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27841"},"modified":"2023-04-26T16:51:38","modified_gmt":"2023-04-26T09:51:38","slug":"chan-doan-va-dieu-tri-viem-tuy-thi-than-kinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/chan-doan-va-dieu-tri-viem-tuy-thi-than-kinh\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh"},"content":{"rendered":"<p><b>Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh (NMOSD) l\u00e0 b\u1ec7nh ti\u1ebfn tri\u1ec3n t\u1eebng \u0111\u1ee3t v\u1edbi c\u00e1c di ch\u1ee9ng v\u1ec1 c\u1ea3m gi\u00e1c, v\u1eadn \u0111\u1ed9ng, th\u1ecb l\u1ef1c , ch\u1ee9c n\u0103ng bang quang t\u00edch l\u0169y theo th\u1eddi gian. Trong b\u00e0i vi\u1ebft n\u00e0y ch\u00fang ta h\u00e3y c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd n\u00e0y.<\/b><\/p>\n<h2>1. Gi\u1edbi thi\u1ec7u<\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, \u0111\u1ecbnh ngh\u0129a v\u1ec1 b\u1ec7nh vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c (NMO), hay b\u1ec7nh Devic, \u0111\u00e3 \u0111\u01b0\u1ee3c m\u1edf r\u1ed9ng khi m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong huy\u1ebft thanh c\u1ee7a nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh. <\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Do \u0111\u00f3, thu\u1eadt ng\u1eef Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh (NMOSD) hi\u1ec7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ec9 vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n \u1edf t\u1ee7y s\u1ed1ng v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n th\u1ea7n kinh kh\u00e1c li\u00ean quan \u0111\u1ebfn kh\u00e1ng th\u1ec3 aquaporin-4 immunoglobulin G (AQP4-IgG) trong huy\u1ebft thanh.<\/span><\/li>\n<li>Trong nhi\u1ec1u n\u0103m, b\u1ec7nh \u0111a x\u01a1 c\u1ee9ng (Multi Sclerosis) l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u1ee7a b\u1ec7nh vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c. Tuy nhi\u00ean nh\u1eefng kh\u00e1m ph\u00e1 g\u1ea7n \u0111\u00e2y \u0111\u00e3 l\u00e0m n\u1ed5i b\u1eadt l\u00ean c\u00e1c bi\u1ec3u hi\u1ec7n hi\u1ebfm h\u01a1n, nguy hi\u1ec3m h\u01a1n c\u1ee7a vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c nh\u01b0 Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh v\u00e0 b\u1ec7nh kh\u00e1ng th\u1ec3 kh\u00e1ng Myelin Oligodendrocyte Glycoprotein (MOG), c\u1ea7n ph\u1ea3i l\u01b0u t\u00e2m trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<h2>2. Nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh<\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh (NMOSD) v\u1eabn ch\u01b0a r\u00f5 r\u00e0ng. Tr\u01b0\u1edbc \u0111\u00e2y, NMOSD \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t bi\u1ebfn th\u1ec3 c\u1ee7a b\u1ec7nh \u0111a x\u01a1 c\u1ee9ng, nh\u01b0ng c\u00e1c nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y \u0111\u00e3 l\u00e0m s\u00e1ng t\u1ecf s\u1ef1 kh\u00e1c bi\u1ec7t trong qu\u00e1 tr\u00ecnh g\u00e2y b\u1ec7nh b\u1ec7nh, bi\u1ec3u hi\u1ec7n v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Gi\u1ea3i tr\u00ecnh t\u1ef1 to\u00e0n b\u1ed9 b\u1ed9 gen \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ed9t s\u1ed1 ki\u1ec3u gen c\u00f3 nguy c\u01a1 m\u1eafc NMOSD.<\/span><\/li>\n<\/ul>\n<h2>3. Sinh l\u00fd b\u1ec7nh Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh<\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">NMOSD l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam ch\u1ee7 y\u1ebfu \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c v\u00e0 t\u1ee7y s\u1ed1ng. Tr\u01b0\u1edbc \u0111\u00e2y, NMO\/NMOSD \u0111\u01b0\u1ee3c m\u1ed9t s\u1ed1 ng\u01b0\u1eddi coi l\u00e0 bi\u1ebfn th\u1ec3 c\u1ee7a b\u1ec7nh \u0111a x\u01a1 c\u1ee9ng, nh\u01b0ng vi\u1ec7c ph\u00e1t hi\u1ec7n ra kh\u00e1ng th\u1ec3 IgG ch\u1ed1ng l\u1ea1i aquaporin-4 \u0111\u00e3 khi\u1ebfn NMOSD \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn r\u1ed9ng r\u00e3i h\u01a1n nh\u01b0 b\u1ec7nh l\u00fd v\u1edbi c\u01a1 ch\u1ebf v\u00e0 sinh b\u1ec7nh h\u1ecdc ri\u00eang bi\u1ec7y.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\"><span class=\"Y2IQFc\" lang=\"vi\"> Aquaporin 4 (AQP4) l\u00e0 m\u1ed9t lo\u1ea1i protein g\u1eafn m\u00e0ng c\u00f3 n\u1ed3ng \u0111\u1ed9 cao \u1edf m\u1ed9t s\u1ed1 b\u1ed9 ph\u1eadn c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, ch\u1eb3ng h\u1ea1n nh\u01b0 d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c, t\u1ee7y s\u1ed1ng. V\u1ec1 b\u1ea3n ch\u1ea5t, NMOSD l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd t\u1ef1 mi\u1ec5n l\u00e0m t\u1ebf b\u00e0o h\u00ecnh sao b\u1ecb m\u1ea5t myelin trong \u0111\u00f3 AQP4-IgG l\u00e0m trung gian cho s\u1ef1 th\u00e2m nhi\u1ec5m t\u1ebf b\u00e0o lympho quanh m\u1ea1ch m\u00e1u d\u1eabn \u0111\u1ebfn m\u1ea5t s\u1ee3i tr\u1ee5c \u0111\u1eb7c bi\u1ec7t l\u00e0 t\u1ea1i c\u00e1c v\u00f9ng c\u00f3 nguy c\u01a1 \u0111\u00e3 n\u00f3i \u1edf tr\u00ean.<\/span><\/span>\n<p><figure id=\"attachment_27916\" aria-describedby=\"caption-attachment-27916\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-27916\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-tuy-thi-than-kinh-300x225.jpg\" alt=\"Minh-hoa-viem-tuy-thi-than-kinh\" width=\"300\" height=\"225\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-tuy-thi-than-kinh-300x225.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-tuy-thi-than-kinh.jpg 460w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-27916\" class=\"wp-caption-text\">Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh<\/figcaption><\/figure><\/li>\n<\/ul>\n<h2>4. Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p><strong>4.1. L\u00e2m s\u00e0ng<\/strong><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Th\u00f4ng th\u01b0\u1eddng, vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i v\u00e0 c\u00f3 bi\u1ec3u hi\u1ec7n kh\u1edfi ph\u00e1t c\u1ea5p t\u00ednh:<\/span><\/li>\n<\/ul>\n<p><span class=\"Y2IQFc\" lang=\"vi\">\u00a0 \u00a0 \u00a0 &#8211; \u0110au nh\u1ee9c trong m\u1eaft, \u0111au t\u0103ng khi v\u1eadn \u0111\u1ed9ng m\u1eaft<\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">\u00a0 \u00a0 \u00a0 &#8211; Gi\u1ea3m th\u1ecb l\u1ef1c m\u1ed9t m\u1eaft<\/span><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\"> Kh\u00e1m l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c c\u1ea5p t\u00ednh ph\u1ea3i lu\u00f4n ki\u1ec3m tra th\u1ecb l\u1ef1c, \u0111\u1ed3ng t\u1eed v\u00e0 nh\u00e3n \u00e1p, sau \u0111\u00f3 l\u00e0 ki\u1ec3m tra th\u1ea7n kinh th\u1ecb gi\u00e1c k\u1ef9 l\u01b0\u1ee1ng. Ki\u1ec3m tra \u0111\u00e1y m\u1eaft th\u01b0\u1eddng s\u1ebd th\u1ea5y s\u1ef1 nh\u00f4 cao c\u1ee7a \u0111\u1ea7u d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c \u1edf b\u00ean b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Do c\u00e1c t\u00e0i li\u1ec7u g\u1ea7n \u0111\u00e2y n\u00eau b\u1eadt nh\u1eefng nguy\u00ean nh\u00e2n \u00edt ph\u1ed5 bi\u1ebfn h\u01a1n nh\u01b0ng nguy hi\u1ec3m h\u01a1n c\u1ee7a vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c nh\u01b0 NMOSD ho\u1eb7c MOG, b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c c\u1ea5p t\u00ednh n\u00ean \u0111\u01b0\u1ee3c h\u1ecfi th\u00eam c\u00e1c c\u00e2u h\u1ecfi c\u1ee5 th\u1ec3 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng. N\u1ebfu b\u1ec7nh nh\u00e2n b\u1ecb n\u1ea5c c\u1ee5t kh\u00f3 ch\u1eefa, bu\u1ed3n n\u00f4n ho\u1eb7c n\u00f4n kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n ho\u1eb7c c\u00f3 tri\u1ec7u ch\u1ee9ng ng\u1ee7 r\u0169, \u0111\u00e2y c\u00f3 th\u1ec3 l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u cho th\u1ea5y vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c c\u00f3 th\u1ec3 do NMOSD g\u00e2y ra.<\/span><\/li>\n<li>Th\u00f4ng th\u01b0\u1eddng r\u1ea5t g\u1ee3i \u00fd vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh n\u1ebfu vi\u00eam th\u1ecb th\u1ea7n kinh ti\u1ebfn tri\u1ec3n t\u1eeb m\u1ed9t b\u00ean sang 2 b\u00ean, ho\u1eb7c \u0111\u1ed3ng th\u1eddi c\u1ea3 2 b\u00ean.<\/li>\n<\/ul>\n<p><strong>4.2 C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Vi\u1ec7c ph\u00e1t hi\u1ec7n ra kh\u00e1ng th\u1ec3 aquaporin-4 d\u1eabn \u0111\u1ebfn x\u00e9t nghi\u1ec7m huy\u1ebft thanh kh\u00e1ng th\u1ec3 n\u00e0y \u0111\u00f3ng vai tr\u00f2 ch\u00ednh trong ch\u1ea9n \u0111o\u00e1n NMOSD. NMOSD \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng c\u00e1ch kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 x\u00e9t nghi\u1ec7m huy\u1ebft thanh \u0111\u1ed1i v\u1edbi AQP4-IgG c\u0169ng nh\u01b0 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 gadolinium. <\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Ch\u1ea9n \u0111o\u00e1n d\u1ef1a tr\u00ean c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng \u0111\u00f3ng vai tr\u00f2 ch\u1ee7 \u0111\u1ea1o v\u00e0 \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1eb1ng x\u00e9t nghi\u1ec7m b\u1ed5 sung, c\u0169ng nh\u01b0 t\u1ed3n t\u1ea1i m\u1ed9t s\u1ed1 ti\u00eau ch\u00ed. <\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Do \u0111\u00f3, ti\u00eau ch\u00ed ch\u1ea9n \u0111o\u00e1n \u0111\u1ed3ng thu\u1eadn qu\u1ed1c t\u1ebf \u0111\u00e3 \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp v\u00e0o n\u0103m 2015, chia NMOSD th\u00e0nh c\u00e1c tr\u1ea1ng th\u00e1i AQP4-IgG (c\u00f3 x\u00e9t nghi\u1ec7m, kh\u00f4ng x\u00e9t nghi\u1ec7m ho\u1eb7c ch\u01b0a x\u00e1c \u0111\u1ecbnh) v\u00e0 x\u00e1c \u0111\u1ecbnh c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m tr\u00ean l\u00e2m s\u00e0ng v\u00e0 MRI c\u1ee7a NMOSD.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Test nh\u00ecn m\u00e0u c\u00f3 th\u1ec3 cho th\u1ea5y s\u1ef1 gi\u1ea3m kh\u1ea3 n\u0103ng nh\u00ecn m\u00e0u v\u00e0 kh\u00e1m th\u1ecb tr\u01b0\u1eddng c\u00f3 th\u1ec3 cho th\u1ea5y c\u00f3 \u00e1m \u0111i\u1ec3m trung t\u00e2m. Ki\u1ec3m tra b\u1ed5 sung b\u1eb1ng ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n v\u00e0 c\u00f3 th\u1ec3 cho th\u1ea5y l\u1edbp s\u1ee3i th\u1ea7n kinh m\u1ecfng h\u01a1n so v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111a x\u01a1 c\u1ee9ng. MRI c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 gadolinium c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 \u0111\u00e1nh gi\u00e1 NMOSD. C\u00e1c d\u1ea5u hi\u1ec7u \u0111\u1eb7c tr\u01b0ng trong vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c bao g\u1ed3m t\u1ed5n th\u01b0\u01a1ng ch\u1ea5t tr\u1eafng v\u00e0 t\u0103ng t\u00edn hi\u1ec7u th\u1ea7n kinh th\u1ecb gi\u00e1c (t\u1ed5n th\u01b0\u01a1ng t\u0103ng t\u00edn hi\u1ec7u tr\u00ean T2W ho\u1eb7c h\u00ecnh \u1ea3nh t\u0103ng \u0111\u1ed9 t\u01b0\u01a1ng ph\u1ea3n tr\u00ean T1W).<\/span><\/li>\n<\/ul>\n<h2>5. \u0110i\u1ec1u tr\u1ecb<\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">C\u00e1c tr\u01b0\u1eddng h\u1ee3p NMOSD l\u00e0 t\u01b0\u01a1ng \u0111\u1ed1i hi\u1ebfm, vi\u1ec7c \u0111\u01b0a ra c\u00e1c h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb l\u00e0 kh\u00e1 kh\u00f3 kh\u0103n. H\u1ea7u h\u1ebft \u0111\u1ec1 xu\u1ea5t m\u1ed9t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch ng\u1eafn h\u1ea1n (th\u01b0\u1eddng l\u00e0 corticosteroid), sau \u0111\u00f3 l\u00e0 m\u1ed9t s\u1ed1 h\u00ecnh th\u1ee9c tr\u1ecb li\u1ec7u \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch k\u00e9o d\u00e0i.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">\u0110i\u1ec1u tr\u1ecb giai \u0111o\u1ea1n c\u1ea5p t\u00ednh c\u1ee7a NMOSD th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng steroid ti\u00eam t\u0129nh m\u1ea1ch nh\u01b0 methylprednisolone, th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi li\u1ec1u l\u01b0\u1ee3ng cao (500-100 mg\/ ng\u00e0y) trong 5-10 ng\u00e0y. C\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c \u1ee7ng h\u1ed9 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p l\u1ecdc huy\u1ebft t\u01b0\u01a1ng (55 ml\/kg) c\u0169ng nh\u01b0 immunoglobulin ti\u00eam t\u0129nh m\u1ea1ch.<\/span><\/li>\n<li>Li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch k\u00e9o d\u00e0i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1edbi azathioprine ho\u1eb7c rituximab l\u00e0 thu\u1ed1c \u0111\u1ea7u tay. C\u00e1c thu\u1ed1c h\u00e0ng 2 c\u00f3 th\u1ec3 bao g\u1ed3m mycophenolate ho\u1eb7c methotrexate. C\u00e1c t\u00e1c nh\u00e2n h\u00e0ng 2 n\u00e0y c\u00f3 th\u1ec3 thu\u1eadn l\u1ee3i do \u00edt c\u1ea7n d\u00f9ng th\u01b0\u1eddng xuy\u00ean h\u01a1n. C\u00e1c t\u00e1c nh\u00e2n sinh h\u1ecdc m\u1edbi h\u01a1n \u0111\u01b0\u1ee3c \u0111\u1ecbnh h\u01b0\u1edbng ch\u1ed1ng l\u1ea1i c\u00e1c ch\u1ea5t trung gian mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u nh\u01b0 kh\u00e1ng IL-6, kh\u00e1ng b\u1ed5 th\u1ec3 ho\u1eb7c kh\u00e1ng AQP4-IgG.<\/li>\n<\/ul>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cac-roi-loan-pho-viem-tuy-thi-kinh\/\">C\u00e1c r\u1ed1i lo\u1ea1n ph\u1ed5 vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh<\/a><\/p>\n<p>Ngu\u1ed3n t\u00e0i li\u1ec7u: PubMed: <span class=\"title\">Neuromyelitis Optica (NMO, Devics Disease)<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh (NMOSD) l\u00e0 b\u1ec7nh ti\u1ebfn tri\u1ec3n t\u1eebng \u0111\u1ee3t v\u1edbi c\u00e1c di ch\u1ee9ng v\u1ec1 c\u1ea3m gi\u00e1c, v\u1eadn \u0111\u1ed9ng, th\u1ecb l\u1ef1c , ch\u1ee9c n\u0103ng bang quang t\u00edch l\u0169y theo th\u1eddi gian. Trong b\u00e0i vi\u1ebft n\u00e0y ch\u00fang ta h\u00e3y c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd n\u00e0y. 1. Gi\u1edbi thi\u1ec7u [&hellip;]<\/p>\n","protected":false},"author":26,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh l\u00e0 b\u1ec7nh ti\u1ebfn tri\u1ec3n t\u1eebng \u0111\u1ee3t v\u1edbi c\u00e1c di ch\u1ee9ng t\u00edch l\u0169y theo th\u1eddi gian.C\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb.\" \/>\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=\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Vi\u00eam t\u1ee7y th\u1ecb th\u1ea7n kinh - 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