{"id":29374,"date":"2023-04-29T18:20:57","date_gmt":"2023-04-29T11:20:57","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29374"},"modified":"2023-04-29T18:20:57","modified_gmt":"2023-04-29T11:20:57","slug":"dai-thao-duong-va-cac-benh-ly-kem-theo","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/dai-thao-duong-va-cac-benh-ly-kem-theo\/","title":{"rendered":"\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo"},"content":{"rendered":"

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/a> l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p. C\u00e1c b\u1ec7nh l\u00fd \u0111i k\u00e8m khi m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m. C\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n

1.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch<\/strong><\/h2>\n

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch. C\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a qu\u00e1 tr\u00ecnh n\u00e0y cho \u0111\u1ebfn nay v\u0201n ch\u01b0a ho\u00e0n to\u00e0n \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5, tuy nhi\u00ean c\u00f3 m\u1ed1i li\u00ean quan ch\u1eb7t ch\u1ebd gi\u1eefa m\u1ee9c \u0111\u1ed9 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch v\u1edbi t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft, r\u1ed1i lo\u1ea1n lipid m\u00e1u, t\u0103ng huy\u1ebft \u00e1p, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o n\u1ed9i m\u00f4, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 tr\u01a1n th\u00e0nh m\u1ea1ch, hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam m\u1ea1n t\u00ednh, t\u0103ng \u0111\u00f4ng v\u00e0 ho\u1ea1t h\u00f3a ti\u1ec3u c\u1ea7u.<\/p>\n

Nitric oxide (NO) \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng \u0111\u1ec3 duy tr\u00ec ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o n\u1ed9i m\u00f4 – ch\u1ed1ng ho\u1ea1t h\u00f3a ti\u1ec3u c\u1ea7u, b\u1ea1ch c\u1ea7u, v\u00e0 qu\u00e1 tr\u00ecnh \u0111\u00f4ng m\u00e1u. Qu\u00e1 tr\u00ecnh stress oxy h\u00f3a do t\u00ecnh tr\u1ea1ng \u0111\u01b0\u1eddng huy\u1ebft t\u0103ng cao, acid b\u00e9o ho\u1eb7c t\u00ecnh tr\u1ea1ng kh\u00e1ng insulin \u0111\u00e3 l\u00e0m gi\u1ea3m t\u1ed5ng h\u1ee3p NO c\u1ee7a t\u1ebf b\u00e0o n\u1ed9i m\u00f4 m\u1ea1ch m\u00e1u \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. H\u1eadu qu\u1ea3 l\u00e0 l\u00e0m gi\u1ea3m t\u00e1c \u0111\u1ed9ng c\u1ee7a NO l\u00ean t\u1ebf b\u00e0o c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u, gi\u1ea3m kh\u1ea3 n\u0103ng gi\u00e3n m\u1ea1ch. B\u00ean c\u1ea1nh \u0111\u00f3, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o n\u1ed9i m\u00f4 c\u00f2n l\u00e0m t\u0103ng gi\u1ea3i ph\u00f3ng c\u00e1c ch\u1ea5t co m\u1ea1ch nh\u01b0 prostanoid v\u00e0 endothelin.<\/p>\n

Song song v\u1edbi nh\u1eefng b\u1ea5t th\u01b0\u1eddng ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o n\u1ed9i m\u00f4, thay \u0111\u1ed5i s\u1ef1 b\u1ed9c l\u1ed9 c\u00e1c ph\u00e2n t\u1eed b\u00e1m d\u00ednh tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o n\u1ed9i m\u00f4 c\u0169ng \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong c\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a x\u01a1 v\u1eefa m\u1ea1ch. C\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 t\u0103ng b\u00e1m d\u00ednh \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ebf b\u00e0o m\u00e1u, b\u1ea1ch c\u1ea7u th\u00f4ng qua c\u00e1c receptor, c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o li\u00ean k\u1ebft v\u1edbi c\u00e1c ph\u00e2n t\u1eed LDL-C oxy h\u00f3a t\u1ea1o th\u00e0nh c\u00e1c t\u1ebf b\u00e0o b\u1ecdt ch\u00ednh l\u00e0 c\u01a1 ch\u1ea5t ch\u00ednh d\u0201n \u0111\u1ebfn s\u1ef1 h\u00ecnh th\u00e0nh v\u00e0 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c m\u1ea3ng x\u01a1 v\u1eefa.<\/p>\n

T\u1ebf b\u00e0o c\u01a1 tr\u01a1n th\u00e0nh m\u1ea1ch t\u0103ng nhanh c\u00f9ng v\u1edbi s\u1ef1 th\u00e2m nhi\u1ec5m v\u00e0 l\u1eafng \u0111\u1eb7ng collagen v\u00e0 c\u00e1c protein ngo\u1ea1i b\u00e0o kh\u00e1c v\u00e0o m\u1ea3ng x\u01a1 v\u1eefa. M\u1eb7t kh\u00e1c, \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y ch\u1ee9c n\u0103ng ti\u1ec3u c\u1ea7u th\u01b0\u1eddng r\u1ed1i lo\u1ea1n, bi\u1ec3u hi\u1ec7n b\u1eb1ng s\u1ef1 t\u0103ng b\u00e1m d\u00ednh v\u00e0 ho\u1ea1t h\u00f3a ti\u1ec3u c\u1ea7u, \u0111i k\u00e8m v\u1edbi hi\u1ec7n t\u01b0\u1ee3ng t\u0103ng \u0111\u00f4ng do r\u1ed1i lo\u1ea1n c\u00e1c y\u1ebfu t\u1ed1 tham gia v\u00e0o qu\u00e1 tr\u00ecnh \u0111\u00f4ng m\u00e1u, d\u0201n \u0111\u1ebfn h\u1eadu qu\u1ea3 cu\u1ed1i c\u00f9ng l\u00e0 h\u00ecnh th\u00e0nh c\u1ee5c huy\u1ebft kh\u1ed1i, g\u00f3p ph\u1ea7n t\u0103ng nguy c\u01a1 h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng t\u1ea1i v\u1ecb tr\u00ed m\u1ea3ng x\u01a1 v\u1eefa b\u1ecb n\u1ee9t v\u1ee1 ho\u1eb7c th\u1eadm ch\u00ed t\u1ea1i ch\u00ednh v\u1ecb tr\u00ed \u0111\u1ed9ng m\u1ea1ch v\u00e0nh \u0111\u01b0\u1ee3c \u0111\u1eb7t stent.<\/p>\n

Nh\u1eefng d\u1eef li\u1ec7u nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh l\u00fd tim m\u1ea1ch t\u1eeb 2 – 4 l\u1ea7n. Nh\u1eefng bi\u1ebfn ch\u1ee9ng m\u1ea1ch m\u00e1u l\u1edbn nh\u01b0 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o, b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean ch\u00ednh l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n chi\u1ee7 y\u1ebfu d\u0201n \u0111\u1ebfn t\u1eed vong v\u00e0 t\u00e0n ph\u1ebf.<\/p>\n

2.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch v\u00e0nh<\/h2>\n

Theo nghi\u00ean c\u1ee9u Framingham, nguy c\u01a1 m\u1eafc b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch v\u00e0nh \u1edf b\u1ec7nh nh\u00e2n\u00a0 g\u1ea5p 2 l\u1ea7n \u1edf nam v\u00e0 3 l\u1ea7n \u1edf n\u1eef so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/em><\/strong>. \u0110\u00e2y v\u0201n l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch ch\u00ednh v\u00e0 \u0111\u1ed9c l\u1eadp ngay c\u1ea3 khi \u0111\u00e3 hi\u1ec7u ch\u1ec9nh v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c nh\u01b0 tu\u1ed5i cao, t\u0103ng huy\u1ebft \u00e1p, h\u00fat thu\u1ed1c l\u00e1, t\u0103ng cholesterol m\u00e1u v\u00e0 ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i.<\/p>\n

K\u1ebft qu\u1ea3 t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u1edbn c\u00f2n cho th\u1ea5y\u00a0 l\u00e0m t\u0103ng t\u1ec9 l\u1ec7 nh\u00f3m nh\u1ed3i m\u00e1u c\u01a1 tim \u0111e d\u1ecda t\u1eed vong so v\u1edbi nh\u1ed3i m\u00e1u c\u01a1 tim kh\u00f4ng \u0111e d\u1ecda t\u1eed vong. B\u00ean c\u1ea1nh \u0111\u00f3, t\u1ef7 l\u1ec7 nh\u1ed3i m\u00e1u c\u01a1 tim th\u1ea7m l\u1eb7ng c\u0169ng th\u01b0\u1eddng g\u1eb7p h\u01a1n. T\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u th\u00e2n \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u0169ng th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh kh\u00f4ng tri\u1ec7u ch\u1ee9ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 hai ho\u1eb7c nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch. M\u1eb7t kh\u00e1c, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u0169ng l\u00e0m t\u0103ng t\u1ec9 l\u1ec7 c\u00e1c bi\u1ebfn c\u1ed1 bao g\u1ed3m c\u1ea3 s\u1ed1c tim v\u00e0 t\u1eed vong \u1edf c\u00e1c b\u1ec7nh nh\u00e2n nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p.<\/p>\n

V\u00ec v\u1eady, c\u00e1c x\u00e9t nghi\u1ec7m nh\u1eb1m t\u1ea7m so\u00e1t v\u00e0 \u0111\u00e1nh gi\u00e1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n \u1edf t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch v\u00e0nh.<\/p>\n

3.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o<\/h2>\n

B\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 cao g\u1ea5p 1,5 \u0111\u1ebfn 3 l\u1ea7n so v\u1edbi ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng do h\u1eadu qu\u1ea3 c\u1ee7a b\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u l\u1edbn v\u00e0 nh\u1ecf. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0m t\u0103ng g\u1ea7n g\u1ea5p \u0111\u00f4i nguy c\u01a1 t\u00e1i ph\u00e1t \u0111\u1ed9t qu\u1ef5.<\/p>\n

B\u1ec7nh nh\u00e2n n\u00e0y b\u1ecb \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o c\u0169ng c\u00f3 k\u1ebft c\u1ee5c l\u00e2m s\u00e0ng x\u1ea5u h\u01a1n, th\u1eddi gian n\u1eb1m vi\u1ec7n l\u00e2u h\u01a1n v\u00e0 t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong trong th\u1eddi gian n\u1eb1m vi\u1ec7n c\u0169ng nh\u01b0 t\u1ef7 l\u1ec7 t\u1eed vong sau khi ra vi\u1ec7n. H\u01a1n n\u1eefa nh\u1eefng di ch\u1ee9ng v\u1ec1 khi\u1ebfm khuy\u1ebft th\u1ea7n kinh th\u01b0\u1eddng n\u1eb7ng n\u1ec1 h\u01a1n v\u00e0 l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 t\u00e0n t\u1eadt sau \u0111\u1ed9t qu\u1ef5.<\/p>\n

B\u1ec7nh nh\u00e2n n\u00e0y th\u01b0\u1eddng g\u1eb7p \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o h\u01a1n so v\u1edbi \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o. T\u1ef7 l\u1ec7 t\u1eed vong sau 1 n\u0103m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y cao h\u01a1n g\u1ea7n g\u1ea5p hai l\u1ea7n so v\u1edbi nh\u00f3m b\u1ec7nh nh\u00e2n \u0111\u1ed9t qu\u1ef5 kh\u00f4ng b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 sau 5 n\u0103m ch\u1ec9 c\u00f3 1\/5 s\u1ed1 b\u1ec7nh nh\u00e2n trong nh\u00f3m n\u00e0y n\u00e0y c\u00f2n s\u1ed1ng s\u00f3t.<\/p>\n

C\u00f3 m\u1ed9t t\u1ef7 l\u1ec7 kh\u00f4ng nh\u1ecf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng b\u1ecb \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o th\u1ea7m l\u1eb7ng. Nguy\u00ean nh\u00e2n l\u00e0 do tho\u00e1i h\u00f3a m\u1ee1 k\u00ednh \u1edf c\u00e1c m\u1ea1ch nh\u1ecf g\u00e2y ra c\u00e1c \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o \u1ed5 khuy\u1ebft (k\u00edch th\u01b0\u1edbc \u1ed5 nh\u1ed3i m\u00e1u nh\u1ecf h\u01a1n 15 mm).<\/p>\n

M\u1eb7c d\u00f9 k\u1ebft c\u1ee5c l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng b\u1ecb \u0111\u1ed9t qu\u1ef5 r\u1ea5t k\u00e9m, nh\u01b0ng kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o di\u1ec7n r\u1ed9ng gi\u1eefa nh\u00f3m b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 c\u00f3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Tuy nhi\u00ean t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 tho\u00e1ng qua (TIA) l\u1ea1i g\u1eb7p \u00edt h\u01a1n \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n

4.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean<\/h2>\n

M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 nguy c\u01a1 li\u00ean quan t\u1edbi b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean nh\u01b0 gi\u1edbi t\u00ednh, th\u1eddi gian m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Th\u1eddi gian m\u1eafc b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00e0ng l\u00e2u, nguy c\u01a1 m\u1eafc b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean c\u00e0ng cao. \u0110\u1ed3ng th\u1eddi, t\u00ecnh tr\u1ea1ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft k\u00e9m c\u0169ng l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh l\u00fd m\u1ea1ch ngo\u1ea1i bi\u00ean, \u01b0\u1edbc t\u00ednh c\u1ee9 m\u1ed7i 1% HbA1c t\u0103ng l\u00ean s\u1ebd l\u00e0m t\u0103ng th\u00eam 30% nguy c\u01a1 m\u1eafc b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean. Nghi\u00ean c\u1ee9u Framingham cho th\u1ea5y, \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 \u0111\u01b0\u1eddng ni\u1ec7u, nguy c\u01a1 ti\u1ebfn tri\u1ec3n \u0111au c\u00e1ch h\u1ed3i t\u0103ng g\u1ea5p 9 l\u1ea7n \u1edf n\u1eef v\u00e0 3 – 5 l\u1ea7n \u1edf nam gi\u1edbi.<\/p>\n

5.B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi<\/h2>\n

L\u00e0 bi\u1ebfn ch\u1ee9ng m\u1ea1ch m\u00e1u th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Th\u1eddi gian b\u1ec7nh k\u00e9o d\u00e0i, ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u k\u00e9m, c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 x\u01a1 v\u1eefa kh\u00e1c k\u00e8m theo v\u00e0\/ ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch l\u00e0m t\u0103ng nguy c\u01a1 b\u1ec7nh \u0110M chi d\u01b0\u1edbi.<\/p>\n

Nghi\u00ean c\u1ee9u NHANES cho th\u1ea5y \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean 2,71 l\u1ea7n v\u00e0 t\u0103ng 4,46 l\u1ea7n n\u1ebfu k\u00e8m theo h\u00fat thu\u1ed1c l\u00e1 . C\u00e1c nghi\u00ean c\u1ee9u thu\u1ea7n t\u1eadp theo d\u00f5i h\u01a1n 20 n\u0103m c\u0169ng ch\u1ec9 ra nguy c\u01a1 t\u1eed vong t\u0103ng cao h\u01a1n \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean c\u00f3 k\u00e8m theo \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n

Tri\u1ec7u ch\u1ee9ng \u0111au c\u00e1ch h\u1ed3i xu\u1ea5t hi\u1ec7n khi c\u00f3 s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa nhu c\u1ea7u v\u00e0 kh\u1ea3 n\u0103ng c\u1ea5p m\u00e1u c\u1ee7a h\u1ec7 \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng c\u0169ng nh\u01b0 v\u1ecb tr\u00ed c\u1ee7a t\u1ed5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n t\u1eeb kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c r\u1ea5t nh\u1eb9, cho t\u1edbi m\u1ee9c n\u1eb7ng n\u1ec1, thi\u1ebfu m\u00e1u chi tr\u1ea7m tr\u1ecdng, \u0111e d\u1ecda c\u1eaft c\u1ee5t chi. Tuy nhi\u00ean, \u1edf b\u1ec7nh nh\u00e2n tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng kh\u00f4ng \u0111i\u1ec3n h\u00ecnh.<\/p>\n

\u1ede b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh \u0110M chi d\u01b0\u1edbi, t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng \u1edf t\u1ea7ng d\u01b0\u1edbi g\u1ed1i, v\u00ec v\u1eady vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng \u00e1n t\u00e1i th\u00f4ng, kh\u1ea3 n\u0103ng th\u00e0nh c\u00f4ng \u0111\u1ec1u h\u1ea1n ch\u1ebf. Ngo\u00e0i ra, do c\u00f3 b\u1ec7nh l\u00fd th\u1ea7n kinh k\u00e8m theo l\u00e0m gi\u1ea3m c\u1ea3m gi\u00e1c \u0111au, b\u1ec7nh th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf giai \u0111o\u1ea1n mu\u1ed9n (nh\u01b0 lo\u00e9t kh\u00f4ng li\u1ec1n…) l\u00e0m t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng.<\/p>\n

Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm b\u1ec7nh \u0110M chi d\u01b0\u1edbi c\u00f3 vai tr\u00f2 quan tr\u1ecdng. \u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng bao g\u1ed3m: Khai th\u00e1c ti\u1ec1n s\u1eed, \u0111\u00e1nh gi\u00e1 tri\u1ec7u ch\u1ee9ng, th\u0103m kh\u00e1m b\u1ec7nh l\u00fd th\u1ea7n kinh. Ch\u1ec9 s\u1ed1 huy\u1ebft \u00e1p c\u1ed5 ch\u00e2n – c\u00e1nh tay (ABI) < 0,9 c\u00f3 \u0111\u1ed9 nh\u1ea1y 80% , \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 95% trong ch\u1ea9n \u0111o\u1ea1n h\u1eb9p\/t\u1eafc \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean. Tuy nhi\u00ean, \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a ABI \u1edf b\u1ec7nh nh\u00e2n n\u00e0y th\u1ea5p h\u01a1n. Khi l\u00e2m s\u00e0ng nghi ng\u1edd, ABI b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng ABI g\u1eafng s\u1ee9c ho\u1eb7c ch\u1ec9 s\u1ed1 ng\u00f3n ch\u00e2n – c\u00e1nh tay (TBI).<\/p>\n

6.B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh<\/h2>\n

Thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u1eeb h\u1eb9p \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh chi\u1ebfm 10 – 15% nguy\u00ean nh\u00e2n t\u1ea5t c\u1ea3 \u0111\u1ed9t qu\u1ef5. C\u1ea7n ph\u1ea3i lo\u1ea1i tr\u1eeb b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh \u1edf b\u1ec7nh nh\u00e2n c\u00f3 thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 tho\u00e1ng qua ho\u1eb7c \u0111\u1ed9t qu\u1ef5. Tuy nhi\u00ean, \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed \u0111\u1ed9t qu\u1ef5 n\u00e3o ho\u1eb7c thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 tho\u00e1ng qua kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 s\u00e0ng l\u1ecdc th\u01b0\u1eddng quy c\u00e1c b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh nh\u1eb1m c\u1ea3i thi\u1ec7n k\u1ebft c\u1ee5c.<\/p>\n

\u1ede b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, c\u00e1c khuy\u1ebfn c\u00e1o ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb kh\u00f4ng kh\u00e1c nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n

7.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 suy tim<\/h2>\n

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng c\u1ee7a suy tim v\u00e0 c\u00f3 m\u1ed1i li\u00ean quan m\u1eadt thi\u1ebft v\u1edbi nhau. B\u1ec7nh nh\u00e2n b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng\/ ti\u1ec1n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t hi\u1ec7n suy tim g\u1ea5p 2 – 5 l\u1ea7n so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o.<\/p>\n

\u0111\u01b0\u1eddng. \u0110\u00e1ng l\u01b0u \u00fd l\u00e0 c\u00f3 t\u1edbi 28% b\u1ec7nh nh\u00e2n b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 suy tim k\u00e8m theo (trong \u0111\u00f3 25% suy tim c\u00f3 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m) tuy nhi\u00ean r\u1ea5t nhi\u1ec1u trong s\u1ed1 n\u00e0y ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n.<\/p>\n

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u00e1 th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy tim, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n suy tim c\u00f3 ph\u00e2n s\u1ed1 t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n (HFpEF). Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 nguy c\u01a1 t\u1eed vong cao h\u01a1n nhi\u1ec1u so v\u1edbi nh\u00f3m b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb b\u1ec7nh.<\/p>\n

Nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y suy tim l\u00e0 do h\u1eadu qu\u1ea3 c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo nh\u01b0 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh, t\u0103ng huy\u1ebft \u00e1p, ho\u1eb7c do t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp c\u1ee7a hi\u1ec7n t\u01b0\u1ee3ng kh\u00e1ng insulin v\u00e0 t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft l\u00ean c\u01a1 tim d\u0201n t\u1edbi b\u1ec7nh c\u01a1 tim k\u1ec3 c\u1ea3 khi kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh\/ t\u0103ng huy\u1ebft \u00e1p.<\/p>\n

\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed9c l\u1eadp l\u00e0m t\u0103ng nguy c\u01a1 bi\u1ebfn c\u1ed1 \u1edf c\u00e1c b\u1ec7nh nh\u00e2n suy tim, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n suy tim c\u00f3 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m.<\/p>\n

Nh\u1eefng \u0111i\u1ec3m ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb suy tim \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng gi\u1ed1ng v\u1edbi khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb c\u1ee7a ESC n\u0103m 2016 v\u1ec1 qu\u1ea3n l\u00fd v\u00e0 \u0111i\u1ec1u tr\u1ecb suy tim<\/p>\n

Khuy\u1ebfn c\u00e1o n\u0103m 2019 c\u1ee7a ESC v\u1ec1 \u0111i\u1ec1u tr\u1ecb suy tim \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0a r<\/em><\/strong>a m\u1ed9t s\u1ed1 \u0111i\u1ec3m m\u1edbi trong s\u1eed d\u1ee5ng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb:<\/p>\n

    \n
  • Nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf SGLT2 (empagliflozin, canagliflozin v\u00e0 dapagliflozin) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng l\u00e0m gi\u1ea3m nguy c\u01a1 nh\u1eadp vi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n suy tim c\u00f3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/li>\n
  • Metformin c\u00f3 th\u1ec3 d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u1edf b\u1ec7nh nh\u00e2n suy tim n\u1ebfu m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn > 30 mL\/min\/1,73m 2 .<\/li>\n
  • Insulin c\u00f3 th\u1ec3 xem x\u00e9t s\u1eed d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n v\u00e0o vi\u1ec7n v\u00ec \u0111\u1ee3t c\u1ea5p suy tim c\u00f3 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u gi\u1ea3m.<\/li>\n
  • C\u00e1c thu\u1ed1c nh\u00f3m \u1ee9c ch\u1ebf GLP1 (lixisenatide, liraglutide, semaglutide, exenatide, and dulaglutide) v\u00e0 nh\u00f3m \u1ee9c ch\u1ebf DPP4 (sitagliptin v\u00e0 linagliptin) ch\u1ec9 c\u00f3 t\u00e1c d\u1ee5ng trung t\u00ednh l\u00ean nguy c\u01a1 nh\u1eadp vi\u1ec7n v\u00ec suy tim v\u00e0 c\u00f3 th\u1ec3 xem x\u00e9t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb \u1edf b\u1ec7nh nh\u00e2n suy tim c\u00f3 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/li>\n
  • Nh\u00f3m thu\u1ed1c Thiazolidinediones (pioglitazone and rosiglitazone) v\u00e0 saxagliptin (DPP4) kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng\u00a0 do l\u00e0m t\u0103ng nguy c\u01a1 suy tim.<\/li>\n<\/ul>\n

    \"\u0110\u00e1i<\/p>\n

    Bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch<\/strong><\/p>\n

    8.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp tim<\/h2>\n

    Nh\u1eefng nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y ch\u1ec9 ra l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed9c l\u1eadp g\u00e2y rung nh\u0129, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i. C\u01a1 ch\u1ebf b\u1ec7nh sinh l\u00e0m t\u0103ng nguy c\u01a1 rung nh\u0129 bao g\u1ed3m: T\u0103ng t\u00ednh t\u1ef1 \u0111\u1ed9ng, t\u00e1i c\u1ea5u tr\u00fac t\u00e2m nh\u0129, s\u1ef1 dao \u0111\u1ed9ng \u0111\u01b0\u1eddng m\u00e1u. Rung nh\u0129 l\u00e0m t\u0103ng nguy c\u01a1 suy tim c\u1ea5p m\u1ea5t b\u00f9 do nh\u1ecbp tim nhanh v\u00e0 m\u1ea5t t\u00ednh \u0111\u1ed3ng b\u1ed9 co b\u00f3p nh\u0129 – th\u1ea5t l\u00e0m gi\u1ea3m \u0111\u1ed5 \u0111\u1ea7y th\u1ea5t tr\u00e1i.<\/p>\n

    B\u00ean c\u1ea1nh \u0111\u00f3, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 l\u00e0m t\u0103ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o l\u00ean 2 – 3,5% m\u1ed7i n\u0103m. V\u00ec v\u1eady, \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 k\u00e8m theo rung nh\u0129 n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng nh\u1eb1m d\u1ef1 ph\u00f2ng nguy c\u01a1 thuy\u00ean t\u1eafc m\u1ea1ch t\u1eeb tim.<\/p>\n

    Ngo\u1ea1i t\u00e2m thu th\u1ea5t, c\u01a1n tim nhanh th\u1ea5t kh\u00f4ng b\u1ec1n b\u1ec9 l\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t kh\u00e1 th\u01b0\u1eddng g\u1eb7p. Nguy\u00ean nh\u00e2n c\u1ee7a s\u1ef1 t\u0103ng t\u00ednh b\u1ea5t \u1ed5n \u0111i\u1ec7n h\u1ecdc kh\u00f4ng r\u00f5 r\u00e0ng. Khi ph\u00e2n t\u00edch \u0111\u1ed3ng th\u1eddi \u0111\u01b0\u1eddng m\u00e1u v\u00e0 holter ECG ch\u1ec9 ra r\u1eb1ng:<\/p>\n

      \n
    • C\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp ch\u1eadm, ngo\u1ea1i t\u00e2m thu nh\u0129, ngo\u1ea1i t\u00e2m thu th\u1ea5t g\u1eb7p nhi\u1ec1u h\u01a1n khi \u0111\u01b0\u1eddng m\u00e1u th\u1ea5p v\u1ec1 \u0111\u00eam. \u0110i\u1ec1u n\u00e0y g\u1ee3i \u00fd c\u01a1 ch\u1ebf gia t\u0103ng nguy c\u01a1 t\u1eed vong (h\u1ed9i ch\u1ee9ng t\u1eed vong t\u1ea1i gi\u01b0\u1eddng ) khi ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u ch\u1eb7t ch\u1ebd.<\/li>\n
    • \u1ede c\u00e1c b\u1ec7nh nh\u00e2n th\u01b0\u1eddng xuy\u00ean c\u00f3 tri\u1ec7u ch\u1ee9ng do ngo\u1ea1i t\u00e2m thu th\u1ea5t ho\u1eb7c ghi nh\u1eadn \u0111\u01b0\u1ee3c nh\u1eefng c\u01a1n nhanh th\u1ea5t kh\u00f4ng b\u1ec1n b\u1ec9 ph\u1ea3i l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 c\u00e1c b\u1ec7nh tim c\u1ea5u tr\u00fac nh\u01b0 \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 g\u1eafng s\u1ee9c, si\u00eau \u00e2m tim, ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh ho\u1eb7c ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim.<\/li>\n<\/ul>\n

      X\u1eed tr\u00ed c\u01a1n tim nhanh th\u1ea5t b\u1ec1n b\u1ec9, xo\u1eafn \u0111\u1ec9nh ho\u1eb7c rung th\u1ea5t\u00a0 kh\u00f4ng kh\u00e1c bi\u1ec7t so v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1c. C\u1ea5y m\u00e1y ph\u00e1 rung t\u1ef1 \u0111\u1ed9ng l\u00e0 c\u1ea7n thi\u1ebft \u1edf t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n khi kh\u00f4ng t\u00ecm th\u1ea5y c\u00e1c y\u1ebfu t\u1ed1 kh\u1edfi ph\u00e1t c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c.<\/p>\n

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

      \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p. C\u00e1c b\u1ec7nh l\u00fd \u0111i k\u00e8m khi m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m. C\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp d\u01b0\u1edbi \u0111\u00e2y. 1.\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 th\u00fac \u0111\u1ea9y […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\n\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m. 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