{"id":30130,"date":"2023-05-01T22:49:31","date_gmt":"2023-05-01T15:49:31","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30130"},"modified":"2023-05-01T22:49:31","modified_gmt":"2023-05-01T15:49:31","slug":"amyloidosis","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/amyloidosis\/","title":{"rendered":"Amyloidosis v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

Amyloidosis<\/a> (ch\u1ee9ng tho\u00e1i h\u00f3a b\u1ed9t) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 l\u1eafng \u0111\u1ecdng ngo\u1ea1i b\u00e0o c\u1ee7a c\u00e1c protein s\u1ee3i kh\u00f4ng tan (amyloid). Protein c\u00f3 th\u1ec3 l\u1eafng \u0111\u1ecdng \u1edf m\u00f4 li\u00ean k\u1ebft, c\u00e1c m\u1ea1ch m\u00e1u, v\u00e0 nhi\u1ec1u b\u1ed9 ph\u1eadn bao g\u1ed3m tim, th\u1eadn, gan v\u00e0 h\u1ec7 th\u1ea7n kinh.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a<\/h2>\n

Amyloidosis <\/strong>(ch\u1ee9ng tho\u00e1i h\u00f3a b\u1ed9t) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 l\u1eafng \u0111\u1ecdng ngo\u1ea1i b\u00e0o c\u1ee7a c\u00e1c protein s\u1ee3i kh\u00f4ng tan (amyloid). Protein c\u00f3 th\u1ec3 l\u1eafng \u0111\u1ecdng \u1edf m\u00f4 li\u00ean k\u1ebft, c\u00e1c m\u1ea1ch m\u00e1u, v\u00e0 nhi\u1ec1u b\u1ed9 ph\u1eadn bao g\u1ed3m tim, th\u1eadn, gan v\u00e0 h\u1ec7 th\u1ea7n kinh. B\u1ec7nh tim tho\u00e1i h\u00f3a b\u1ed9t \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng b\u1edfi c\u00e1c d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim v\u00e0 h\u1ec7 d\u0201n truy\u1ec1n do s\u1ef1 l\u1eafng \u0111\u1ecdng amyloid \u1edf tim, l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a tho\u00e1i h\u00f3a b\u1ed9t t\u1ea1i ch\u1ed7 ho\u1eb7c h\u1ec7 th\u1ed1ng.<\/p>\n

2. Ph\u00e2n lo\u1ea1i<\/h2>\n
    \n
  • Tho\u00e1i h\u00f3a b\u1ed9t chu\u1ed7i nh\u1eb9 (AL) h\u1ec7 th\u1ed1ng <\/strong>l\u00e0 th\u1ec3 hay g\u1eb7p nh\u1ea5t c\u1ee7a b\u1ec7nh, hay c\u00f2n g\u1ecdi l\u00e0 tho\u00e1i h\u00f3a b\u1ed9t nguy\u00ean ph\u00e1t. C\u00e1c s\u1ee3i AL g\u1ed3m c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng chu\u1ed7i’ nh\u1eb9 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb t\u1ebf b\u00e0o lympho B b\u1ea5t th\u01b0\u1eddng (v\u00ed d\u1ee5 u t\u1ee7y, u lympho\u2026 ), tuy v\u1eady c\u00e1c b\u1ec7nh l\u00fd globulin mi\u1ec5n d\u1ecbch \u0111\u01a1n d\u00f2ng l\u00e0nh t\u00ednh v\u0201n l\u00e0 ph\u1ed5 bi\u1ebfn nh\u1ea5t. T\u1ef7 l\u1ec7 g\u1eb7p \u1edf nam v\u00e0 n\u1eef tr\u00ean 50 tu\u1ed5i l\u00e0 ngang nhau, th\u01b0\u1eddng t\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m nhi\u1ec1u c\u01a1 quan. Tho\u00e1i h\u00f3a b\u1ed9t \u1edf tim c\u00f3 \u0111\u1ebfn 90% ng\u01b0\u1eddi b\u1ec7nh \u1eca\u00e0 th\u1ec3 AL, v\u1edbi kho\u1ea3ng 50% b\u1ecb suy tim t\u00e2m tr\u01b0\u01a1ng.<\/li>\n
  • Tho\u00e1i h\u00f3a b\u1ed9t th\u1ec3 vi\u00eam (AA) h\u1ec7 th\u1ed1ng <\/strong>\u1eca\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a vi\u00eam m\u1ea1n t\u00ednh v\u1edbi \u0111\u1eb7c tr\u01b0ng \u0111\u00e1p \u1ee9ng giai \u0111o\u1ea1n c\u1ea5p t\u00ednh k\u00e9o d\u00e0i g\u00e2y t\u0103ng sinh protein A huy\u1ebft thanh. Tho\u00e1i h\u00f3a b\u1ed9t \u1edf tim hi\u1ebfm g\u1eb7p, th\u01b0\u1eddng g\u1eb7p trong b\u1ec7nh th\u1eadn, v\u1edbi bi\u1ec3u hi\u1ec7n protein ni\u1ec7u v\u00e0 suy th\u1eadn.<\/li>\n
  • Tho\u00e1i h\u00f3a b\u1ed9t tim transthyretin (ATTR) <\/strong>\u1eca\u00e0 m\u1ed9t th\u1ec3 tho\u00e1i h\u00f3a b\u1ed9t h\u1ec7 th\u1ed1ng c\u00f3 t\u00ednh di truy\u1ec1n qua nhi\u1ec5m s\u1eafc th\u1ec3 tr\u1ed9i do \u0111\u1ed9t bi\u1ebfn trong ph\u00e2n t\u1eed transthyretin. B\u1ec7nh c\u01a1 tim nhi\u1ec5m b\u1ed9t ATTR th\u01b0\u1eddng g\u1eb7p nh\u1ea5t do \u0111\u1ed9t bi\u1ebfn gen Va\u1eca122I\u1ecae (thay th\u1ebf va\u1ecaine b\u1edfi iso\u1ecaeucine \u1edf v\u1ecb tr\u00ed 122), ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf ng\u01b0\u1eddi M\u1ef9 g\u1ed1c Phi, g\u00e2y b\u1ec7nh c\u01a1 tim xu\u1ea5t hi\u1ec7n mu\u1ed9n v\u00e0 suy tim ti\u1ebfn tri\u1ec3n n\u1eb7ng.<\/li>\n
  • Tho\u00e1i h\u00f3a b\u1ed9t h\u1ec7 th\u1ed1ng tu\u1ed5i gi\u00e0 <\/strong>\u1eca\u00e0 b\u1ec7nh c\u01a1 tim th\u00e2m nhi\u1ec5m ti\u1ebfn tri\u1ec3n t\u1eeb t\u1eeb, th\u01b0\u1eddng g\u1eb7p \u1edf nam gi\u1edbi, v\u1edbi t\u1ef7 \u1eca\u1ec7 25 – 36% nam tr\u00ean 80 tu\u1ed5i. Th\u1ec3 n\u00e0y hi\u1ebfm g\u1eb7p d\u01b0\u1edbi 60 tu\u1ed5i v\u00e0 ti\u1ebfn tri\u1ec3n ch\u1eadm h\u01a1n tho\u00e1i h\u00f3a b\u1ed9t AL, m\u1eb7c d\u00f9 t\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m tim nhi\u1ec1u h\u01a1n.<\/li>\n<\/ul>\n

    3. B\u1ec7nh h\u1ecdc<\/h2>\n
      \n
    • Th\u00e2m nhi\u1ec5m c\u01a1 th\u1ea5t <\/strong>v\u1edbi c\u00e1c protein s\u1ee3i (amyloid) g\u00e2y m\u1ea5t c\u00e2n b\u1eb1ng v\u00e0 gi\u1ea3m s\u1ef1 gi\u00e3n c\u01a1 tim. \u00c1p l\u1ef1c nh\u0129 tr\u00e1i v\u00e0 ph\u1ea3i t\u0103ng d\u1ea7n, d\u0201n \u0111\u1ebfn ph\u00f9 ph\u1ed5i v\u00e0 qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch ngo\u1ea1i vi.<\/li>\n
    • Th\u00e2m nhi\u1ec5m n\u1ed9i m\u1ea1c <\/strong>d\u0201n \u0111\u1ebfn h\u1edf van hai l\u00e1, van ba l\u00e1, l\u00e0m t\u0103ng nhi\u1ec1u h\u01a1n \u00e1p l\u1ef1c t\u00e2m nh\u0129.<\/li>\n<\/ul>\n

      C\u00e1c s\u1ee3i amyloid trong c\u01a1 tim kh\u1edfi ph\u00e1t qu\u00e1 tr\u00ecnh vi\u00eam v\u00e0 x\u01a1 h\u00f3a<\/strong>, xu h\u01b0\u1edbng l\u00e0m t\u0103ng c\u00e1c \u1ed5 r\u1ed1i lo\u1ea1n nh\u1ecbp nguy hi\u1ec3m. Gi\u00e3n t\u00e2m nh\u0129 d\u0201n \u0111\u1ebfn rung nh\u0129. Th\u00e2m nhi\u1ec5m tr\u1ef1c ti\u1ebfp m\u00f4 d\u0201n truy\u1ec1n c\u01a1 tim li\u00ean quan \u0111\u1ebfn ng\u1eebng tim v\u00e0 \u0111\u1ed9t t\u1eed. Th\u00e2m nhi\u1ec5m amyloid trong m\u1ea1ch v\u00e0nh c\u00f3 th\u1ec3 g\u00e2y c\u01a1n \u0111au ng\u1ef1c ho\u1eb7c \u0111\u1ed9t t\u1eed. Th\u00e2m nhi\u1ec5m m\u00e0ng ngo\u00e0i tim v\u1edbi \u0111\u1eb7c \u0111i\u1ec3m tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim s\u1ed1 l\u01b0\u1ee3ng \u00edt, th\u01b0\u1eddng l\u00e0 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u00edt \u0111\u01b0\u1ee3c ch\u00fa \u00fd \u0111\u1ebfn.<\/p>\n

      \"Amyloidosis\"<\/p>\n

      B\u1ec7nh sinh c\u1ee7a Amyloidosis<\/strong><\/p>\n

      4. L\u00e2m s\u00e0ng<\/h2>\n

      T\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m \u1edf tim g\u1eb7p d\u01b0\u1edbi 4% b\u1ec7nh nh\u00e2n m\u1eafc ch\u1ee9ng tho\u00e1i h\u00f3a b\u1ed9t.<\/p>\n

      Tr\u00ean l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p t\u00ecnh tr\u1ea1ng suy tim ph\u1ea3i; suy tim tr\u00e1i xu\u1ea5t hi\u1ec7n \u1edf giai \u0111o\u1ea1n mu\u1ed9n c\u1ee7a b\u1ec7nh.<\/p>\n

      \u0110au ng\u1ef1c hi\u1ebfm g\u1eb7p v\u00e0 do nguy\u00ean nh\u00e2n l\u1eafng \u0111\u1ecdng amyloid trong th\u00e0nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh. Ch\u00f3ng m\u1eb7t v\u00e0 ng\u1ea5t do m\u1ed9t v\u00e0i y\u1ebfu t\u1ed1, bao g\u1ed3m h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf th\u1ee9 ph\u00e1t do b\u1ec7nh th\u1ea7n kinh t\u1ef1 \u0111\u1ed9ng v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh – ch\u1eadm.<\/p>\n

      Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng suy tim ph\u1ea3i: T\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i, gan to, ph\u00f9 chi d\u01b0\u1edbi v\u00e0 c\u1ed5 tr\u01b0\u1edbng.<\/p>\n

      Trong tr\u01b0\u1eddng h\u1ee3p mu\u1ed9n, th\u00e2m nhi\u1ec5m th\u1ea5t tr\u00e1i d\u0201n \u0111\u1ebfn suy tim g\u00e2y h\u1ea1 huy\u1ebft \u00e1p v\u00e0 ph\u00f9 ph\u1ed5i.<\/p>\n

      Th\u0103m kh\u00e1m v\u00f9ng tr\u01b0\u1edbc tim c\u00f3 ti\u1ebfng T3 do \u0111\u1ed5 \u0111\u1ea7y nhanh v\u00e0 \u0111\u1ed9t ng\u1ed9t t\u00e2m th\u1ea5t \u1edf th\u00ec \u0111\u1ea7u t\u00e2m tr\u01b0\u01a1ng.<\/p>\n

      5. Ch\u1ea9n \u0111o\u00e1n<\/h2>\n

      B\u1ec7nh tim tho\u00e1i h\u00f3a b\u1ed9t n\u00ean \u0111\u01b0\u1ee3c ngh\u0129 \u0111\u1ebfn trong b\u1ea5t k\u1ef3 b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng suy tim ch\u01b0a r\u00f5 nguy\u00ean nh\u00e2n, \u0111\u1eb7c bi\u1ec7t n\u1ebfu c\u00f3 b\u1eb1ng ch\u1ee9ng tr\u00ean si\u00eau \u00e2m tim d\u00e0y th\u1ea5t tr\u00e1i v\u1edbi k\u00edch th\u01b0\u1edbc bu\u1ed3ng tim b\u00ecnh th\u01b0\u1eddng.<\/p>\n

      \u0110i\u1ec7n t\u00e2m \u0111\u1ed3: <\/strong>Kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, c\u00f3 th\u1ec3 g\u1eb7p h\u00ecnh \u1ea3nh \u0111i\u1ec7n th\u1ebf th\u1ea5p (QRS < 0,5 mV \u1edf \u0111i\u1ec7n c\u1ef1c chi v\u00e0 < 1 mV \u1edf \u0111i\u1ec7n c\u1ef1c ngo\u1ea1i vi) v\u00e0 h\u00ecnh \u1ea3nh gi\u1ea3 nh\u1ed3i m\u00e1u c\u01a1 tim (s\u00f3ng Q b\u1ec7nh l\u00fd v\u00e0 s\u00f3ng T \u0111\u1ea3o ng\u01b0\u1ee3c) g\u1eb7p \u1edf tr\u00ean 50% tr\u01b0\u1eddng h\u1ee3p. R\u1ed1i lo\u1ea1n nh\u1ecbp ph\u1ed5 bi\u1ebfn l\u00e0 rung nh\u0129, cu\u1ed3ng nh\u0129, block nh\u0129 th\u1ea5t c\u00e1c m\u1ee9c \u0111\u1ed9.<\/p>\n

      Si\u00eau \u00e2m tim: <\/strong>Bi\u1ec3u hi\u1ec7n s\u1edbm l\u00e0 d\u00e0y th\u00e0nh th\u1ea5t tr\u00e1i v\u1edbi k\u00edch th\u01b0\u1edbc bu\u1ed3ng tim b\u00ecnh th\u01b0\u1eddng v\u00e0 suy ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng.<\/p>\n

      \u0110\u1eb7c tr\u01b0ng l\u00e0 c\u01a1 tim c\u00f3 h\u00ecnh \u1ea3nh \u201c\u0111\u1ed1m\u201d<\/strong>.<\/p>\n

      H\u00ecnh \u1ea3nh c\u00f3 th\u1ec3 g\u1eb7p l\u00e0 n\u1ed9i m\u1ea1c d\u00e0y, h\u1edf van nh\u0129 th\u1ea5t, gi\u00e3n hai bu\u1ed3ng nh\u0129, v\u00e1ch li\u00ean nh\u0129 s\u00e1ng.<\/p>\n

      C\u01a1 th\u1ea5t gi\u1ea3m th\u00edch nghi, d\u0201n \u0111\u1ebfn gi\u1edbi h\u1ea1n s\u1ef1 \u0111\u1ed5 \u0111\u1ea7y v\u00e0 t\u0103ng \u0111\u00e1ng k\u1ec3 \u00e1p l\u1ef1c hai nh\u0129 \u1edf giai \u0111o\u1ea1n b\u1ec7nh ti\u1ebfn tri\u1ec3n.<\/p>\n

      \u1ede giai \u0111o\u1ea1n mu\u1ed9n c\u1ee7a b\u1ec7nh, th\u01b0\u1eddng g\u1eb7p suy ch\u1ee9c n\u0103ng t\u00e2m thu.<\/p>\n

      N\u1ebfu th\u00e0nh th\u1ea5t d\u00e0y > 15 mm, ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i gi\u1ea3m < 40% v\u00e0 tr\u00ean l\u00e2m s\u00e0ng c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a suy tim, t\u1ef7 l\u1ec7 s\u1ed1ng c\u00f2n trung b\u00ecnh th\u01b0\u1eddng kh\u00f4ng qu\u00e1 6 th\u00e1ng.<\/p>\n

      MRI tim: <\/strong>\u0110ang nghi\u00ean c\u1ee9u hi\u1ec7n nay, ch\u1ec9 ra s\u1ef1 t\u0103ng to\u00e0n th\u1ec3 l\u1edbp d\u01b0\u1edbi n\u1ed9i m\u1ea1c \u0111\u1eb7c tr\u01b0ng v\u00e0 t\u0103ng gadolinium mu\u1ed9n.<\/p>\n

      Ch\u1ee5p b\u1eb1ng ph\u00f3ng x\u1ea1: <\/strong>S\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt ph\u00f3ng x\u1ea1 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n s\u1ef1 ph\u00e2n b\u1ed1 c\u1ee7a protein amyloid huy\u1ebft thanh nh\u01b0ng trong th\u1ef1c h\u00e0nh kh\u00f3 s\u1eed d\u1ee5ng v\u00ec k\u1ef9 thu\u1eadt kh\u00f3 v\u1edbi t\u1ea1ng r\u1ed7ng v\u00e0 chuy\u1ec3n \u0111\u1ed9ng.<\/p>\n

      Sinh thi\u1ebft m\u00f4: <\/strong>Sinh thi\u1ebft n\u1ed9i m\u1ea1c l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n khi ph\u1ea7n m\u00f4 \u0111\u01b0\u1ee3c nhu\u1ed9m Congo \u0111\u1ecf. C\u00e1c ph\u1ea7n m\u00f4 c\u00f3 m\u00e0u \u201cxanh t\u00e1o\u201d khi quan s\u00e1t d\u01b0\u1edbi \u00e1nh s\u00e1ng ph\u00e2n c\u1ef1c. Ch\u1ea9n \u0111o\u00e1n m\u00f4 h\u1ecdc \u00edt c\u1ea7n thi\u1ebft tr\u01b0\u1edbc s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a c\u00e1c h\u00ecnh \u1ea3nh tim \u0111\u1eb7c tr\u01b0ng tr\u00ean si\u00eau \u00e2m v\u00e0 MRI tim.<\/p>\n

      Sinh h\u00f3a: <\/strong>C\u00e1c ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m sinh h\u1ecdc troponin I, troponin T v\u00e0 hormone l\u1ee3i ni\u1ec7u NT – proBNP t\u0103ng trong b\u1ec7nh tim tho\u00e1i h\u00f3a b\u1ed9t. T\u0103ng c\u00e1c troponin do l\u1eafng \u0111\u1ecdng amyloid g\u00e2y ho\u1ea1i t\u1eed t\u1ebf b\u00e0o c\u01a1 v\u00e0 thi\u1ebfu m\u00e1u vi m\u1ea1ch. T\u0103ng BNP sau khi c\u00f3 suy ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng, khi BNP t\u0103ng c\u00f3 gi\u00e1 tr\u1ecb ti\u00ean l\u01b0\u1ee3ng t\u00ecnh tr\u1ea1ng suy tim ti\u1ebfn tri\u1ec3n.<\/p>\n

      Mi\u1ec5n d\u1ecbch: <\/strong>Mi\u1ec5n d\u1ecbch \u0111i\u1ec7n di huy\u1ebft thanh v\u00e0 x\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u t\u00ecm c\u00e1c chu\u1ed7i nh\u1eb9 l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng r\u1ed1i lo\u1ea1n t\u1ed5ng h\u1ee3p kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng.<\/p>\n

      6. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

      Ch\u1ee7 y\u1ebfu l\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3. H\u00f3a tr\u1ecb li\u1ec7u v\u00e0 \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng vi\u00eam <\/strong>\u0111\u1ec3 ng\u0103n s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a protein A v\u00e0 c\u00e1c kh\u00e1ng th\u1ec3 mi\u1ec5n d\u1ecbch huy\u1ebft thanh.<\/p>\n

      \u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng suy tim v\u1edbi l\u1ee3i ti\u1ec3u quai v\u00e0 kh\u00e1ng aldosterone. Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng r\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n mang l\u1ea1i l\u1ee3i \u00edch trong b\u1ec7nh tim tho\u00e1i h\u00f3a b\u1ed9t. Th\u1ef1c t\u1ebf, c\u01a1 ch\u1ebf gi\u00e3n t\u0129nh m\u1ea1ch do thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u1ed5 \u0111\u1ea7y th\u1ea5t v\u00e0 gi\u1ea3m cung l\u01b0\u1ee3ng tim.<\/p>\n

      C\u00e1c thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m <\/strong>c\u00f3 th\u1ec3 g\u00e2y b\u1ea5t l\u1ee3i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh suy tim n\u1eb7ng – t\u00ecnh tr\u1ea1ng c\u1ea7n \u0111\u00e1p \u1ee9ng nh\u1ecbp tim th\u00edch h\u1ee3p \u0111\u1ec3 duy tr\u00ec cung l\u01b0\u1ee3ng tim.<\/p>\n

      Digoxin v\u00e0 c\u00e1c thu\u1ed1c ch\u1eb9n k\u00eanh canxi <\/strong>ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00ec thu\u1ed1c c\u00f3 xu h\u01b0\u1edbng k\u1ebft d\u00ednh c\u00e1c s\u1ee3i amyloid g\u00e2y ng\u1ed9 \u0111\u1ed9c c\u01a1 tim.<\/p>\n

      Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng <\/strong>c\u1ea7n \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi c\u00f3 nguy c\u01a1 huy\u1ebft kh\u1ed1i trong bu\u1ed3ng tim do rung nh\u0129 v\u00e0 suy ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i n\u1eb7ng.<\/p>\n

      M\u00e1y t\u1ea1o nh\u1ecbp v\u0129nh vi\u1ec5n <\/strong>c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p nh\u1ecbp ch\u1eadm c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c block nh\u0129 th\u1ea5t \u0111\u1ed9 cao.<\/p>\n

      Vai tr\u00f2 c\u1ee7a m\u00e1y ph\u00e1 rung t\u1ef1 \u0111\u1ed9ng (ICD) <\/strong>c\u00f2n \u0111ang tranh c\u00e3i, c\u00f3 \u00fd ki\u1ebfn cho r\u1eb1ng ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n khi \u0111\u00e3 xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng ti\u00ean l\u01b0\u1ee3ng s\u1ed1ng d\u01b0\u1edbi 1 n\u0103m. Vai tr\u00f2 c\u1ee7a m\u00e1y t\u1ea1o nh\u1ecbp hai bu\u1ed3ng th\u1ea5t ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh.<\/p>\n

      Gh\u00e9p tim <\/strong>v\u1edbi h\u00f3a tr\u1ecb li\u1ec7u li\u1ec1u cao hay c\u1ea5y t\u1ebf b\u00e0o g\u1ed1c t\u1ef1 th\u00e2n l\u00e0 nh\u1eefng bi\u1ec7n ph\u00e1p \u0111ang \u0111\u01b0\u1ee3c h\u1ee9a h\u1eb9n.<\/p>\n","protected":false},"excerpt":{"rendered":"

      Amyloidosis (ch\u1ee9ng tho\u00e1i h\u00f3a b\u1ed9t) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 l\u1eafng \u0111\u1ecdng ngo\u1ea1i b\u00e0o c\u1ee7a c\u00e1c protein s\u1ee3i kh\u00f4ng tan (amyloid). Protein c\u00f3 th\u1ec3 l\u1eafng \u0111\u1ecdng \u1edf m\u00f4 li\u00ean k\u1ebft, c\u00e1c m\u1ea1ch m\u00e1u, v\u00e0 nhi\u1ec1u b\u1ed9 ph\u1eadn bao g\u1ed3m tim, th\u1eadn, gan v\u00e0 h\u1ec7 th\u1ea7n kinh. 1. \u0110\u1ecbnh ngh\u0129a Amyloidosis […]<\/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":"\nAmyloidosis v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Amyloidosis (ch\u1ee9ng tho\u00e1i h\u00f3a b\u1ed9t) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 l\u1eafng \u0111\u1ecdng ngo\u1ea1i b\u00e0o c\u1ee7a c\u00e1c protein s\u1ee3i kh\u00f4ng tan (amyloid).\" \/>\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=\"Amyloidosis v\u00e0 \u0111i\u1ec1u tr\u1ecb - 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