{"id":30711,"date":"2023-05-04T17:17:30","date_gmt":"2023-05-04T10:17:30","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30711"},"modified":"2023-05-04T17:17:30","modified_gmt":"2023-05-04T10:17:30","slug":"thieu-mau","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/thieu-mau\/","title":{"rendered":"Thi\u1ebfu m\u00e1u trong b\u1ec7nh th\u1eadn m\u1ea1n: c\u01a1 ch\u1ebf v\u00e0 ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

Thi\u1ebfu m\u00e1u l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn v\u00e0 nghi\u00eam tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00f4ng qua x\u00e9t nghi\u1ec7m m\u00e1u v\u00e0 \u0111\u00e1nh gi\u00e1 n\u1ed3ng \u0111\u1ed9 EPO trong m\u00e1u. N\u1ebfu n\u1ed3ng \u0111\u1ed9 EPO th\u1ea5p v\u00e0 s\u1ed1 l\u01b0\u1ee3ng h\u1ed3ng c\u1ea7u trong m\u00e1u gi\u1ea3m, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u s\u1ebd \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh. Ngo\u00e0i ra, c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c nh\u01b0 \u0111o n\u1ed3ng \u0111\u1ed9 s\u1eaft trong m\u00e1u v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn c\u0169ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/h1>\n

Thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh b\u1ec7nh th\u1eadn m\u1ea1n ( bao g\u1ed3m c\u1ea3 b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i v\u00e0 gh\u00e9p th\u1eadn) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng li\u00ean quan \u0111\u1ebfn ch\u1ee9c n\u0103ng th\u1eadn suy gi\u1ea3m v\u00e0 nhi\u1ec1u r\u1ed1i lo\u1ea1n kh\u00e1c nh\u01b0 huy\u1ebft h\u1ecdc, d\u1ea1 d\u00e0y ru\u1ed9t, hocmon\u2026Thi\u1ebfu m\u00e1u g\u1eb7p \u1edf 43% v\u00e0 57% s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh b\u1ec7nh th\u1eadn m\u1ea1n t\u01b0\u01a1ng \u1ee9ng giai \u0111o\u1ea1n 1-2 v\u00e0 3-5. N\u1ed3ng \u0111\u1ed9 Hemoglobin(Hb) m\u00e1u ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1ed9 tu\u1ed5i, gi\u1edbi t\u00ednh, ch\u1ee7ng t\u1ed9c, nhi\u1ec5m tr\u00f9ng, vi\u00eam, c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh t\u1eadt \u0111\u1ed3ng th\u1eddi, vi\u1ec7c l\u1ecdc m\u00e1u \u0111\u1ea7y \u0111\u1ee7, ch\u1ea5t l\u01b0\u1ee3ng n\u01b0\u1edbc\u2026.<\/p>\n

Thi\u1ebfu m\u00e1u g\u00e2y t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong, t\u0103ng ph\u00ec \u0111\u1ea1i th\u1ea5t tr\u00e1i v\u00e0 suy tim xung huy\u1ebft, t\u0103ng t\u1ed1c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n \u0111\u1ebfn suy th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i[6]. K\u1ebft qu\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u cho th\u1ea5y, nguy c\u01a1 t\u1eed vong t\u0103ng l\u00ean 3 l\u1ea7n v\u1edbi m\u1ed7i 10g\/l Hb gi\u1ea3m \u0111i (trong kho\u1ea3ng 90-130g\/l).<\/p>\n

2. C\u01a1 ch\u1ebf thi\u1ebfu m\u00e1u c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh th\u1eadn m\u1ea1n<\/strong><\/h2>\n

2.1.Thi\u1ebfu Erythropoietin (EPO)<\/strong><\/h3>\n

L\u00e0 c\u01a1 ch\u1ebf ch\u1ee7 y\u1ebfu. B\u00ecnh th\u01b0\u1eddng, n\u1ed3ng \u0111\u1ed9 Erythropoietin(EPO) t\u1eeb 3-30 mU\/ml, t\u0103ng l\u00ean 100 l\u1ea7n khi Hb gi\u1ea3m xu\u1ed1ng. M\u1ed1i li\u00ean quan ngh\u1ecbch n\u00e0y gi\u1ea3m ho\u1eb7c m\u1ea5t \u0111i khi m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn <30 -40 ml\/p. M\u1ed9t s\u1ed1 c\u01a1 ch\u1ebf g\u00e2y ra t\u00ecnh tr\u1ea1ng thi\u1ebfu EPO t\u01b0\u01a1ng \u0111\u1ed1i :<\/p>\n

    \n
  • Th\u00edch nghi c\u1ee7a th\u1eadn gi\u1ea3m l\u00e0m gi\u1ea3m ti\u00eau th\u1ee5 oxy, c\u1ea3i thi\u1ec7n s\u1ef1 oxy h\u00f3a \u1edf ph\u1ea7n t\u1ee7y th\u1eadn ngo\u00e0i, gi\u1ea3m k\u00edch th\u00edch s\u1ea3n xu\u1ea5t EPO.<\/li>\n
  • EPO \u0111\u01b0\u1ee3c trung h\u00f2a b\u1edfi c\u00e1c receptor EPO h\u00f2a tan( t\u0103ng s\u1ea3n xu\u1ea5t khi c\u00f3 m\u1eb7t c\u00e1c ch\u1ea5t trung gian.<\/li>\n
  • EPO b\u1ecb b\u1ea5t ho\u1ea1t b\u1edfi c\u00e1c proteinase( ho\u1ea1t \u0111\u1ed9ng t\u0103ng l\u00ean trong m\u00f4i tr\u01b0\u1eddng ure m\u00e1u cao)<\/li>\n
  • Th\u1eadm ch\u00ed n\u1ebfu EPO v\u1edbi m\u1ed9t l\u01b0\u1ee3ng \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ebfn \u0111\u01b0\u1ee3c m\u1ed9t t\u1ee7y x\u01b0\u01a1ng nguy\u00ean v\u1eb9n, ho\u1ea1t \u0111\u1ed9ng c\u1ee7a n\u00f3 v\u1eabn c\u00f3 th\u1ec3 b\u1ecb suy y\u1ebfu b\u1edfi s\u1ef1 v\u1eafng m\u1eb7t c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 cho ph\u00e9p( IL-3, calcitriol,..) v\u00e0 s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 ng\u0103n c\u1ea3n( PTH..).<\/li>\n<\/ul>\n

    2.2. Thi\u1ebfu s\u1eaft<\/strong><\/h3>\n

    Bao g\u1ed3m thi\u1ebfu s\u1eaft tuy\u1ec7t \u0111\u1ed1i v\u00e0 t\u01b0\u01a1ng \u0111\u1ed1i<\/p>\n

      \n
    • Thi\u1ebfu s\u1eaft tuy\u1ec7t \u0111\u1ed1i<\/strong> do m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n nh\u01b0 m\u1ea5t m\u00e1u, lo\u1ea1n s\u1ea3n m\u1ea1ch m\u00e1u ru\u1ed9t, ch\u1ea3y m\u00e1u do ure m\u00e1u cao. Ng\u01b0\u1eddi b\u1ec7nh th\u1eadn nh\u00e2n t\u1ea1o m\u1ea5t s\u1eaft trung b\u00ecnh 1-3g\/n\u0103m.<\/li>\n
    • Thi\u1ebfu s\u1eaft t\u01b0\u01a1ng \u0111\u1ed1i<\/strong> ( thi\u1ebfu s\u1eaft ch\u1ee9c n\u0103ng) x\u1ea3y ra khi c\u01a1 th\u1ec3 kh\u00f4ng th\u1ec3 huy \u0111\u1ed9ng \u0111\u01b0\u1ee3c \u0111\u1ee7 s\u1eaft t\u1eeb ngu\u1ed3n d\u1ef1 tr\u1eef cung c\u1ea5p cho qu\u00e1 tr\u00ecnh sinh s\u1ea3n h\u1ed3ng c\u1ea7u<\/li>\n<\/ul>\n

      2.3. Tan m\u00e1u <\/strong><\/h3>\n

      \u1ede ng\u01b0\u1eddi b\u1ec7nh m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n, t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u b\u1ecb t\u0103ng ph\u00e1 h\u1ee7y. H\u1ed3ng c\u1ea7u c\u00f3 t\u00ednh ch\u1ea5t nh\u01b0\u1ee3c s\u1eafc, \u00edt s\u1eaft, s\u1edbm b\u1ecb v\u1ee1 v\u00e0 b\u1ecb th\u1ef1c b\u00e0o. M\u00e0ng t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u gi\u1ea3m kh\u1ea3 n\u0103ng bi\u1ebfn d\u1ea1ng. Tan m\u00e1u c\u00f3 th\u1ec3 x\u1ea3y ra trong th\u1eadn nh\u00e2n t\u1ea1o do hi\u1ec7n t\u01b0\u1ee3ng ly gi\u1ea3i c\u01a1 h\u1ecdc v\u00e0 ti\u1ebfp x\u00fac v\u1edbi ch\u1ea5t g\u00e2y \u00f4 nhi\u1ec5m ngu\u1ed3n n\u01b0\u1edbc ( chloramines, arsenic, k\u1ebdm\u2026).<\/p>\n

      2.4. Thi\u1ebfu dinh d\u01b0\u1ee1ng<\/strong><\/h3>\n

      \u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng y\u1ebfu t\u1ed1 d\u1ec5 b\u1ecb b\u1ecf qua. C\u00e1c Vitamin nh\u00f3m B( \u0111\u1eb7c bi\u1ec7t B6, B9( acid folic), B12) l\u00e0 c\u00e1c \u0111\u1ed3ng y\u1ebfu t\u1ed1 thi\u1ebft y\u1ebfu trong sinh s\u1ea3n h\u1ed3ng c\u1ea7u. L-carnitin gi\u1ea3m khi m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn gi\u1ea3m v\u00e0 b\u1ed5 sung L-Cartinine c\u00f3 th\u1ec3 ch\u1ed1ng l\u1ea1i s\u1ef1 ch\u1ebft t\u1ebf b\u00e0o. Gi\u1ea3m phosphate m\u00e1u l\u00e0m c\u1ea1n ki\u1ec7t ATP, gi\u1ea3m s\u1ef1 bi\u1ebfn d\u1ea1ng m\u00e0ng t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u, d\u1eabn t\u1edbi l\u00e3o h\u00f3a s\u1edbm ho\u1eb7c th\u1eadm ch\u00ed l\u00e0 thi\u1ebfu m\u00e1u tan m\u00e1u c\u1ea5p.<\/p>\n

      \"\"
      \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Ngu\u1ed3n: Cleveland Clinic journal of medicine<\/strong><\/figcaption><\/figure>\n

      3. Ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u<\/strong><\/h2>\n

      3.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/h3>\n

      Ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n<\/p>\n

      + > 15 tu\u1ed5i: khi Hb<130g\/l \u1edf nam v\u00e0 <120g\/l \u1edf n\u1eef<\/p>\n

      + 12-15 tu\u1ed5i: khi Hb <120g\/l<\/p>\n

      + 5-12 tu\u1ed5i: khi Hb<115g\/l<\/p>\n

      + 6 th\u00e1ng-5 tu\u1ed5i: <110g\/l<\/p>\n

      K\u1ebft qu\u1ea3 Hb c\u00f3 th\u1ec3 dao \u0111\u1ed9ng t\u1edbi 5g\/l trong m\u1ed9t m\u1eabu m\u00e1u. \u1ede ng\u01b0\u1eddi b\u1ec7nh th\u1eadn nh\u00e2n t\u1ea1o, n\u1ed3ng \u0111\u1ed9 Hb kh\u00e1c nhau gi\u1eefa c\u00e1c th\u1eddi \u0111i\u1ec3m. M\u1ed7i l\u00edt si\u00eau l\u1ecdc l\u00e0m t\u0103ng Hb \u0111\u1ebfn 0,4g\/dl. V\u00ec v\u1eady, n\u00ean x\u00e9t nghi\u1ec7m Hb v\u00e0o bu\u1ed5i l\u1ecdc m\u00e1u gi\u1eefa tu\u1ea7n, gi\u00e1 tr\u1ecb n\u00e0y th\u01b0\u1eddng x\u1ea5p x\u1ec9 v\u1edbi Hb trung b\u00ecnh c\u1ee7a c\u1ea3 tu\u1ea7n.<\/p>\n

      3.2. T\u1ea7n su\u1ea5t \u0111\u00e1nh gi\u00e1 thi\u1ebfu m\u00e1u ( \u0111o l\u01b0\u1eddng n\u1ed3ng \u0111\u1ed9 Hb m\u00e1u)<\/strong><\/h3>\n

      – V\u1edbi ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng thi\u1ebfu m\u00e1u<\/p>\n

      + \u00cdt nh\u1ea5t h\u00e0ng n\u0103m v\u1edbi CKD giai \u0111o\u1ea1n 3<\/p>\n

      + \u00cdt nh\u1ea5t 2 l\u1ea7n\/n\u0103m v\u1edbi CKD giai \u0111o\u1ea1n 4-5<\/p>\n

      + \u00cdt nh\u1ea5t m\u1ed7i 3 th\u00e1ng v\u1edbi ng\u01b0\u1eddi b\u1ec7nh th\u1eadn nh\u00e2n t\u1ea1o ho\u1eb7c l\u1ecdc m\u00e0ng b\u1ee5ng.<\/p>\n

      – V\u1edbi ng\u01b0\u1eddi b\u1ec7nh thi\u1ebfu m\u00e1u kh\u00f4ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ESA<\/p>\n

      + \u00cdt nh\u1ea5t m\u1ed7i 3 th\u00e1ng v\u1edbi ng\u01b0\u1eddi b\u1ec7nh m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n kh\u00f4ng do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 ng\u01b0\u1eddi b\u1ec7nh l\u1ecdc m\u00e0ng b\u1ee5ng<\/p>\n

      +\u00cdt nh\u1ea5t h\u00e0ng th\u00e1ng v\u1edbi ng\u01b0\u1eddi b\u1ec7nh th\u1eadn nh\u00e2n t\u1ea1o<\/p>\n

      3.3. \u0110\u00e1nh gi\u00e1 c\u00e1c t\u00ecnh tr\u1ea1ng li\u00ean quan <\/strong><\/h3>\n

      \u0110\u00e1nh gi\u00e1 s\u01a1 b\u1ed9 bao g\u1ed3m<\/p>\n

      – T\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi<\/p>\n

      – \u0110\u1ebfm t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u l\u01b0\u1edbi tuy\u1ec7t \u0111\u1ed1i<\/p>\n

      – Ferritin m\u00e1u<\/p>\n

      – \u0110\u1ed9 b\u00e3o h\u00f2a transferin (TSAT)<\/p>\n

      – N\u1ed3ng \u0111\u1ed9 vitamin B12 v\u00e0 acid folic<\/p>\n

      C\u1ea7n lo\u1ea1i tr\u1eeb thi\u1ebfu m\u00e1u do kh\u00f4ng t\u00e1i t\u1ea1o (b\u1ea5t s\u1ea3n) v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n t\u1ee7y x\u01b0\u01a1ng kh\u00e1c. \u0110o l\u01b0\u1eddng n\u1ed3ng \u0111\u1ed9 EPO \u00edt c\u00f3 gi\u00e1 tr\u1ecb v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/p>\n

      Thi\u1ebfu s\u1eaft c\u00f3 th\u1ec3 th\u1ef1c s\u1ef1 t\u1ed3n t\u1ea1i k\u1ec3 c\u1ea3 khi ch\u01b0a c\u00f3 thi\u1ebfu m\u00e1u. Th\u00f4ng s\u1ed1 t\u1ed1t nh\u1ea5t \u0111\u00e1nh gi\u00e1 d\u1ef1 tr\u1eef s\u1eaft l\u00e0 kh\u00f3 x\u00e1c \u0111\u1ecbnh. M\u1ed9t s\u1ed1 ch\u1ec9 s\u1ed1 nh\u01b0 MCH ho\u1eb7c MCV g\u1ee3i \u00fd thi\u1ebfu s\u1eaft nh\u01b0ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. Tr\u00ean l\u00e2m s\u00e0ng, Ferritin m\u00e1u th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. B\u00ecnh th\u01b0\u1eddng, 1ng\/ml ferritin t\u01b0\u01a1ng \u1ee9ng v\u1edbi 8 mg s\u1eaft d\u1ef1 tr\u1eef. Khi c\u00f3 t\u00ecnh tr\u1ea1ng vi\u00eam m\u1ea1n t\u00ednh, Ferritin m\u00e1u ph\u1ea3n \u00e1nh kh\u00f4ng \u0111\u00fang t\u00ecnh tr\u1ea1ng Ferritin \u1edf m\u00f4. Ferritin m\u00e1u c\u0169ng kh\u00f4ng qu\u00e1 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng s\u1eaft \u1edf t\u1ee7y x\u01b0\u01a1ng. \u0110\u1ed9 b\u00e3o h\u00f2a transferring \u0111\u1ea1i di\u1ec7n cho kh\u1ea3 n\u0103ng s\u1eb5n c\u00f3 c\u1ee7a s\u1eaft cung c\u1ea5p cho sinh s\u1ea3n h\u1ed3ng c\u1ea7u nh\u01b0ng gi\u00e1 tr\u1ecb th\u01b0\u1eddng dao \u0111\u1ed9ng t\u1ea1i c\u00e1c th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau. M\u1ed9t s\u1ed1 ch\u1ec9 s\u1ed1 kh\u00e1c nh\u01b0 l\u01b0\u1ee3ng Hb trong h\u1ed3ng c\u1ea7u l\u01b0\u1edbi, t\u1ef7 l\u1ec7 h\u1ed3ng c\u1ea7u nh\u01b0\u1ee3c s\u1eafc, TfR h\u00f2a tan( b\u00e0i ti\u1ebft b\u1edfi c\u00e1c hc trong t\u1ee7y \u0111ang thi\u1ebfu s\u1eaft )\u2026\u0111\u1ec1u kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. N\u1ed3ng \u0111\u1ed9 hepcidin m\u00e1u v\u00e0 protoporphyrin h\u1ed3ng c\u1ea7u \u0111\u01b0\u1ee3c xem l\u00e0 c\u00f3 gi\u00e1 tr\u1ecb, tuy nhi\u00ean \u0111o l\u01b0\u1eddng ch\u00ednh x\u00e1c hepcidin m\u00e1u hi\u1ec7n nay l\u00e0 b\u1ea5t kh\u1ea3 thi tr\u00ean l\u00e2m s\u00e0ng.<\/p>\n

      Ngu\u1ed3n tham kh\u1ea3o<\/strong>: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh th\u1eadn \u2013 ti\u1ebft ni\u1ec7u theo B\u1ed9 Y t\u1ebf 2015<\/p>\n","protected":false},"excerpt":{"rendered":"

      Thi\u1ebfu m\u00e1u l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn v\u00e0 nghi\u00eam tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00f4ng qua x\u00e9t nghi\u1ec7m m\u00e1u v\u00e0 \u0111\u00e1nh gi\u00e1 n\u1ed3ng \u0111\u1ed9 EPO trong m\u00e1u. N\u1ebfu n\u1ed3ng \u0111\u1ed9 EPO th\u1ea5p v\u00e0 s\u1ed1 l\u01b0\u1ee3ng h\u1ed3ng […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[29,33],"tags":[],"yoast_head":"\nThi\u1ebfu m\u00e1u trong b\u1ec7nh th\u1eadn m\u1ea1n: c\u01a1 ch\u1ebf v\u00e0 ch\u1ea9n \u0111o\u00e1n - Vinmec<\/title>\n<meta name=\"description\" content=\"Thi\u1ebfu m\u00e1u l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn v\u00e0 nghi\u00eam tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n. 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