{"id":30744,"date":"2023-05-04T17:17:05","date_gmt":"2023-05-04T10:17:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30744"},"modified":"2023-05-08T13:02:23","modified_gmt":"2023-05-08T06:02:23","slug":"erythropoietin","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/erythropoietin\/","title":{"rendered":"Erythropoietin trong \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n"},"content":{"rendered":"

Erythropoietin (EPO) l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n hi\u1ec7u qu\u1ea3 nh\u1ea5t v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Thu\u1ed1c EPO \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 th\u00fac \u0111\u1ea9y s\u1ea3n xu\u1ea5t h\u1ed3ng c\u1ea7u trong c\u01a1 th\u1ec3, gi\u00fap c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng v\u1eadn chuy\u1ec3n oxy trong m\u00e1u v\u00e0 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng thi\u1ebfu m\u00e1u.<\/strong><\/p>\n

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

Thi\u1ebfu m\u00e1u l\u00e0 m\u1ed9t trong c\u00e1c bi\u1ebfn ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p \u1edf ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n. Khi suy th\u1eadn c\u00e0ng n\u1eb7ng th\u00ec t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u c\u00e0ng tr\u1ea7m tr\u1ecdng do th\u1eadn gi\u1ea3m s\u1ea3n xu\u1ea5t Erythropoietin<\/span>. \u0110\u00e2y l\u00e0 ch\u1ea5t c\u1ea7n thi\u1ebft trong qu\u00e1 tr\u00ecnh bi\u1ec7t ho\u00e1 h\u1ed3ng c\u1ea7u t\u1ea1i tu\u1ef7 x\u01b0\u01a1ng.<\/p>\n

Thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n d\u1eabn \u0111\u1ebfn gia t\u0103ng nguy c\u01a1 b\u1ec7nh t\u1eadt v\u00e0 t\u1eed vong. \u0110i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n l\u00e0 m\u1ed9t trong nh\u1eefng m\u1ee5c ti\u00eau quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n v\u00e0 \u0111i\u1ec1u tr\u1ecb thay th\u1ebf. T\u1ea5t c\u1ea3 c\u00e1c ng\u01b0\u1eddi b\u1ec7nh b\u1ecb thi\u1ebfu m\u00e1u m\u1ea1n t\u00ednh c\u00f3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh \u0111\u1ec1u \u0111\u01b0\u1ee3c xem x\u00e9t ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb, tu\u1ef3 v\u00e0o m\u1ee9c \u0111\u1ed9 thi\u1ebfu m\u00e1u.<\/p>\n

2. Nguy\u00ean nh\u00e2n thi\u1ebfu Erythropoietin<\/strong><\/h2>\n

\u1ede ng\u01b0\u1eddi b\u1ec7nh th\u1eadn m\u1ea1n thi\u1ebfu h\u1ee5t Erythropoietin l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u, tuy nhi\u00ean m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n kh\u00e1c c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u n\u1eb7ng h\u01a1n nh\u01b0: thi\u1ebfu s\u1eaft, suy dinh d\u01b0\u1ee1ng, m\u1ea5t m\u00e1u m\u1ea1n t\u00ednh trong th\u1eadn nh\u00e2n t\u1ea1o chu k\u1ef3, b\u1ec7nh \u0111\u01b0\u1eddng ti\u00eau h\u00f3a m\u1ea1n t\u00ednh, t\u00ecnh tr\u1ea1ng vi\u00eam m\u1ea1n t\u00ednh\u2026<\/p>\n

\"\"
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ngu\u1ed3n: Iron-deficiency Anemia and Chronic Kidney Disease: An Overview<\/strong><\/figcaption><\/figure>\n

3. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n

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

D\u1ef1a v\u00e0o n\u1ed3ng \u0111\u1ed9 Hemoglobin \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n:<\/p>\n

\u1ede ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh:<\/p>\n

– Thi\u1ebfu m\u00e1u \u1edf gi\u1edbi n\u1eef khi Hb < 11,5 g\/dl<\/p>\n

– Thi\u1ebfu m\u00e1u \u1edf gi\u1edbi nam khi Hb < 13,5 g\/dl<\/p>\n

3.1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong>:<\/p>\n

* Tri\u1ec7u ch\u1ee9ng thi\u1ebfu m\u00e1u:<\/strong><\/p>\n

M\u1ec7t m\u1ecfi, da xanh ni\u00eam m\u1ea1c nh\u1ee3t, m\u1ea5t ng\u1ee7, nh\u1ecbp tim nhanh, suy tim, suy gi\u1ea3m nh\u1eadn th\u1ee9c, suy gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng\u2026<\/p>\n

* Tri\u1ec7u ch\u1ee9ng suy th\u1eadn:<\/strong><\/p>\n

M\u1ec7t m\u1ecfi, ph\u00f9, ti\u1ec3u \u00edt, t\u0103ng huy\u1ebft \u00e1p, c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a h\u1ed9i ch\u1ee9ng ure m\u00e1u cao( ch\u00e1n \u0103n, n\u00f4n, bu\u1ed3n n\u00f4n\u2026).<\/p>\n

3.1.2. C\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/p>\n

* C\u00f4ng th\u1ee9c m\u00e1u<\/strong>: thi\u1ebfu m\u00e1u khi c\u00f3 Hb gi\u1ea3m d\u01b0\u1edbi 95% c\u1ee7a ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng c\u00f9ng gi\u1edbi, c\u00f9ng \u0111\u1ed9 tu\u1ed5i:<\/p>\n

– Hb<115g\/L v\u1edbi ph\u1ee5 n\u1eef tr\u01b0\u1edfng th\u00e0nh.<\/p>\n

– Hb<135g\/L v\u1edbi nam gi\u1edbi tr\u01b0\u1edfng th\u00e0nh.<\/p>\n

* Ch\u1ee9c n\u0103ng th\u1eadn<\/strong> :<\/p>\n

– Ure, creatinin m\u00e1u t\u0103ng<\/p>\n

– M\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn gi\u1ea3m,<\/p>\n

– \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3 m\u00e1u c\u00f3 thay \u0111\u1ed5i (Kali th\u01b0\u1eddng cao, canxi c\u00f3 th\u1ec3 gi\u1ea3m ho\u1eb7c t\u0103ng tu\u1ef3 theo giai \u0111o\u1ea1n b\u1ec7nh…)<\/p>\n

* X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u:<\/strong><\/p>\n

– C\u00f3 protein ni\u1ec7u,<\/p>\n

– C\u00f3 h\u1ed3ng c\u1ea7u ni\u1ec7u<\/p>\n

– C\u00f3 th\u1ec3 c\u00f3 b\u1ea1ch c\u1ea7u ni\u1ec7u<\/p>\n

* Si\u00eau \u00e2m<\/strong>: h\u00ecnh \u1ea3nh th\u1eadn tu\u1ef3 thu\u1ed9c v\u00e0o lo\u1ea1i b\u1ec7nh l\u00fd th\u1eadn, giai \u0111o\u1ea1n b\u1ec7nh th\u1eadn m\u1ea1n c\u1ee5 th\u1ec3<\/p>\n

3.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n

C\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u do c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y ra:<\/p>\n

– Thi\u1ebfu m\u00e1u do m\u1ea5t m\u00e1u: xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a, ho ra m\u00e1u, rong kinh, ch\u1ea5n th\u01b0\u01a1ng\u2026<\/p>\n

– Thi\u1ebfu m\u00e1u do t\u1ea1o m\u00e1u kh\u00f4ng \u0111\u1ee7: suy t\u1ee7y x\u01b0\u01a1ng, leukemia, thi\u1ebfu nguy\u00ean li\u1ec7u t\u1ea1o m\u00e1u…<\/p>\n

– Thi\u1ebfu m\u00e1u do tan m\u00e1u: tan m\u00e1u t\u1ef1 mi\u1ec5n, tan m\u00e1u do thu\u1ed1c, Lupus\u2026<\/p>\n

3.3. Nguy\u00ean nh\u00e2n thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n<\/strong><\/h3>\n

– Thi\u1ebfu h\u1ee5t Erythropoietin (quan tr\u1ecdng nh\u1ea5t).<\/p>\n

– Do gi\u1ea3m \u0111\u1eddi s\u1ed1ng h\u1ed3ng c\u1ea7u.<\/p>\n

– Do thi\u1ebfu h\u1ee5t c\u00e1c y\u1ebfu t\u1ed1 t\u1ea1o m\u00e1u (s\u1eaft, vitamin B12, Acid Folic, protein…)<\/p>\n

– M\u1ea5t m\u00e1u tr\u01b0\u1eddng di\u1ec5n\u2026<\/p>\n

4. \u0110i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh nh\u00e2n b\u1ec7nh th\u1eadn m\u1ea1n b\u1eb1ng Erythropoietin<\/strong><\/h2>\n

4.1. Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

C\u00f3 ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi l\u1edbn khi n\u1ed3ng \u0111\u1ed9 Hb <100g\/L<\/p>\n

4.2. M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

– Duy tr\u00ec Hb 11g\/dL – 12g\/dL (Hct 33% – 36%) \u0111\u1ea1t \u0111\u01b0\u1ee3c trong v\u00f2ng 4 th\u00e1ng k\u1ec3 t\u1eeb khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng EPO (Erythropoietin ng\u01b0\u1eddi t\u00e1i t\u1ed5 h\u1ee3p).<\/p>\n

– Hb m\u1ee5c ti\u00eau tr\u00ean \u0111\u00e2y kh\u00f4ng \u00e1p d\u1ee5ng cho li\u1ec7u ph\u00e1p truy\u1ec1n m\u00e1u.<\/p>\n

4.3. \u0110\u00e1nh gi\u00e1 m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn thi\u1ebfu m\u00e1u \u1edf ng\u01b0\u1eddi b\u1ec7nh b\u1ec7nh th\u1eadn m\u1ea1n<\/strong><\/h3>\n

– C\u1ea7n \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng d\u1ef1 tr\u1eef s\u1eaft th\u01b0\u1eddng xuy\u00ean \u0111\u1ec3 b\u1ed5 xung s\u1eaft \u0111\u1ea7y \u0111\u1ee7 ( \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch ho\u1eb7c \u0111\u01b0\u1eddng u\u1ed1ng) cho \u0111\u1ebfn khi \u0111\u1eb7t m\u1ee9c Hb m\u1ee5c ti\u00eau. L\u01b0u \u00fd c\u1ea7n ng\u1eebng truy\u1ec1n s\u1eaft t\u0129nh m\u1ea1ch 1 tu\u1ea7n tr\u01b0\u1edbc khi x\u00e9t nghi\u1ec7m t\u00ecnh tr\u1ea1ng s\u1eaft.<\/p>\n

– \u0110\u00e1nh gi\u00e1 s\u1ed1 l\u01b0\u1ee3ng h\u1ed3ng c\u1ea7u l\u01b0\u1edbi<\/p>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng vi\u00eam<\/p>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng dinh d\u01b0\u1ee1ng<\/p>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng l\u1ecdc m\u00e1u \u0111\u1ea7y \u0111\u1ee7<\/p>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng m\u1ea5t m\u00e1u m\u1ea1n t\u00ednh<\/p>\n

4.4. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng Erythropoietin (rHuEPO).<\/strong><\/h3>\n

4.4.1. Lo\u1ea1i Erythropoietin<\/strong><\/p>\n

– Epoietin Alfa: Eprex, Epogen, Epokin, Epotiv…<\/p>\n

– Epoietin Beta: NeoRecormon, Betapoietin…<\/p>\n

– Darbepoetin alfa: Aranesp<\/p>\n

– Methoxy polyethylene glycol \u2013 epoetin beta : Mircera<\/p>\n

4.4.2. \u0110\u01b0\u1eddng d\u00f9ng<\/strong><\/p>\n

\u0110\u01b0\u1eddng d\u00f9ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn tu\u1ef3 thu\u1ed9c v\u00e0o t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3: ti\u00eam t\u0129nh m\u1ea1ch ho\u1eb7c ti\u00eam d\u01b0\u1edbi da.<\/p>\n

– \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n giai \u0111o\u1ea1n \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n: c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn m\u1ed9t trong c\u00e1c nh\u00f3m thu\u1ed1c EPO n\u00f3i tr\u00ean, n\u00ean ti\u00eam d\u01b0\u1edbi da.<\/p>\n

– \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh th\u1eadn nh\u00e2n t\u1ea1o chu k\u1ef3: n\u00ean ti\u00eam t\u0129nh m\u1ea1ch EPO v\u00e0o c\u00e1c bu\u1ed5i l\u1ecdc m\u00e1u. Tuy nhi\u00ean ti\u00eam d\u01b0\u1edbi da c\u00f3 th\u1ec3 gi\u1ea3m \u0111\u01b0\u1ee3c li\u1ec1u EPO.<\/p>\n

– \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh l\u1ecdc m\u00e0ng b\u1ee5ng chu k\u1ef3: EPO n\u00ean ti\u00eam d\u01b0\u1edbi da<\/p>\n

– C\u00f3 th\u1ec3 ti\u00eam 1 l\u1ea7n\/ th\u00e1ng t\u00f9y theo \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb \u0111\u1ed1i v\u1edbi lo\u1ea1i EPO th\u1ebf h\u1ec7 m\u1edbi nh\u01b0 Mircera<\/span><\/p>\n

4.4.3. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb<\/strong><\/p>\n

T\u1ea5n c\u00f4ng: v\u1edbi m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb \u0111\u1ea1t m\u1ee9c Hb 11 \u2013 12g\/dl (KDOQI 2007 v\u00e0 KDIGO 2012 \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u trong b\u1ec7nh th\u1eadn m\u1ea1n))<\/p>\n

Li\u1ec1u t\u1ea5n c\u00f4ng c\u1ee7a EPO ph\u1ee5 thu\u1ed9c v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0 m\u1ee9c \u0111\u1ed9 thi\u1ebfu m\u00e1u v\u00e0 nguy\u00ean nh\u00e2n c\u01a1 b\u1ea3n c\u1ee7a thi\u1ebfu m\u00e1u.<\/p>\n

+ EPO alfa v\u00e0 beta ti\u00eam d\u01b0\u1edbi da: 20 UI\/kg x 3 l\u1ea7n\/tu\u1ea7n ho\u1eb7c 60 UI\/kg x 1 l\u1ea7n\/ tu\u1ea7n<\/p>\n

+EPO alfa v\u00e0 beta ti\u00eam t\u0129nh m\u1ea1ch: 40 UI\/kg x 3 l\u1ea7n\/ tu\u1ea7n ho\u1eb7c 120 UI\/kg x 1 l\u1ea7n\/tu\u1ea7n. Tr\u1ebb em d\u01b0\u1edbi 5 tu\u1ed5i li\u1ec1u 300 UI\/kg\/tu\u1ea7n.<\/p>\n

+ Darbepoietin: 0,45 mcg\/kg\/tu\u1ea7n ti\u00eam d\u01b0\u1edbi da ho\u1eb7c t\u0129nh m\u1ea1ch<\/p>\n

L\u01b0u \u00fd c\u1ea7n ki\u1ec3m tra Hb th\u01b0\u1eddng xuy\u00ean 2- 4 tu\u1ea7n\/l\u1ea7n:<\/p>\n

+ N\u1ebfu Hb t\u0103ng t\u1eeb 1- 2 g\/dl\/th\u00e1ng l\u00e0 h\u1ee3p l\u00fd.<\/p>\n

+ N\u1ebfu Hb t\u0103ng < 1g\/dl\/th\u00e1ng th\u00ec c\u1ea7n t\u0103ng 25% li\u1ec1u m\u1ed7i tu\u1ea7n, ho\u1eb7c<\/p>\n

+ N\u1ebfu Hb t\u0103ng > 2g\/dl\/ th\u00e1ng th\u00ec c\u1ea7n gi\u1ea3m 25-50% li\u1ec1u m\u1ed7i tu\u1ea7n.<\/p>\n

Duy tr\u00ec: khi \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb v\u1edbi Hb 11 \u2013 12g\/dl \u1edf ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn m\u1ea1n<\/p>\n

Li\u1ec1u duy tr\u00ec th\u01b0\u1eddng th\u1ea5p h\u01a1n t\u1eeb tr\u00ean 30% li\u1ec1u t\u1ea5n c\u00f4ng. Trong giai \u0111o\u1ea1n duy tr\u00ec n\u00ean ki\u1ec3m tra Hb m\u1ed7i 2 \u2013 3 th\u00e1ng.<\/p>\n

– Kh\u00f4ng khuy\u1ebfn c\u00e1o Hb>13g \/dl v\u00ec t\u0103ng nguy c\u01a1 t\u1eed vong do b\u1ec7nh tim m\u1ea1ch<\/p>\n

4.4.4. M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n g\u00e2y \u0111\u00e1p \u1ee9ng k\u00e9m v\u1edbi Erythropoietin.<\/strong><\/p>\n

+ Thi\u1ebfu s\u1eaft.<\/p>\n

+ Nhi\u1ec5m tr\u00f9ng\/vi\u00eam ( nhi\u1ec5m tr\u00f9ng, ph\u1eabu thu\u1eadt, AIDS, SLE..).<\/p>\n

+ M\u1ea5t m\u00e1u m\u1ea1n t\u00ednh.<\/p>\n

+ C\u01b0\u1eddng c\u1eadn gi\u00e1p.<\/p>\n

+ Vi\u00eam x\u01a1 x\u01b0\u01a1ng, nhi\u1ec5m \u0111\u1ed9c nh\u00f4m.<\/p>\n

+ B\u1ec7nh b\u1ea5t th\u01b0\u1eddng Hb( di truy\u1ec1n: Thalassem ias, b\u1ec7nh h\u1ed3ng c\u1ea7u h\u00ecnh li\u1ec1m..).<\/p>\n

+ Thi\u1ebfu Vitamin B12 ho\u1eb7c Folate.<\/p>\n

+ \u0110a u tu\u1ef7 x\u01b0\u01a1ng, suy dinh d\u01b0\u1ee1ng, tan m\u00e1u\u2026..<\/p>\n

N\u1ebfu nh\u1eefng y\u1ebfu t\u1ed1 tr\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb, c\u1ea7n xem x\u00e9t kh\u1ea3 n\u0103ng b\u1ecb kh\u00e1ng v\u1edbi EPO (b\u1ea5t s\u1ea3n nguy\u00ean h\u1ed3ng c\u1ea7u).<\/p>\n

Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u00e1p \u1ee9ng k\u00e9m v\u1edbi \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p th\u00eam v\u1edbi truy\u1ec1n m\u00e1u.<\/p>\n

4.4.5. T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Erythropoietin.<\/strong><\/p>\n

C\u00f3 th\u1ec3 g\u1eb7p m\u1ed9t s\u1ed1 bi\u1ec3u hi\u1ec7n tr\u00ean l\u00e2m s\u00e0ng khi \u0111i\u1ec1u tr\u1ecb EPO, \u0111\u01b0\u1ee3c coi nh\u01b0 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a thu\u1ed1c nh\u01b0:<\/p>\n

– H\u1ed9i ch\u1ee9ng gi\u1ea3 c\u00fam.<\/p>\n

– \u0110au \u0111\u1ea7u<\/p>\n

– T\u0103ng HA.<\/p>\n

– Ng\u1ee9a<\/p>\n

– N\u1ed5i m\u1ea9n<\/p>\n

– Huy\u1ebft kh\u1ed1i.<\/p>\n

– B\u1ea5t s\u1ea3n nguy\u00ean h\u1ed3ng c\u1ea7u\u2026<\/p>\n

C\u1ea7n theo d\u00f5i v\u00e0 x\u1eed tr\u00ed k\u1ecbp th\u1eddi, t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 c\u1ee7a c\u00e1c bi\u1ec3u hi\u1ec7n tr\u00ean \u0111\u1ec3 x\u00e9t ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb hay ng\u1eebng \u0111i\u1ec1u tr\u1ecb.<\/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":"

Erythropoietin (EPO) l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n hi\u1ec7u qu\u1ea3 nh\u1ea5t v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Thu\u1ed1c EPO \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 th\u00fac \u0111\u1ea9y s\u1ea3n xu\u1ea5t h\u1ed3ng c\u1ea7u trong c\u01a1 th\u1ec3, gi\u00fap c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng v\u1eadn chuy\u1ec3n oxy trong m\u00e1u […]<\/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":"\nErythropoietin trong \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n - Vinmec<\/title>\n<meta name=\"description\" content=\"Erythropoietin (EPO) l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n hi\u1ec7u qu\u1ea3 nh\u1ea5t v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn trong th\u1ef1c h\u00e0nh\" \/>\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=\"Erythropoietin trong \u0111i\u1ec1u tr\u1ecb thi\u1ebfu m\u00e1u \u1edf b\u1ec7nh th\u1eadn m\u1ea1n - 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