{"id":33177,"date":"2023-05-11T16:13:17","date_gmt":"2023-05-11T09:13:17","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33177"},"modified":"2023-05-11T16:13:17","modified_gmt":"2023-05-11T09:13:17","slug":"dieu-tri-viem-ruot-non-hieu-qua-phoi-hop-infliximab-va-azathioprine","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/11\/dieu-tri-viem-ruot-non-hieu-qua-phoi-hop-infliximab-va-azathioprine\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non: Hi\u1ec7u qu\u1ea3 ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine"},"content":{"rendered":"

Vi\u00eam ru\u1ed9t non l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng ru\u1ed9t ph\u1ed5 bi\u1ebfn. B\u1ec7nh c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u1ea5t k\u1ef3 \u0111\u1ed9 tu\u1ed5i n\u00e0o. Vi\u00eam ru\u1ed9t non c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y v\u00e0 n\u00f4n, bu\u1ed3n n\u00f4n ho\u1eb7c m\u1ec7t m\u1ecfi, c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 vi\u00eam ru\u1ed9t non v\u00e0 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb khi ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine<\/a>.<\/strong><\/p>\n

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1. Infliximab v\u00e0 Azathioprine l\u00e0 g\u00ec?<\/h2>\n

Infliximab l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1ng TNF-\u03b1 (tumor necrosis factor-alpha inhibitor) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m vi\u00eam v\u00e0 ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd mi\u1ec5n d\u1ecbch, bao g\u1ed3m b\u1ec7nh Crohn v\u00e0 vi\u00eam \u0111\u1ea1i tr\u00e0ng. Infliximab ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch v\u00e0 gi\u1ea3m vi\u00eam trong c\u01a1 th\u1ec3.<\/p>\n

Azathioprine l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd mi\u1ec5n d\u1ecbch, bao g\u1ed3m Vi\u00eam ru\u1ed9t non. Azathioprine ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch gi\u1ea3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch trong c\u01a1 th\u1ec3.<\/p>\n

C\u1ea3 Infliximab v\u00e0 Azathioprine \u0111\u1ec1u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam ru\u1ed9t non c\u1ea5p t\u00ednh v\u00e0 m\u00e3n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c. Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 ki\u1ec3m so\u00e1t c\u1ee7a c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m v\u00e0 \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd \u0111\u1ec3 tr\u00e1nh c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nguy hi\u1ec3m.<\/p>\n

2. Hi\u1ec7u qu\u1ea3 c\u1ee7a Infliximab v\u00e0 Azathioprine khi ph\u1ed1i h\u1ee3p s\u1eed d\u1ee5ng<\/h2>\n

C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n t\u1ed1t h\u01a1n c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh.<\/p>\n

– M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi Takeda v\u00e0 \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 cho th\u1ea5y r\u1eb1ng s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Crohn c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n t\u1ed1t h\u01a1n c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh v\u00e0 gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t b\u1ec7nh.<\/p>\n

– M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 tr\u00ean t\u1ea1p ch\u00ed New England Journal of Medicine (NEJM) \u0111\u00e3 cho th\u1ea5y r\u1eb1ng ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non c\u1ea5p t\u00ednh c\u00f3 hi\u1ec7u qu\u1ea3 cao h\u01a1n so v\u1edbi s\u1eed d\u1ee5ng ri\u00eang l\u1ebb m\u1ed9t trong hai lo\u1ea1i thu\u1ed1c. Nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00e3 ti\u1ebfn h\u00e0nh tr\u00ean 508 b\u1ec7nh nh\u00e2n v\u1edbi b\u1ec7nh Crohn c\u1ea5p t\u00ednh v\u00e0 k\u1ebft qu\u1ea3 ch\u1ec9 ra r\u1eb1ng t\u1ef7 l\u1ec7 ch\u1eefa kh\u1ecfi b\u1ec7nh \u1edf nh\u00f3m s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p thu\u1ed1c l\u00e0 56% so v\u1edbi 44% c\u1ee7a nh\u00f3m s\u1eed d\u1ee5ng ri\u00eang l\u1ebb Infliximab v\u00e0 30% c\u1ee7a nh\u00f3m s\u1eed d\u1ee5ng ri\u00eang l\u1ebb Azathioprine.<\/p>\n

– Ngo\u00e0i ra, m\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c c\u0169ng \u0111\u00e3 cho th\u1ea5y s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non m\u00e3n t\u00ednh c\u00f3 th\u1ec3 gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t b\u1ec7nh v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Nghi\u00ean c\u1ee9u n\u00e0y \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 tr\u00ean t\u1ea1p ch\u00ed Journal of Crohn’s and Colitis v\u00e0 ti\u1ebfn h\u00e0nh tr\u00ean 54 b\u1ec7nh nh\u00e2n v\u1edbi vi\u00eam ru\u1ed9t non m\u00e3n t\u00ednh.<\/p>\n

Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 ki\u1ec3m so\u00e1t c\u1ee7a c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m v\u00e0 \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd \u0111\u1ec3 tr\u00e1nh c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nguy hi\u1ec3m.<\/p>\n

3. T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Infliximab v\u00e0 Azathioprine<\/h2>\n

M\u1eb7c d\u00f9 ph\u1ed1i h\u1ee3p s\u1eed d\u1ee5ng Infliximab v\u00e0 Azathioprine c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb Vi\u00eam ru\u1ed9t non, nh\u01b0ng c\u1ea3 hai lo\u1ea1i thu\u1ed1c \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n

Theo th\u00f4ng tin t\u1eeb C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 (FDA), t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Infliximab c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, nhi\u1ec5m tr\u00f9ng, s\u1ed1t, \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, m\u1ea9n ng\u1ee9a, v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 huy\u1ebft \u00e1p. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 s\u1ee9c kh\u1ecfe kh\u00e1c.<\/p>\n

T\u01b0\u01a1ng t\u1ef1, t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Azathioprine c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ec7t m\u1ecfi, bu\u1ed3n n\u00f4n, \u0111au \u0111\u1ea7u, s\u1ed1t v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ti\u00eau h\u00f3a. Ngo\u00e0i ra, Azathioprine c\u0169ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3, t\u1eeb \u0111\u00f3 t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe kh\u00e1c.<\/p>\n

Do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb Vi\u00eam ru\u1ed9t non c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m v\u00e0 \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 x\u1eed l\u00fd c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 k\u1ecbp th\u1eddi.<\/p>\n

T\u00f3m l\u1ea1i, vi\u00eam ru\u1ed9t non l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng ru\u1ed9t kh\u00e1 th\u01b0\u1eddng g\u1eb7p, g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh bao g\u1ed3m c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nhau, ph\u01b0\u01a1ng ph\u00e1p thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 \u0111\u1eddi s\u1ed1ng, v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c. S\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n t\u1ed1t h\u01a1n c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 nh\u1ea5t \u0111\u1ecbnh. Do \u0111\u00f3, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c ki\u1ec3m tra th\u01b0\u1eddng xuy\u00ean v\u00e0 \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd khi s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y. Ph\u1ed1i h\u1ee3p s\u1eed d\u1ee5ng Infliximab v\u00e0 Azathioprine trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n so v\u1edbi s\u1eed d\u1ee5ng ri\u00eang l\u1ebb m\u1ed9t trong hai lo\u1ea1i thu\u1ed1c. Tuy nhi\u00ean, c\u1ea3 Infliximab v\u00e0 Azathioprine \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y ra m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5, nh\u01b0ng c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3m thi\u1ec3u khi thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m. N\u00ean th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u00eam ru\u1ed9t non l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng ru\u1ed9t ph\u1ed5 bi\u1ebfn. B\u1ec7nh c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u1ea5t k\u1ef3 \u0111\u1ed9 tu\u1ed5i n\u00e0o. Vi\u00eam ru\u1ed9t non c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y v\u00e0 n\u00f4n, bu\u1ed3n n\u00f4n ho\u1eb7c m\u1ec7t m\u1ecfi, c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"\n\u0110i\u1ec1u tr\u1ecb vi\u00eam ru\u1ed9t non: Hi\u1ec7u qu\u1ea3 ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine<\/title>\n<meta name=\"description\" content=\"Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 vi\u00eam ru\u1ed9t non v\u00e0 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb khi ph\u1ed1i h\u1ee3p Infliximab v\u00e0 Azathioprine. 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