{"id":35944,"date":"2023-07-01T22:04:56","date_gmt":"2023-07-01T15:04:56","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35944"},"modified":"2023-07-01T22:04:56","modified_gmt":"2023-07-01T15:04:56","slug":"thuoc-chen-beta-giai-phap-hieu-qua-cho-benh-nhan-tim-mach","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/07\/01\/thuoc-chen-beta-giai-phap-hieu-qua-cho-benh-nhan-tim-mach\/","title":{"rendered":"Thu\u1ed1c ch\u1eb9n beta: Gi\u1ea3i ph\u00e1p hi\u1ec7u qu\u1ea3 cho b\u1ec7nh nh\u00e2n tim m\u1ea1ch"},"content":{"rendered":"<p><strong>Thu\u1ed1c ch\u1eb9n beta (Beta blocker) l\u00e0 nh\u00f3m thu\u1ed1c ch\u00ednh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tim m\u1ea1ch. Thu\u1ed1c thu\u1ed9c nh\u00f3m n\u00e0y \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn \u0111i\u1ec1u tr\u1ecb, s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ng\u1eeba nh\u1ecbp tim nhanh, t\u0103ng huy\u1ebft \u00e1p, nh\u1ed3i m\u00e1u c\u01a1 tim, suy tim sung huy\u1ebft, tim lo\u1ea1n nh\u1ecbp, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p v\u00e0 m\u00e3n, &#8230; B\u00e0i vi\u1ebft sau \u0111\u00e2y nh\u1eb1m cung c\u1ea5p th\u00f4ng tin v\u1ec1 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng, ph\u00e2n lo\u1ea1i, ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, li\u1ec1u l\u01b0\u1ee3ng, t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u00e0 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c ch\u1eb9n beta tr\u00ean c\u00e1c b\u1ec7nh tim m\u1ea1ch.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35945 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/7dbef258-ac6d-4fa6-97e9-704b1742f707-300x300.jpg\" alt=\"thuoc-chen-beta\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/7dbef258-ac6d-4fa6-97e9-704b1742f707-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/7dbef258-ac6d-4fa6-97e9-704b1742f707-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/7dbef258-ac6d-4fa6-97e9-704b1742f707-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/7dbef258-ac6d-4fa6-97e9-704b1742f707.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1. \u0110\u1ea1i c\u01b0\u01a1ng thu\u1ed1c ch\u1eb9n beta<\/h2>\n<p><strong>1.1 C\u01a1 ch\u1ebf thu\u1ed1c ch\u1eb9n beta:<\/strong><\/p>\n<p>C\u00f3 ba lo\u1ea1i th\u1ee5 th\u1ec3 beta adrenergic, beta 1 (B1), beta 2 (B2) v\u00e0 beta 3 (B3), v\u1edbi lo\u1ea1i \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng l\u00e2m s\u00e0ng nhi\u1ec1u nh\u1ea5t l\u00e0 th\u1ee5 th\u1ec3 B1 v\u00e0 \u200b\u200bB2. Th\u1ee5 th\u1ec3 B1 c\u00f3 nhi\u1ec1u trong tim v\u00e0 th\u1eadn. Th\u1ee5 th\u1ec3 B2 c\u00f3 nhi\u1ec1u trong ph\u1ebf qu\u1ea3n, c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u, c\u01a1 ti\u00eau h\u00f3a, c\u01a1 v\u00e2n. C\u00e1c th\u1ee5 th\u1ec3 B3 c\u00f3 trong m\u00f4 m\u1ee1, b\u00e0ng quang v\u00e0 ru\u1ed9t. Thu\u1ed1c ch\u1eb9n beta ng\u0103n ch\u1eb7n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh adrenaline v\u00e0 noradrenaline th\u00f4ng qua c\u01a1 ch\u1ebf ng\u0103n ch\u1eb7n c\u00e1c th\u1ee5 th\u1ec3 beta, ng\u0103n kh\u00f4ng cho c\u00e1c ch\u1ea5t n\u00e0y g\u1eafn k\u1ebft v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 B1 v\u00e0 \u200b\u200bB2 c\u1ee7a t\u1ebf b\u00e0o th\u1ea7n kinh giao c\u1ea3m. \u0110i\u1ec1u n\u00e0y l\u00e0m ch\u1eadm nh\u1ecbp tim, l\u00e0m gi\u00e3n m\u1ea1ch m\u00e1u, h\u1ea1 huy\u1ebft \u00e1p v\u00e0 g\u00e2y co th\u1eaft ph\u1ebf qu\u1ea3n&#8230;<\/p>\n<p>Khi thu\u1ed1c ch\u1eb9n beta li\u00ean k\u1ebft v\u1edbi th\u1ee5 th\u1ec3 B1 v\u00e0 \u200b\u200bB2, ch\u00fang s\u1ebd ch\u1eb7n c\u00e1c th\u1ee5 th\u1ec3 \u0111\u00f3. \u0110i\u1ec1u n\u00e0y l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng t\u0103ng co b\u00f3p c\u01a1 tim (t\u0103ng nh\u1ecbp tim v\u00e0 t\u0103ng l\u1ef1c co b\u00f3p), d\u1eabn \u0111\u1ebfn nh\u1ecbp tim th\u1ea5p h\u01a1n. Thu\u1ed1c ch\u1eb9n beta c\u0169ng l\u00e0m gi\u1ea3m huy\u1ebft \u00e1p th\u00f4ng qua nhi\u1ec1u c\u01a1 ch\u1ebf, bao g\u1ed3m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 renin v\u00e0 gi\u1ea3m cung l\u01b0\u1ee3ng tim. Gi\u1ea3m nhu c\u1ea7u oxy c\u1ee7a c\u01a1 tim gi\u1ea3m do \u1ea3nh h\u01b0\u1edfng c\u1ee7a gi\u1ea3m nh\u1ecbp tim v\u00e0 s\u1ee9c co b\u00f3p c\u01a1 tim. \u0110\u00e2y l\u00e0 c\u00e1ch c\u1ea3i thi\u1ec7n ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c sau khi d\u00f9ng thu\u1ed1c ch\u1eb9n beta. Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y l\u00e0m t\u0103ng s\u1ee9c ch\u1ecbu \u0111\u1ef1ng c\u1ee7a t\u00e2m nh\u0129 v\u00e0 c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng lo\u1ea1n nh\u1ecbp.<\/p>\n<p><strong>1.2 Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/p>\n<ul>\n<li>T\u0103ng huy\u1ebft \u00e1p<\/li>\n<li>Suy tim<\/li>\n<\/ul>\n<ul>\n<li>B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p v\u00e0 m\u1ea1n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>B\u1ec7nh van tim*Loan nh\u1ecbp tim<\/li>\n<li>B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb trong k\u1ef3 chu ph\u1eabu cua ph\u1eabu thu\u1eadt ngo\u00e0i tim*<\/li>\n<\/ul>\n<p><strong>1.3 C\u00e1c th\u1ebf h\u1ec7 thu\u1ed1c ch\u1eb9n beta:<\/strong><\/p>\n<p>Thu\u1ed1c ch\u1eb9n beta kh\u00e1c nhau v\u1ec1 t\u00ednh \u0111\u1eb7c hi\u1ec7u \u0111\u1ed1i v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 kh\u00e1c nhau. M\u1ed9t s\u1ed1 thu\u1ed1c ch\u1eb9n beta c\u0169ng li\u00ean k\u1ebft v\u1edbi th\u1ee5 th\u1ec3 alpha \u1edf m\u1ed9t m\u1ee9c \u0111\u1ed9 n\u00e0o \u0111\u00f3 c\u00f3 t\u00e1c d\u1ee5ng l\u00e2m s\u00e0ng kh\u00e1c nhau. Thu\u1ed1c ch\u1eb9n beta \u0111\u01b0\u1ee3c chia th\u00e0nh ba th\u1ebf h\u1ec7:<\/p>\n<p>Th\u1ebf h\u1ec7 1: Propranolol, Timolol, Nadolol&#8230; \u0110\u00e2y l\u00e0 nh\u1eefng thu\u1ed1c ch\u1eb9n beta kh\u00f4ng ch\u1ecdn l\u1ecdc. C\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng \u0111\u1ed3ng th\u1eddi tr\u00ean th\u1ee5 th\u1ec3 B1 v\u00e0 B2 l\u00e0m gi\u1ea3m nh\u1ecbp tim, gi\u00e3n m\u1ea1ch. Gi\u1ea3m huy\u1ebft \u00e1p ngo\u1ea1i vi.<\/p>\n<p>Th\u1ebf h\u1ec7 2: atenolol, bisoprolol, metoprolol\u2026 T\u00e1c d\u1ee5ng \u00a0ch\u1ecdn l\u1ecdc ch\u1ee7 y\u1ebfu \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1ee5 th\u1ec3 B1. V\u00ec v\u1eady, c\u00e1c t\u00e1c d\u1ee5ng ch\u00ednh l\u00e0: l\u00e0m ch\u1eadm nh\u1ecbp tim, gi\u1ea3m co th\u1eaft, gi\u1ea3m cung l\u01b0\u1ee3ng tim v\u00e0 h\u1ea1 huy\u1ebft \u00e1p. \u0110\u00e2y l\u00e0 l\u00fd do t\u1ea1i sao thu\u1ed1c ch\u1eb9n beta th\u1ebf h\u1ec7 th\u1ee9 hai c\u00f3 t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p nhanh v\u00e0 m\u1ea1nh. \u00a0N\u00f3 c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m ch\u1eadm nh\u1ecbp tim v\u00e0 kh\u00f4ng c\u00f3 l\u1ee3i cho b\u1ec7nh nh\u00e2n nh\u1ecbp tim ch\u1eadm.<\/p>\n<p>Th\u1ebf h\u1ec7 th\u1ee9 3: Carvedilol, Labetalol, Nebivolol&#8230; C\u1ea3 thu\u1ed1c ch\u1eb9n alpha v\u00e0 beta (carvedilol, labetalol): t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf kh\u00f4ng ch\u1ecdn l\u1ecdc \u0111\u1ed1i v\u1edbi B1 v\u00e0 \u200b\u200bB2, ng\u0103n ch\u1eb7n th\u1ee5 th\u1ec3 alpha-1, N\u00f3 c\u00f3 t\u00e1c d\u1ee5ng gi\u00e3n m\u1ea1ch, gi\u1ea3m s\u1ee9c c\u1ea3n ngo\u1ea1i vi v\u00e0 h\u1ea1 huy\u1ebft \u00e1p<\/p>\n<h2>2. Beta blocker trong b\u1ec7nh m\u1ea1ch v\u00e0nh<\/h2>\n<ul>\n<li>Gi\u1ea3m nhu c\u1ea7u oxy l\u00fac ngh\u1ec9 v\u00e0 l\u00fac g\u1eafng s\u1ee9c do gi\u1ea3m nh\u1ecbp tim, gi\u1ea3m co c\u01a1 tim, gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng tim v\u00e0 gi\u1ea3m HA, ch\u1ec9 \u0111\u1ecbnh trong \u0111au th\u1eaft ng\u1ef1c m\u1ea1n t\u00ednh do g\u1eafng s\u1ee9c<\/li>\n<li>Duy tr\u00ec h\u00e0ng ng\u00e0y gi\u00fap gi\u1ea3m c\u01a1n \u0111au th\u1eaft ng\u1ef1c y\u00ean l\u1eb7ng, \u0111au th\u1eaft ng\u1ef1c v\u00e0o s\u00e1ng, gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong sau NMCT c\u00f3 s\u00f3ng Q, n\u00ean khuy\u00ean d\u00f9ng cho \u0111au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh c\u00f3 r\u1ed1i lo\u1ea1n th\u1ea5t tr\u00e1i<\/li>\n<li>Kh\u00f4ng d\u00f9ng cho \u0111au th\u1eaft ng\u1ef1c Prinzmetal v\u00ec l\u00e0m t\u0103ng s\u1ee9c c\u1ea3n m\u1ea1ch v\u00e0nh.<\/li>\n<\/ul>\n<p>B\u1eaft \u0111\u1ea7u cho ch\u1eb9n beta cho b\u1ec7nh nh\u00e2n STEMI trong 24g \u0111\u1ea7u n\u1ebfu kh\u00f4ng c\u00f3:<\/p>\n<p>1) D\u1ea5u suy tim,<\/p>\n<p>2) Bi\u1ec3u hi\u1ec7n t\u00ecnh tr\u1ea1ng cung l\u01b0\u1ee3ng tim th\u1ea5p,<\/p>\n<p>3) Nguy c\u01a1 cho\u00e1ng tim cao, ho\u1eb7c<\/p>\n<p>4) Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i kh\u00e1c (PR &gt; 0.24s, bloc nh\u0129-th\u1ea5t \u0111\u1ed9 2-3, hen ti\u1ebfn tri\u1ec3n, b\u1ec7nh \u0111\u01b0\u1eddng th\u1edf ti\u1ebfn tri\u1ec3n).<\/p>\n<p>&#8211; Ch\u1eb9n b\u00eata n\u00ean ch\u1ec9 \u0111\u1ecbnh ti\u1ebfp t\u1ee5c trong v\u00e0 sau khi n\u1eb1m vi\u1ec7n \u1edf t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n STEMI m\u00e0 kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi ch\u1eb9n b\u00eata.<\/p>\n<p>&#8211; B\u1ec7nh nh\u00e2n c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi ch\u1eb9n b\u00eata trong 24 gi\u1edd \u0111\u1ea7u ti\u00ean sau STEMI n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u1ea1i \u0111\u1ec3 xem l\u1ea1i ch\u1ec9 \u0111\u1ecbnh ch\u1eb9n b\u00eata sau \u0111\u00f3.<\/p>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5: Suy tim, nh\u1ecbp tim ch\u1eadm, \u1ee9c ch\u1ebf nh\u0129 th\u1ea5t<\/p>\n<h2>3. Beta blocker trong \u0111i\u1ec1u tr\u1ecb suy tim<\/h2>\n<p>Ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb suy tim: c\u1ea7n thi\u1ebft gi\u00fap c\u1ea3i thi\u1ec7n s\u1ed1ng c\u00f2n cho b\u1ec7nh nh\u00e2n<\/p>\n<p>M\u1ee5c ti\u00eau c\u1ee7a \u0111i\u1ec1u tr\u1ecb suy tim l\u00e0 : Gi\u1ea3m t\u1eed vong. C\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng, ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng, t\u0103ng kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c, gi\u1ea3m s\u1ed1 l\u1ea7n nh\u1eadp vi\u1ec7n. Ph\u00f2ng ng\u1eeba t\u0103ng t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim; gi\u1ea3m t\u00e1i c\u1ea5u tr\u00fac c\u01a1 tim.<\/p>\n<ul>\n<li>Ch\u1ec9 \u0111\u1ecbnh:<\/li>\n<li>T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n c\u00f3 PXTM \u2264 40%, NYHA II \u2192IV<\/li>\n<li>\u0110\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng li\u1ec1u \u0111\u1ea7y \u0111\u1ee7 UCMC ho\u1eb7c ch\u1eb9n th\u1ee5 th\u1ec3 AG II \u00b1 \u0111\u1ed1i kh\u00e1ng aldoslerone<\/li>\n<li>L\u00e2m s\u00e0ng \u0111ang \u1ed5n \u0111\u1ecbnh<\/li>\n<li>Kh\u00f4ng b\u1ecb:\n<ul>\n<li>Hen Suy\u1ec5n<\/li>\n<li>Block nh\u0129 th\u1ea5t II,III, h\u1ed9i ch\u1ee9ng suy n\u00fat xoang, nh\u1ecbp xoang ch\u1eadm (&lt; 50\/ph\u00fat)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Kh\u1edfi \u0111\u1ea7u li\u1ec1u th\u1ea5p\n<ul>\n<li>Bisoprolol 1,25 mg\/ng\u00e0y; carvedilol 3.125 \u2013 6.25 2 l\u1ea7n\/ng\u00e0y; metoprolol CR\/XL 12.5- 25 mg\/ng\u00e0y; nebivolol 1.25 mg\/ng\u00e0y<\/li>\n<li>B\u1eaft \u0111\u1ea7u tr\u01b0\u1edbc xu\u1ea5t hi\u1ec7n<\/li>\n<\/ul>\n<\/li>\n<li>T\u0103ng li\u1ec1u m\u1ed7i 2-4 tu\u1ea7n ho\u1eb7c l\u00e2u h\u01a1n<\/li>\n<li>Li\u1ec1u m\u1ee5c ti\u00eau: bisoprolol 10 mg\/ng\u00e0y, carvedilol 25-50 mg 2 l\u1ea7n\/ng\u00e0y, metoprolol CR\/XL 200 mg\/ng\u00e0y; nebivolol 10 mg\/ng\u00e0y.<\/li>\n<\/ul>\n<h2>4. Ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p:<\/h2>\n<p>Ch\u1eb9n beta giao c\u1ea3m kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn ban \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p th\u00f4ng th\u01b0\u1eddng (kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c).<\/p>\n<p>Tuy nhi\u00ean, c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u0103ng huy\u1ebft \u00e1p (chi\u1ebfm t\u1ec9 l\u1ec7 kh\u00f4ng nh\u1ecf) l\u1ea1i c\u1ea7n c\u00f3 ch\u1eb9n beta nh\u01b0:<\/p>\n<p>\u25aa K\u00e8m theo suy tim<\/p>\n<p>\u25aa Sau nh\u1ed3i m\u00e1u c\u01a1 tim<\/p>\n<p>\u25aa C\u00f3 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u1ea1n t\u00ednh<\/p>\n<p>\u25aa Ph\u00ecnh v\u00e0 t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/p>\n<p>\u25aa Nh\u1ecbp nhanh, rung nh\u0129, r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t&#8230;<\/p>\n<p>\u25aa Ph\u1ee5 n\u1eef c\u00f3 thai&#8230;<\/p>\n<p>M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/p>\n<ul>\n<li>M\u1ee5c ti\u00eau ch\u00ednh: gi\u1ea3m t\u1ed1i \u0111a v\u00e0 l\u00e2u d\u00e0i to\u00e0n b\u1ed9 nguy c\u01a1 b\u1ec7nh tim m\u1ea1ch.<\/li>\n<li>C\u1ea7n th\u1ef1c hi\u00ean: gi\u1ea3m m\u1ee9c huy\u1ebft \u00e1p, gi\u1ea3m c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1.<\/li>\n<li>Huy\u1ebft \u00e1p &lt; 140\/90 mmHg v\u00e0 th\u1ea5p h\u01a1n n\u1ebfu dung n\u1ea1p \u0111\u01b0\u01a1c<\/li>\n<li>M\u1ee9c HA &lt; 130\/80 mmHg \u0110T\u0110 ho\u1eb7c nh\u00f3m nguy c\u01a1 cao ho\u1eb7c r\u1ea5t cap (VD: ti\u1ec1n c\u0103n \u0111\u1ed9t qu\u1ef5, NMCT, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1eadn, protein ni\u1ec7u)<\/li>\n<\/ul>\n<h2>5. Ch\u1eb9n beta trong \u0111i\u1ec1u tr\u1ecb lo\u1ea1n nh\u1ecbp tim: hi\u1ec7u q\u1ee7a cao, gi\u1ea3m t\u1eed vong.<\/h2>\n<p><strong>Ch\u1eb9n beta giao c\u1ea3m<\/strong><\/p>\n<ul>\n<li>T\u0103ng th\u1eddi gian d\u1eabn truy\u1ec1n qua n\u00fat nh\u0129 th\u1ea5t (t\u0103ng kho\u1ea3ng PR)<\/li>\n<li>K\u00e9o d\u00e0i th\u1eddi gian tr\u01a1 hi\u1ec7u qu\u1ea3 n\u00fat nh\u0129 th\u1ea5t<\/li>\n<\/ul>\n<p>H\u1eefu \u00edch trong c\u1eaft c\u01a1n lo\u1ea1n nh\u1ecbp do v\u00f2ng v\u00e0o l\u1ea1i n\u00fat nh\u0129 th\u1ea5t v\u00e0 ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 th\u1ea5t trong rung nh\u0129<\/p>\n<ul>\n<li>\u1ee8c ch\u1ebf pha 4 \u2192 l\u00e0m ch\u1eadm h\u1ed3i ph\u1ee5c t\u1ebf b\u00e0o, l\u00e0m ch\u1eadm d\u1eabn truy\u1ec1n v\u00e0 gi\u1ea3m t\u1ef1 \u0111\u1ed9ng t\u00ednh<\/li>\n<li>Gi\u1ea3m t\u1ea7n s\u1ed1 tim, gi\u1ea3m qu\u00e1 t\u1ea3i d\u00f2ng ion k\u00eanh v\u00e0o Ca ++ v\u00e0 \u1ee9c ch\u1ebf t\u1ef1 \u0111\u1ed9ng t\u00ednh sau t\u00e1i c\u1ef1c mu\u1ed9n<\/li>\n<li>Gi\u1ea3m nh\u1ed3i m\u00e1u c\u01a1 tim t\u00e1i ph\u00e1t, \u0111\u1ed9t t\u1eed sau nh\u1ed3i m\u00e1u.<\/li>\n<\/ul>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/tac-dung-phu-cua-thuoc-dieu-tri-tang-huyet-ap\/\">Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Thu\u1ed1c ch\u1eb9n beta (Beta blocker) l\u00e0 nh\u00f3m thu\u1ed1c ch\u00ednh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tim m\u1ea1ch. Thu\u1ed1c thu\u1ed9c nh\u00f3m n\u00e0y \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn \u0111i\u1ec1u tr\u1ecb, s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ng\u1eeba nh\u1ecbp tim nhanh, t\u0103ng huy\u1ebft \u00e1p, nh\u1ed3i m\u00e1u c\u01a1 tim, suy tim sung huy\u1ebft, tim lo\u1ea1n nh\u1ecbp, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Thu\u1ed1c ch\u1eb9n beta: Gi\u1ea3i ph\u00e1p hi\u1ec7u qu\u1ea3 cho b\u1ec7nh nh\u00e2n tim m\u1ea1ch - Vinmec<\/title>\n<meta name=\"description\" content=\"Thu\u1ed1c ch\u1eb9n beta (Beta blocker) l\u00e0 nh\u00f3m thu\u1ed1c ch\u00ednh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tim m\u1ea1ch. 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