Nghiên cứu rối loạn đông máu ở bệnh nhân hội chứng thận hư nguyên phát người lớn

yiu Id phu mgt chiim 17,1%; phu mi mdt Id 20,0%; phii

chdn Id 11,1%; met mdi Id 20,0%; budn ndn Id 31,4%;

ndn Id 5,7%; dau co xuong Id 5,7%; ndi ban va viem da

la 5,7%; xudt huyet trong u Id 2,9%.

- Tde dyng tren hp huyit hpc: hg bgch cau dp I Id

8,7% tdng sd chu ky diiu trj; hg hdng ciu dp I Id 7,6%

tong sd chu ky diiu trj; hg hdng ciu dp II Id 2,2% tdng sd

chu ky diiu trj; khdng gap hg tiiu eau. Tat ca cdc tdc dyng

phu diu xuat hipn d mirc dd I vd II, khdng gap dp III vd IV.

TAI LIEU THAM KHAO

1. Connolly EM, Gaffney E. Reynolds JV et al.

Gastrointestinal Stromal Tumours. Br J Surg 2003 Oct;

90(10): 1178-86.

2. Croom KF, Derry CM et al. Imatinib mesylate:

in the treatment of GIST. Dmgs , 2003; 63(5):513-22;

discussion 523 -4.

3. De Silva CM, Reid R. Gastrointestinal stromal

tumours (GIST): C- kit mutations, CD 117 expression,

differential diangosis and targeted cancer therapy with

Imatinib. Pathol Oncol Res. 2003. 9 (1): 13-9.

4. Fernado Chavez et al. GIST: clinical aspects.

Rev Esp Enferm Dig 2007 Jan; 99(1):19-24.

5. George Demetri M.D., Margaret von Mehren,

M.D., et al. Efficacy and Safety of Imatinib Mesylate in

Advanced Gastrointestinal Stromal Tumours. The New

England

6. Miettinen M et al. Gastrointestinal stromal

tumours: review on morphology, molecular pathology,

prognosis, and differential diangosis". Arch Pathol Lab

med .2006; 130(10): 1466-78.

7. Prakash S, Sarran L, Socci N et al.

Gastrointestinal stromal tumours in children and

NGHIEN CUfU ROI LOAN DONG MAU 0 DENH NHAN

HOI CHUfNG THAN HIT NGUYEN PHAT NGUdl LQTN

NGUYIN THI BfCH NGOC, DINH THJ KIM DUNG

Benh vi€n Bach Mai

HA HOANG KIEM - Hoc vien Quin Y103

TOMTAT

Muc tieu: nghien cdu su biin doi mgt so yiu to

ddng miu va cho'ng ddng miu d benh nhin hgi

chifng than hu (HCTH) nguyen phit ngUdi Idn; Doi

Iwg'ng va phuvng phap: nhdm nghien cifu gom 200

benh nhan HCTH nguyen phit dieu tri ndi tru tai khoa

Than - Tiit Nieu benh vien Bach Mai tit 4/2006 -

4/2009, nhdm chifng gom 40 ngUdi khoe manh; Kit

qua: cic rd'i loan ddng mau d benh nhan HCTH

nguyen phit thudng gip la : giam AT ill, protein S;

ting fibrinogen, tang yiu to' ddng mau V vi Vii I.

Tif khda: yiu td ddng mau, chong ddng miu,

nguyen phit ngudi Idn

SUMMARY

Hemostatic abnomallities in adult idiopathic

nephrotic syndrome: Nephrotic syndrome is offten

associated with a hypergualable state and thrombotic

complication. We investigated hypercoagulability in

200 adults with nephrotic syndrome. We observed a

number of abnomalities in the blood, including AT III,

protein S deficiency, increase concentrations of

fibrinnogen, factors V and Vill.

Keywords: thrombotic complication, nephrotic

syndrome

DAT VAN DE

Hdi chifng thdn hu gdy ra nhieu bie'n chifng, cdc bien

chifng nay lai lam eho hpi chifng than hu tien then ndng

them. Cdc bien chifng thudng gdp bao gdm: suy than

chUc ndng vd suy thdn man, rdi loan ddng mdu vd tac

mach mdu, rdi loan lipid mdu, suy dinh dUdng v.v....

Trong cdc bie'n chifng tren, bjen chifng rd'i loan ddng

mdu vd tac rnach mau Id bie'n chifng ndng vd nguy hiem,

ddc biet Id tie tTnh mach than. Trieu ctiifng Idm sdng tac

tTnh maeh than thudng ngheo ndn vd Idn vdo trieu chifng

cua hpi chifng than hU, do dd khd ehan dodn vd it dupe

phdt hien, tac tTnh maeh dUdc cdc tdc gia nUde ngodi

phdt hien vdi ty le khd cao tU 15-60% sd benh nhdn bj

hpi chimg than hU [3],[8]. Tac tTnh mgch than Idm cho

chifc ndng than suy giam nhanh chdng vd thiic day tdn

thUdng than nhanh de'n suy than man. Viec nghien cifu

rd'i loan ddng mdu, tinh trang nghen tac maeh mdu, mdi

lien quan cua ehung vdi mUc dp ndng cua hpi chifng

than hu, vd the tdn thuong giai phdu benh cua hpi chifng

than hu cd the giup cho viec dieu trj dif phdng cdc bien

chifng ndy cd hieu qua.

0' cdc benh nhdn ed HCTH cd tinh trang tdng ddng

mdu xay ra. Ddc trUng cua tinh trgng tdng ddng mdu b

benh nhdn cd HCTH dUde Brady H.R; Brenner B. M. tdm

tat nhu sau: giam ATIII trong mdu do tdng ddo thai qua

nude tieu, giam ndng dp vd/hode giam hoat tinh eua

protein C, protein S, tdng fibrinogen vd mdt sd ye'u td

ddng mdu do tdng tdng hpp b gan. Giam qud trinh phdn

giai fibrin cd le cd vai trd quan trpng cua tdng aj

antiplasmin. Tdng ngifng tap tieu cau.

Tuy nhien tinh trang tdng ddng mau b benh nhdn cd

HCTH cdn nhieu van de can phai dupc nghien cifu tiep

vd lieu hien tUpng tdng ddng nay cd phai Id nguyen nhdn

gdy nen ty le nghen tac mach eao b benh nhdn cd HCTH

hay khdng, cho den nay vdn chUa dupe xdc djnh.

Muc tieu cua nghien cuu: tim hieu sU bien ddi mdt

sd ye'u td ddng mau vd chdng ddng mdu d benh nhdn

HCTH nguyen phdt

001 TapNG VA PHUONG PHAP NGHIEN CQu

1. Doi tiring nghien ciiru:

- Nhdm benh: 200 benh nhan hpi chimg than hu

nguyen phat ngUdi Idn dupe dieu tri tai khoa than tiet

nieu benh vien Bach Mai tif 4/2006 de'n 4/2009.

Y HOC THirC HANH (727) - SO 7/2010 83