Tỷ lệ nhiễm virus viêm gan và một số đặc điểm lâm sàng, cận lâm sàng bệnh viêm gan ở bệnh nhân suy thận mạn có lọc máu chu kỳ tại Bệnh viện Đại học Y Thái Bình

TY l j NHIEIHI VIRUS VIEM GAN VA MOT SO DAC DIEM LAM SANG, CAN LAM SANG

BENH VIEM GAN Of BENH NHAN SUY THAN MAN Cd LOC MAU CHU KY

TAI BENH VIEN DAI HOC Y THAI BINH

n g u y I n d u y c u o n g , p h a m d Ang t h u a n

Bo mon Hoi s u t cap cuu Truong DH Y Dupe Thai Binh

TOM TAT

Nghiin ciru khao s it ty le nhidm virus viem gan B,

virus vidm gan C vd nhin xdt mot s6 die didm lim

sing v i c$n lim sing cua viem gan d b$nh nhin suy

thin m$n cd Iq c m iu chu ky (LMCK) t$i khoa thin

nhin tQO bdnh vi$n Dai h<?c Y T hii Binh cho thiy:

+ Ty 10 nhiim chung HBV, HCV l i 35,2%,

+ Ty 10 nhiim HBV hoic HCV Ian hryt l i 8,8% v i

28,6%; <36ng nhi§m c i HBV va HCV l i 2,2%.

+ 6 b$nh nhin LMCK thi tinh trang vidm gan r it

hay gip v&i cic trieu chiing lim sing d iin hinh nhu:

mdt mdi, ng&a, gan to, roi loan tidu hda, dau ha su&n

phii, hoing din. C ic tridu chirng c$n lim sing cua

vidm gan biiu hien r6 nhit la: giam protein - Albumin

miu, ting men gan. Trong do & nhdm nhiim virus

vidm gan biiu hien d c tri$u chirng lim sing v i cin

lim sing r6 r it hon nhdm khong nhiim.

Tifkhda: viem gan, suy than man.

SUMMARY

PREVALENCE OF HEPATITIS VIRUS AND SOME

CLINICAL FEATURES, CLINICAL ANIFESTATIONS OF

HEPATITIS IN CHRONIC RENAL FAILURE PATIENTS

ON DIALYSIS CYCLE

The study surveyed the prevalence of hepatitis B

vims, hepatitis C virus and some remarks and clinical

characteristics of subclinical hepatitis in patients with

chronic renal failure on heamodialysis. Results shows

that:

+ Overall prevalence of HBV, HCV was 35.2%,

+ HBV or HCV prevalence was 8.8% and

respectively 28.6%, both HBV and HCV co-infection

was 2.2%.

+ In patients with liver inflammation LMCK is very

common with the typical clinical symptoms such as

fatigue, itching, enlarged liver, digestive disorders,

right upper quadrant pain, jaundice. The symptoms of

hepatitis subclinical manifestation are: reduced

protein - blood albumin, liver enzyme elevations. In

the group that hepatitis virus infection manifest

clinical symptoms and more pronounced subclinical

infection group.

Keywords: hepatitis, chronic renal failure.

o a tv A n d£

Virus vifem gan B, C Ife mot trong nhung nguyfen

nh3n chu yiu gfey vifem gan clip tinh. Vdi nhung

ngu’di binh thudng vifem gan cap dfe IS mfet t6n

thu’cyng nghifem trpng, gfey hau qua nhu mo gan bj

huy hogi, chirc nSng gan dfec bifet IS chuc nfeng

chuyen h6a vfe thai tor chit doc bi suy giam. Neu

vifem gan xfey ra trfen bfenh nhan STM thi nhung hfeu

qua nfey cbn nang ne han rit nhieu [1], Nhifem Virus

vifem gan khfeng nhung gfey t6n hai true tiip cho

ngudi bfenh mfe nhung bfenh nhfen nfey niu khfeng

duac phfet hifen, quan ly se Ife ngufen Ifey nhifem rit

nguy hiem cho cfeng dong, true tiep Ife cfec bfenh nhfen

cung diiu trj, nhfen vifen y t l hfeng ngfey true tiip diiu

trj cho bfenh nhfen vfe cfeng dfeng dfen cu trong xfe hfei

[2], Do vfey vifec dfenh gife dung ty Ife nhifem virus vifem

gan vfe tinh trang vifem gan d bfenh nhfen Ipc mfeu chu

ky cfe y nghTa het sue quan trpng d l kjp thdi diiu trj

cung nhu cfe bifen phfep cfech ly tu dfe nhfem nfeng cao

chit luang cufec sfeng cung nhu gfep phin Ifem tfeng

tuoi tho cua bfenh nhfen. Muc tifeu cua d l tfei:

- Nhfen xfet ty Ife nhifem virus vifem gan d bfenh

nhfen suy thfen man cfe Ipc mfeu chu ky tai khoa Thfen

nhfen tao bfenh vifen Dai hoc Y Thfei Binh.

- Nhfen xfet mfet so dfec diem Ifem sfeng vfe cfen Ifem

sang cua vifem gan d bfenh nhfen suy thfen man cfe Ipc

mfeu chu ky.

061 TU^NG VA PHUmiG PHAP NGHIEN Cl>U

1. Ddi tuang nghifen cuu

Tidu chuin chon b$nh nhin

- T it ca cfec bfenh nhfen suy thfen man cfe Ipc mfeu

chu ky tai bfenh vifen Dai hpc Y Thfei Binh.

- Dfeng y tham gia nghifen cuu.

2. Phuang phfep nghifen ci>u

2.1. Thiet ke nghiin ciru: Mfe ta cfet ngang, tiin

cuu.

2.2. Th&i gian nghiin c lp u : Tu 01/2013 din

06/2013.

2.3. Thu thap mau nghien ciru

+ Hoi khai thfec cfec trifeu chung ca nfena cua vifem

gan virus: Met moi, roi loan tifeu hfea, sot, dau ha

sudn phai, vfeng da, vang mfet...

+ Khfem thuc th i phfet hifen cfec trifeu chirng vfe hfei

chung: Hofeng dan, suy t l bfeo gan, tfeng fep luc tTnh

mach cira...

+ Xfet nghifem HBsAg, anti-HCV tai khoa Vi sinh

bfenh vifen Dai hpc Y Thfei Binh.

+ Xfet nghifem men gan (ALT, AST), Potein,

Albumil, Bilirubil (true tiip - gifen tiip) tai khoa Hfea

sinh bfenh vifen Dai hoc Y Thfei Binh.

- Phfet hifen HbsAg bing test nhanh.

- Phfet hifen anti-HCV: Ky thufet ELISA th i hfe 3.

- Men gan (ALT, AST), Potein, Albumil, Bilirubil

(true tiip - gifen tiip) bfeng phuang phfep dfeng hoc

enzym trfen mfey tu dfeng.

2.4. P h in tich v i xir ly so liiu : Bfeng phin mim

Epi-lnfo 6.0.

V HOC THUC HANH (905) - SO 2/2014 85