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GIM BCH CU HT BNH NHN CNG GIPNguyn Th Thnh1
SUMMARY
GRANULOCYTOPENIA IN PATIENTS WITHHYPERTHYROIDISM
Nguyn ThThnh
Data from 137 patients with hyperthyroidismhospitalized in Nhn
Dn Gia nh Hospital in2001 and 2002 were recorded.
Granulocytopenia (
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cnh bo bnh nhn khi au hng, st, vim li, lot ming cn ngng thuc v
nnnh gi BC ht v gim BC ht thng xy t ngt (3,7).
Do chng ti nhn thy cn xem xt BC ht c thi thch ng trong iutr.
MC TIU NGHIN CU
Nhn xt BC ht bnh nhn c chn on cng gip nm iu tr ti KhoaNi Tit Thn
trong nm 2001-2002.
Qua tm hiu:
BC ht bnh nhn cng gip mi pht hin.
BC ht bnh nhn ang iu tr thuc khng gip tng hp.
S thay i BC ht sau iu tr.
I TNG V PHNG PHP NGHIN CU
Thit k nghin cu:
Hi cu, ct ngang, m t v phn tch.
i tng nghin cu:
Bnh nhn nm iu tr ti khoa Ni Tit-Thn trong nm 2001&2002.
Tiu chun nhn bnh:
Nhng bnh nhn c triu chng cng gip lm sng v cn lm sng hoc cnlm sng
bnh thng nhng c chn on cng gip v ang iu tr vithuc KGTH.
Lm y cc yu t c quan tm nh c xt nghim nh gi chc nngtuyn gip v cng
thc mu t nht 1 ln lc vo.
Tiu chun loi tr:
Bnh nhn cng gip ngng thuc v xt nghim nh gi chc nng tuyngip trong
gii hn bnh thng.
Bnh nhn khng lm cng thc bch cu.
Cc bc tin hnh:
- Chn nhng bnh nhn nm iu tr ti khoa Ni Tit-Thn trong nm 2001
v2002 tho cc tiu chun nhn bnh v tiu chun loi tr.
- Xt nghim chc nng tuyn gip v cng thc bch cu da vo kt qu caphng
xt nghim bnh vin Nhn Dn Gia nh.
Chc nng tuyn gip c o bng my t ng Asxym ca hng Abott viphng php
min dch hunh quang.
Cng thc BC da vo my huyt hc t ng Technichon H.1
- Bch cu ht c ghi nhn thp khi s lng BC
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N 111 81% 82 29
TC 137 101 73.2% 36 26.27%
Tui: Nh nht 18; Ln nht: 79; Trung bnh:48,7, lch chun
(SD):15,8.
Bch cu ht lc vo (Bng 2):
BCca137bnhnhn
BC ca101 bnhnhn cha iu
tr
BC 36 bnhnhn ang iu
tr
Khc bit v BCnhm iu tr & cha
iu tr
Nh nht 308 308 450
Ln nht 18083 18083 17772 t = 0.11; p>0.05
Trungbnh
4668.3(3359.5)
4722.9(3310) 4626.7(3481.7)
S bnh nhn gim BC ht
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bnh nhn mi c chn on chim t l 73,2% (101/137) cao hn hn bnh nhn
angiu tr 26,27% (38/137).
S bnh nhn gim BC ht
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- Nu bnh nhn cha iu tr v s BC ht thp: Bnh nhn c th gim BC ht
donhim c gip t, iu tr bng thuc khng gip c th lm tng s lng BC ht
ny.Vic theo di cng thc BC sau 1-2 tun l cn thit theo di din tin ca
BC ht doiu tr.
- Trong qu trnh iu tr lu di vic cnh bo bnh nhn cn ngng thuc khi
auhng, st, lot ming, vim li v i xt nghim xc nh gim BC ht l cn thit
vgim BC ht c th xy ra t ngt. Nu c gim BC ht, ty theo mc hay loi
KGTHngi ta c th gim liu hay ngng KGTH v i sang thuc hay phng thc iu
trkhc.
TI LIU THAM KHO1.ALAN P.FARWELL AND LEWIS E.BRAVERMAN.(1996).
Thyroid and antithyroid drug InGood Man &Gilmans the
Pharmacological Basis of Therapeutics Ninth Edition
PP:1397-1406.McGraw-Hill, USA.2. BRAUNWALD E
(2002).Thyrotoxicosis.In Eugene Braunwald ..Harrissons Manualof
Medecine. 15th Edition; p 774-781. McGraw-Hill International
Edition, India.3.JOHNC. MORRIS,MD.(1996). Thyroxicosis. In Robert
E.Rackel,M.D . Conns Current
Therapy, 48th edition PP 619- 624.W.B Sauders , the United
states of America.4.MAI TH TRCH (2000). Cng Gip . Trong Ni Tit Hc i
Cng (Mai Th Trch-Nguyn Thy Khu ch bin). Tr:212-137. Nh xut bn Thnh
Ph H Ch Minh.5.ROBER D.UTIGER.(1995).The Thyroid: Treatment of
Thyrotoxicosis. In Philip Felig,M.D.Endocrinology And Metabolism,
Third Edition. Volume 1, PP 479-492.McGraw-Hill,Inc.USA.6.THI HNG
QUANG(1997).Bnh Basedow . Trong Bnh Ni Tit (Thi Hng Quang chbin)
Tr:116-171 Nh xut bn Y Hc, H Ni.7.WILLIAM
E.CLUSTTER.(2001).Hyperthyroidism.In Shubhada N.Ahya.The
WashingtonManual of Medical Therapeutics. 30Edition
PP.473-490,Wolters Kluwer, USA .
Tn tc gi: Nguyn th Thnh.
Hc v: Tin s.
Chc v: Trng khoa Ni Tit Thn Bnh Vin Nhn Dn Gia nh
a ch lin h: Bnh Vin Nhn Dn Gia nh S 1 N Trang Long Bnh Thnh.TP H
ChMInh
Nh : 46 inh Tin Hong Phng 1 Qun Bnh Thnh TP H Ch Minh.
in Thoi: 8412381
0913651815
Email: [email protected]
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