{"id":147119,"date":"2024-02-21T09:10:17","date_gmt":"2024-02-21T09:10:17","guid":{"rendered":"https:\/\/labinsights.com\/acf_article\/vai-tro-quan-trong-cua-cac-dau-an-sinh-hoc-trong-nhiem-trung-huyet\/"},"modified":"2026-02-16T09:05:25","modified_gmt":"2026-02-16T09:05:25","slug":"the-role-of-biomarkers-in-management-of-sepsis","status":"publish","type":"acf_article","link":"https:\/\/labinsights.com\/vi\/disease-area\/sepsis\/the-role-of-biomarkers-in-management-of-sepsis\/","title":{"rendered":"Vai tr\u00f2 quan tr\u1ecdng c\u1ee7a c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong nhi\u1ec5m tr\u00f9ng huy\u1ebft"},"content":{"rendered":"

\u0110\u1ecbnh ngh\u0129a \u0111\u1ed3ng thu\u1eadn qu\u1ed1c t\u1ebf l\u1ea7n th\u1ee9 ba v\u1ec1 nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m tr\u00f9ng huy\u1ebft (Sepsis-3) <\/a> \u0111\u1ecbnh ngh\u0129a nhi\u1ec5m tr\u00f9ng huy\u1ebft l\u00e0 ‘r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan \u0111e d\u1ecda t\u00ednh m\u1ea1ng do ph\u1ea3n \u1ee9ng kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u h\u00f2a c\u1ee7a v\u1eadt ch\u1ee7 \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng’.<\/p>\n

S\u1ed1c nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 ‘m\u1ed9t ph\u00e2n nh\u00f3m c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft trong \u0111\u00f3 c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 tu\u1ea7n ho\u00e0n, t\u1ebf b\u00e0o v\u00e0 chuy\u1ec3n h\u00f3a ti\u1ec1m \u1ea9n c\u00f3 li\u00ean quan \u0111\u1ebfn nguy c\u01a1 t\u1eed vong cao h\u01a1n so v\u1edbi nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u01a1n thu\u1ea7n’. Nhi\u1ec5m tr\u00f9ng huy\u1ebft l\u00e0 m\u1ed9t ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00ec kh\u00f4ng c\u00f3 x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n ri\u00eang bi\u00ea\u0323t. C\u1ea3 b\u1ea5t th\u01b0\u1eddng sinh l\u00fd v\u00e0 x\u00e9t nghi\u1ec7m \u0111\u1ec1u c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n. Sepsis-3 \u0111\u00e3 lo\u1ea1i b\u1ecf thu\u1eadt ng\u1eef ‘nhi\u1ec5m tr\u00f9ng huy\u1ebft n\u1eb7ng’, thay v\u00e0o \u0111\u00f3 \u0111\u1ecbnh ngh\u0129a v\u00e0 ph\u00e2n t\u1ea7ng ‘s\u1ed1c nhi\u1ec5m tr\u00f9ng’ v\u00e0 ‘nhi\u1ec5m tr\u00f9ng huy\u1ebft’ v\u1edbi m\u1ee5c ti\u00eau t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho vi\u1ec7c ph\u00e1t hi\u1ec7n s\u1edbm h\u01a1n v\u00e0 qu\u1ea3n l\u00fd k\u1ecbp th\u1eddi h\u01a1n b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng huy\u1ebft. Nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u01b0\u01a1\u0323c bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng m\u1ed9t ph\u1ed5 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng. M\u1eb7c d\u00f9 c\u00f3 th\u1ec3 kh\u00f4ng ch\u1eafc ch\u1eafn v\u1ec1 ch\u1ea9n \u0111o\u00e1n, nh\u01b0ng kh\u1ea3 n\u0103ng x\u1ea5u \u0111i nhanh ch\u00f3ng v\u00e0 nghi\u00eam tr\u1ecdng \u1edf b\u1ea5t k\u1ef3 b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng huy\u1ebft n\u00e0o \u0111\u1ec1u c\u1ea7n ph\u1ea3i can thi\u1ec7p b\u1ea5t c\u1ee9 khi n\u00e0o c\u00f3 kh\u1ea3 n\u0103ng nhi\u1ec5m tr\u00f9ng huy\u1ebft [1].<\/p>\n

Nghi\u00ean c\u1ee9u G\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt to\u00e0n c\u1ea7u \u0111\u00e3 s\u1eed<\/a> d\u1ee5ng d\u1eef li\u1ec7u t\u1eeb 109 tri\u1ec7u h\u1ed3 s\u01a1 t\u1eed vong v\u00e0 8,6 tri\u1ec7u h\u1ed3 s\u01a1 b\u1ec7nh vi\u1ec7n t\u1ea1i 195 qu\u1ed1c gia v\u00e0 v\u00f9ng l\u00e3nh th\u1ed5 \u0111\u1ec3 \u01b0\u1edbc t\u00ednh g\u00e1nh n\u1eb7ng c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Nghi\u00ean c\u1ee9u ph\u00e1t hi\u1ec7n c\u00f3 49 tri\u1ec7u ca nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u00e0 11 tri\u1ec7u ca t\u1eed vong v\u00e0o n\u0103m 2017 – g\u1ea5p \u0111\u00f4i \u01b0\u1edbc t\u00ednh tr\u01b0\u1edbc \u0111\u00f3 – v\u1edbi c\u1ee9 n\u0103m ca t\u1eed vong tr\u00ean to\u00e0n th\u1ebf gi\u1edbi th\u00ec c\u00f3 t\u1edbi m\u1ed9t ca li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng huy\u1ebft. \u0110i\u1ec1u \u0111\u00e1ng lo ng\u1ea1i l\u00e0 c\u00f3 qu\u00e1 nhi\u1ec1u sinh m\u1ea1ng b\u1ecb m\u1ea5t \u0111i do ph\u1ea7n l\u1edbn m\u1ed9t t\u00ecnh tr\u1ea1ng c\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba \u0111\u01b0\u1ee3c. C\u00e1c \u01b0\u1edbc t\u00ednh tr\u01b0\u1edbc \u0111\u00e2y v\u1ec1 g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt \u1edf \u00dac ch\u1ee7 y\u1ebfu l\u00e0 nh\u1eefng ca \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ea1i c\u00e1c \u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t, \u0111\u01b0a ra s\u1ed1 ca b\u1ec7nh l\u00e0 18.000 v\u00e0 s\u1ed1 ca t\u1eed vong l\u00e0 5.000. Nh\u01b0ng \u01b0\u1edbc t\u00ednh c\u1ee7a Nghi\u00ean c\u1ee9u G\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt to\u00e0n c\u1ea7u hi\u1ec7n \u0111\u01b0a ra b\u1ee9c tranh ch\u00ednh x\u00e1c h\u01a1n v\u1ec1 quy m\u00f4 c\u1ee7a v\u1ea5n \u0111\u1ec1 b\u1eb1ng c\u00e1ch bao g\u1ed3m c\u1ea3 nhi\u1ec5m tr\u00f9ng huy\u1ebft x\u1ea3y ra b\u00ean ngo\u00e0i b\u1ec7nh vi\u1ec7n, \u0111\u01b0a s\u1ed1 ca b\u1ec7nh \u1edf \u00dac l\u00ean 55.000 v\u00e0 s\u1ed1 ca t\u1eed vong l\u00e0 8.700.<\/p>\n

Nhi\u1ec5m tr\u00f9ng huy\u1ebft l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u y t\u1ebf kh\u1ea9n c\u1ea5p, x\u1ea3y ra khi t\u0103ng m\u01b0\u0301c \u0111\u00f4\u0323 ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 v\u1edbi nhi\u1ec5m tr\u00f9ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u00e1c m\u00f4 v\u00e0 c\u01a1 quan c\u1ee7a ch\u00ednh n\u00f3. N\u00f3 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ed1c, suy \u0111a c\u01a1 quan v\u00e0 t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi. Nhi\u1ec5m tr\u00f9ng huy\u1ebft \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ecdi l\u1ee9a tu\u1ed5i v\u00e0 b\u1ec7nh nh\u00e2n tr\u00ean nhi\u1ec1u chuy\u00ean khoa l\u00e2m s\u00e0ng kh\u00e1c nhau, nh\u01b0ng \u0111\u1eb7c bi\u1ec7t l\u00e0 tr\u1ebb r\u1ea5t nh\u1ecf, ng\u01b0\u1eddi gi\u00e0 v\u00e0 ng\u01b0\u1eddi d\u00e2n b\u1ea3n \u0111\u1ecba v\u00e0 ng\u01b0\u1eddi d\u00e2n \u0111\u1ea3o Torres Strait. Tuy nhi\u00ean, nh\u1eadn th\u1ee9c c\u00f2n th\u1ea5p v\u1edbi m\u1ed9t cu\u1ed9c kh\u1ea3o s\u00e1t n\u0103m 2016 cho th\u1ea5y 60 ph\u1ea7n tr\u0103m ng\u01b0\u1eddi \u00dac ch\u01b0a t\u1eebng nghe n\u00f3i v\u1ec1 nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u00e0 ch\u1ec9 14 ph\u1ea7n tr\u0103m c\u00f3 th\u1ec3 n\u00eau t\u00ean m\u1ed9t trong nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a n\u00f3. C\u1ea7n c\u00f3 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn toa\u0300n qu\u00f4\u0301c \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p \u0111\u1ec3 gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 nh\u1eadn bi\u1ebft v\u00e0 \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc khi nh\u1eadp vi\u1ec7n v\u00e0 trong b\u1ec7nh vi\u1ec7n, \u0111\u1ec3 gi\u1ea3i quy\u1ebft t\u00ecnh tr\u1ea1ng t\u1eed vong v\u00e0 t\u00e0n t\u1eadt \u0111\u00e1ng k\u1ec3 do nhi\u1ec5m tr\u00f9ng huy\u1ebft g\u00e2y ra [2].<\/p>\n

Vai tr\u00f2 c\u1ee7a procalcitonin trong qua\u0309n ly\u0301 nhi\u1ec5m tr\u00f9ng huy\u1ebft<\/h2>\n

Qu\u1ea3n l\u00fd l\u00e2m s\u00e0ng cho b\u1ec7nh nh\u00e2n nguy k\u1ecbch do nhi\u1ec5m tr\u00f9ng n\u1eb7ng v\u00e0 nhi\u1ec5m tr\u00f9ng huy\u1ebft c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n b\u1eb1ng c\u00e1ch r\u00fat ng\u1eafn th\u1eddi gian \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb (t\u1ee9c l\u00e0 ph\u00e2n bi\u1ec7t gi\u1eefa nhi\u1ec5m tr\u00f9ng do vi khu\u1ea9n, vi-r\u00fat, n\u1ea5m v\u00e0 so v\u1edbi nguy\u00ean nh\u00e2n kh\u00f4ng do nhi\u1ec5m tr\u00f9ng). H\u01a1n n\u1eefa, c\u00e1c quy\u1ebft \u0111\u1ecbnh v\u1ec1 \u0111i\u0323a \u0111i\u00ea\u0309m ch\u0103m s\u00f3c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n (v\u00ed d\u1ee5, xu\u1ea5t vi\u1ec7n s\u1edbm ho\u1eb7c t\u0103ng c\u01b0\u1eddng ch\u0103m s\u00f3c) b\u1eb1ng c\u00e1ch ph\u00e2n t\u1ea7ng nguy c\u01a1 s\u1edbm v\u00e0 cung c\u1ea5p th\u00f4ng tin ti\u00ean l\u01b0\u1ee3ng. C\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u01b0\u1ee3c \u0111o nhi\u1ec1u l\u1ea7n c\u0169ng gi\u00fap theo d\u00f5i b\u1ec7nh nh\u00e2n \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec7u ph\u00e1p ph\u00f9 h\u1ee3p v\u1edbi nhu c\u1ea7u c\u1ee7a t\u1eebng b\u1ec7nh nh\u00e2n (qu\u1ea3n l\u00fd kh\u00e1ng sinh). rong b\u1ed1i c\u1ea3nh n\u00e0y, vi\u1ec7c s\u1eed d\u1ee5ng procalcitonin (PCT) – d\u1ea5u \u1ea5n \u0111\u00e1p \u1ee9ng v\u1eadt ch\u1ee7 v\u00e0 nhi\u1ec5m tr\u00f9ng m\u00e1u – \u0111\u00e3 nh\u1eadn \u0111\u01b0\u1ee3c nhi\u1ec1u s\u1ef1 ch\u00fa \u00fd v\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 theo do\u0303i ti\u0300nh tra\u0323ng kh\u00e1ng khu\u1ea9n \u1edf b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p v\u00e0 nhi\u1ec5m tr\u00f9ng huy\u1ebft. PCT (procalcitonin) l\u00e0 ti\u1ec1n ch\u1ea5t c\u1ee7a calcitonin, kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh. Tuy nhi\u00ean, vi\u1ec7c s\u1ea3n xu\u1ea5t PCT (procalcitonin) \u0111\u01b0\u1ee3c \u0111i\u1ec1u h\u00f2a t\u0103ng l\u00ean \u0111\u1ec3 \u0111\u00e1p \u1ee9ng v\u1edbi nhi\u1ec5m tr\u00f9ng do vi khu\u1ea9n v\u00e0 c\u00f3 th\u1ec3 gi\u1ea3m nhanh ch\u00f3ng trong qu\u00e1 tr\u00ecnh h\u1ed3i ph\u1ee5c. Do \u0111\u00f3, PCT (procalcitonin) cung c\u1ea5p th\u00f4ng tin b\u1ed5 sung quan tr\u1ecdng, c\u00f3 th\u1ec3 b\u1ed5 sung cho c\u00e1c th\u00f4ng s\u1ed1 l\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n. \u0110i\u1ec1u n\u00e0y kh\u00f4ng ch\u1ec9 t\u00e1c \u0111\u1ed9ng l\u1edbn \u0111\u1ebfn quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n co\u0301 nghi ng\u1edd nhi\u1ec5m tr\u00f9ng ho\u1eb7c co\u0301 nhi\u1ec5m tr\u00f9ng huy\u1ebft m\u00e0 c\u00f2n c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1eddi gian \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh. Vi\u1ec7c s\u1eed d\u1ee5ng PCT (procalcitonin) \u0111ang ph\u00e1t tri\u1ec3n trong qu\u1ea3n l\u00fd nhi\u1ec5m tr\u00f9ng huy\u1ebft, v\u00e0 m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u can thi\u1ec7p v\u00e0 t\u1ed5ng quan h\u1ec7 th\u1ed1ng \u0111\u00e3 ph\u00e2n t\u00edch v\u00e0 t\u00f3m t\u1eaft t\u00e1c \u0111\u1ed9ng c\u1ee7a c\u00e1c chi\u1ebfn l\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn PCT (procalcitonin) \u0111\u1ed1i v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh v\u00e0 k\u1ebft qu\u1ea3 s\u1ee9c kh\u1ecfe. Tuy nhi\u00ean, v\u1eabn ch\u01b0a c\u00f3 s\u1ef1 \u0111\u1ed3ng thu\u1eadn chung v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng PCT (procalcitonin) t\u1ed1i \u01b0u trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng huy\u1ebft.<\/p>\n

\u1ede nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh, kh\u00f4ng th\u1ec3 ph\u00e1t hi\u1ec7n PCT (procalcitonin) huy\u1ebft thanh, v\u00ec protein n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng v\u00e0o m\u00e1u khi kh\u00f4ng c\u00f3 t\u00ecnh tr\u1ea1ng vi\u00eam to\u00e0n th\u00e2n. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng huy\u1ebft do nhi\u1ec5m khu\u1ea9n, qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p PCT (procalcitonin) \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t \u1edf h\u1ea7u h\u1ebft c\u00e1c m\u00f4 v\u00e0 do \u0111\u00f3 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c trong m\u00e1u. Qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p PCT (procalcitonin) \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi c\u00e1c \u0111\u1ed9c t\u1ed1 vi khu\u1ea9n, ch\u1eb3ng h\u1ea1n nh\u01b0 n\u1ed9i \u0111\u1ed9c t\u1ed1 v\u00e0 cytokine, v\u00ed d\u1ee5 nh\u01b0 interleukin (IL)-1beta, interleukin-6 v\u00e0 y\u1ebfu t\u1ed1 ho\u1ea1i t\u1eed kh\u1ed1i u (TNF)-alpha. Do c\u00e1c cytokine \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng trong qu\u00e1 tr\u00ecnh nhi\u1ec5m vi-r\u00fat \u1ee9c ch\u1ebf s\u1ea3n xu\u1ea5t TNF-alpha, n\u00ean qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p PCT (procalcitonin) kh\u00f4ng \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m vi-r\u00fat. H\u01a1n n\u1eefa, PCT (procalcitonin) c\u00f3 ph\u1ea1m vi sinh h\u1ecdc r\u1ed9ng, th\u1eddi gian c\u1ea3m \u1ee9ng ng\u1eafn sau khi b\u1ecb k\u00edch th\u00edch b\u1edfi vi khu\u1ea9n v\u00e0 th\u1eddi gian b\u00e1n h\u1ee7y d\u00e0i. Do \u0111\u00f3, PCT (procalcitonin) c\u00f3 kha\u0309 n\u0103ng ph\u00e2n bi\u1ec7t t\u1ed1t gi\u1eefa t\u00ecnh tr\u1ea1ng vi\u00eam do vi khu\u1ea9n v\u00e0 do vi-r\u00fat v\u1edbi k\u1ebft qu\u1ea3 c\u00f3 s\u1eb5n nhanh ch\u00f3ng. B\u1ea3n th\u00e2n PCT (procalcitonin) kh\u00f4ng th\u1ec3 ph\u00e2n l\u1eadp ho\u1eb7c ph\u00e1t hi\u1ec7n c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh c\u1ee5 th\u1ec3, nh\u01b0ng n\u1ed3ng \u0111\u1ed9 PCT (procalcitonin) c\u00f3 th\u1ec3 h\u1eefu \u00edch \u0111\u1ec3 \u01b0\u1edbc t\u00ednh kh\u1ea3 n\u0103ng nhi\u1ec5m tr\u00f9ng do vi khu\u1ea9n nghi\u00eam tr\u1ecdng.<\/p>\n

M\u1eb7c d\u00f9 \u0111\u00e3 nhi\u1ec1u th\u1eadp k\u1ef7 n\u1ed7 l\u1ef1c nghi\u00ean c\u1ee9u, v\u1eabn ch\u01b0a c\u00f3 ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u nhi\u1ec5m tr\u00f9ng huy\u1ebft. \u0110i\u1ec1u quan tr\u1ecdng cho m\u1ed9t qua\u0301 tri\u0323 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng v\u00e0 k\u1ebft qu\u1ea3 kh\u1ea3 quan l\u00e0 ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 ph\u00e2n bi\u1ec7t \u0111\u01b0\u01a1\u0323c v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng nhi\u1ec5m tr\u00f9ng, \u0111\u1ec3 nhanh ch\u00f3ng b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh v\u00e0 b\u00f9 d\u1ecbch. Tuy nhi\u00ean, do c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft giai \u0111oa\u0323n nghi ng\u1edd ho\u1eb7c x\u00e1c \u0111\u1ecbnh c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t v\u00e0 th\u01b0\u1eddng m\u01a1 h\u1ed3, n\u00ean vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb v\u1eabn c\u00f2n nhi\u1ec1u th\u00e1ch th\u1ee9c. Cho \u0111\u1ebfn nay, v\u1eabn ch\u01b0a c\u00f3 ti\u00eau chu\u1ea9n v\u00e0ng n\u00e0o \u0111\u1ec3 ph\u00e1t hi\u1ec7n nhi\u1ec5m tr\u00f9ng huy\u1ebft b\u01a1\u0309i ca\u0301c ta\u0301c nh\u00e2n nhi\u1ec5m tr\u00f9ng co\u0301 trong ma\u0301u. Vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n th\u00f4ng th\u01b0\u1eddng nh\u01b0 c\u1ea5y m\u00e1u v\u00e0 c\u00e1c d\u1ea5u \u1ea5n cu\u0309a ti\u0300nh tra\u0323ng vi\u00eam trong m\u00e1u protein ph\u1ea3n \u1ee9ng C (C-reactive protein, CRP), c\u00f4ng th\u1ee9c b\u1ea1ch c\u1ea7u (WBC) \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nghi ng\u1edd nhi\u1ec5m tr\u00f9ng huy\u1ebft ho\u1eb7c co\u0301 nhi\u1ec5m tr\u00f9ng huy\u1ebft tr\u00ean l\u00e2m s\u00e0ng b\u1ecb tro\u0301i bu\u00f4\u0323c b\u1edfi m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf. Vi\u1ec7c s\u1eed d\u1ee5ng xe\u0301t nghi\u00ea\u0323m c\u1ea5y m\u00e1u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh c\u00f3 th\u1ec3 cung c\u1ea5p th\u00f4ng tin v\u1ec1 lo\u1ea1i vi sinh v\u1eadt v\u00e0 kh\u1ea3 n\u0103ng nh\u1ea1y c\u1ea3m v\u1edbi li\u1ec7u ph\u00e1p kh\u00e1ng sinh. Tuy nhi\u00ean, ch\u1ec9 m\u1ed9t ph\u1ea7n nh\u1ecf c\u00e1c m\u1eabu c\u1ea5y \u0111\u01b0\u1ee3c ph\u00e2n t\u00edch cho k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh, v\u00e0 \u1edf kho\u1ea3ng 40\u201390% b\u1ec7nh nh\u00e2n nghi ng\u1edd nhi\u1ec5m tr\u00f9ng to\u00e0n th\u00e2n, k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u l\u00e0 \u00e2m t\u00ednh v\u00e0 kh\u00f4ng c\u00f3 t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh ph\u00e1t tri\u1ec3n. H\u01a1n n\u1eefa, th\u1eddi gian ch\u1edd k\u1ebft qu\u1ea3 ke\u0301o da\u0300i l\u00e0m h\u1ea1n ch\u1ebf kha\u0309 n\u0103ng ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u v\u00e0 t\u00ecnh tr\u1ea1ng nhi\u1ec5m khu\u00e2\u0309n d\u1eabn \u0111\u1ebfn \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u kh\u00f4ng t\u1ed1i \u01b0u trong k\u1ebft qu\u1ea3 thu \u0111\u01b0\u1ee3c. \u0110\u1ec3 c\u1ea3i thi\u1ec7n c\u00f4ng t\u00e1c ch\u1ea9n \u0111o\u00e1n, c\u1ea7n c\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m b\u1ed5 sung, c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 \u0111\u00e1ng tin c\u1eady [3].<\/p>\n

IL-6 (Interleukin-6) v\u00e0 vai tr\u00f2 c\u1ee7a n\u00f3 trong nhi\u1ec5m tr\u00f9ng huy\u1ebft \u1edf tr\u1ebb s\u01a1 sinh<\/h2>\n

Nhi\u1ec5m tr\u00f9ng huy\u1ebft \u01a1\u0309 tre\u0309 s\u01a1 sinh chi\u1ebfm 0,97% s\u1ed1 n\u0103m s\u1ed1ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo m\u1ee9c \u0111\u1ed9 b\u1ec7nh t\u1eadt tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, co\u0301 t\u1ef7 l\u1ec7 ph\u1ea7n tr\u0103m cao h\u01a1n so v\u1edbi ung th\u01b0 ru\u1ed9t k\u1ebft v\u00e0 tr\u1ef1c tr\u00e0ng, hen suy\u1ec5n ho\u1eb7c ung th\u01b0 v\u00fa. Nhi\u1ec5m tr\u00f9ng huy\u1ebft s\u01a1 sinh c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong cao l\u00e0 11\u201319%2 v\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng n\u00e3o c\u0169ng nh\u01b0 kha\u0309 n\u0103ng ph\u00e1t tri\u1ec3n th\u1ea7n kinh v\u00e0 t\u0103ng tr\u01b0\u1edfng k\u00e9m \u1edf tr\u1ebb nh\u1ecf. Nh\u1eefng k\u1ebft qu\u1ea3 b\u1ea5t l\u1ee3i n\u00e0y \u0111\u00f2i h\u1ecfi ph\u1ea3i \u0111\u01b0\u01a1\u0323c ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 can thi\u1ec7p nhanh ch\u00f3ng. V\u00ec nhi\u1ec5m tr\u00f9ng huy\u1ebft l\u00e0 ph\u1ea3n \u1ee9ng vi\u00eam to\u00e0n th\u00e2n \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng, n\u00ean vi\u1ec7c ph\u00e2n l\u1eadp vi khu\u1ea9n t\u1eeb m\u00e1u \u0111\u01b0\u1ee3c coi l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng. Do th\u1ec3 t\u00edch m\u00e1u th\u00e2\u0301p khi thu \u0111\u01b0\u1ee3c t\u01b0\u0300 tr\u1ebb s\u01a1 sinh r\u00e2\u0301t nhe\u0323 c\u00e2n (tre\u0309 VLBW, c\u00e2n n\u1eb7ng khi sinh < 1500 gm), kho\u1ea3ng 0,5\u20131 ml, t\u1ef7 l\u1ec7 cao th\u01b0\u01a1\u0300ng g\u0103\u0323p la\u0300 nhi\u1ec5m tr\u00f9ng huy\u1ebft m\u1ee9c \u0111\u1ed9 th\u1ea5p v\u00e0 c\u00e2\u0300n co\u0301 th\u1eddi gian d\u00e0i \u0111\u1ec3 c\u00f3 k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u d\u01b0\u01a1ng t\u00ednh, m\u1ed9t s\u1ed1 th\u00f4ng s\u1ed1 \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m v\u1ec1 \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a ch\u00fang trong ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng huy\u1ebft s\u01a1 sinh bao g\u1ed3m procalcitonin, protein li\u00ean k\u1ebft lipopolysaccharide, presepsin v\u00e0 interleukin-6.<\/p>\n

IL-6 l\u00e0 m\u1ed9t cytokine \u0111a ch\u1ee9c n\u0103ng tham gia v\u00e0o ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch, t\u1ea1o m\u00e1u v\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng giai \u0111o\u1ea1n c\u1ea5p. \u0110\u1ec3 \u0111\u00e1p \u1ee9ng v\u1edbi nhi\u1ec5m tr\u00f9ng, IL-6 t\u0103ng c\u01b0\u1eddng s\u1ea3n xu\u1ea5t IgM (Immunoglobulin M), IgG (Immunoglobulin G) v\u00e0 IgA (Immunoglobulin A) c\u0169ng nh\u01b0 s\u1ef1 t\u0103ng sinh c\u1ee7a t\u1ebf b\u00e0o T h\u1ed7 tr\u1ee3 v\u00e0 do \u0111\u00f3 \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong c\u01a1 ch\u1ebf b\u1ea3o v\u1ec7 c\u1ee7a v\u1eadt ch\u1ee7. Sau khi ti\u1ebfp x\u00fac v\u1edbi n\u1ed9i \u0111\u1ed9c t\u1ed1 vi khu\u1ea9n, n\u1ed3ng \u0111\u1ed9 IL-6 t\u0103ng l\u00ean tr\u01b0\u1edbc c\u00e1c ch\u1ea5t ph\u1ea3n \u1ee9ng giai \u0111o\u1ea1n c\u1ea5p bao g\u1ed3m protein ph\u1ea3n \u1ee9ng C (CRP). IL-6 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh trong m\u00e1u cu\u1ed1ng r\u1ed1n ho\u1eb7c huy\u1ebft thanh mang l\u1ea1i \u0111\u1ed9 ch\u00ednh x\u00e1c ch\u1ea9n \u0111o\u00e1n kh\u00e1c nhau. IL-6 trong m\u00e1u cu\u1ed1ng r\u1ed1n c\u00f3 \u0111\u1ed9 nh\u1ea1y 87\u2013100% \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng huy\u1ebft kh\u1edfi ph\u00e1t s\u1edbm. IL-6 trong huy\u1ebft thanh c\u00f3 \u0111\u1ed9 nh\u1ea1y 75\u201385% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 72,8\u201388% \u0111\u1ed1i v\u1edbi ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng huy\u1ebft kh\u1edfi ph\u00e1t s\u1edbm v\u00e0 \u0111\u1ed9 nh\u1ea1y 80\u201393,8% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 80\u201396% \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng huy\u1ebft kh\u1edfi ph\u00e1t mu\u1ed9n, do \u0111\u00f3 v\u01b0\u1ee3t tr\u1ed9i h\u01a1n CRP (C-reactive protein, protein ph\u1ea3n \u1ee9ng C). N\u1ed3ng \u0111\u1ed9 IL-6 trong huy\u1ebft thanh nhanh ch\u00f3ng gi\u1ea3m xu\u1ed1ng m\u1ee9c kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh. \u0110\u1ed9 nh\u1ea1y cao v\u00e0 gi\u00e1 tr\u1ecb d\u1ef1 b\u00e1o \u00e2m t\u00ednh c\u1ee7a IL-6 khi\u1ebfn n\u00f3 tr\u1edf th\u00e0nh \u1ee9ng c\u1eed vi\u00ean ph\u00f9 h\u1ee3p \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng huy\u1ebft \u1edf tr\u1ebb s\u01a1 sinh k\u1ebft h\u1ee3p v\u1edbi CRP \u0111\u1eb7c hi\u1ec7u cao.<\/p>\n

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H\u00ecnh 1: Interleukin-6 v\u00e0 protein pha\u0309n \u01b0\u0301ng C (CRP) v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ch\u00fang theo th\u1eddi gian trong b\u00ea\u0323nh ca\u0309nh nhi\u1ec5m tr\u00f9ng huy\u1ebft. Interleukin-6 v\u00e0 protein pha\u0309n \u01b0\u0301ng C (CRP) trong huy\u1ebft thanh \u1edf nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng nu\u00f4i c\u1ea5y v\u00e0o ng\u00e0y th\u1ee9 1 (a) v\u00e0 sau ng\u00e0y th\u1ee9 7 (b).<\/em><\/p>\n

Theo H\u00ecnh 1, n\u1ed3ng \u0111\u1ed9 IL-6 huy\u1ebft thanh b\u1eaft \u0111\u1ea7u t\u0103ng cao trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh nh\u01a1\u0300 nu\u00f4i c\u1ea5y trong ng\u00e0y DOL 1 (Ng\u00e0y th\u1ee9 1), khi ma\u0300 CRP m\u1ea5t 48 gi\u1edd \u0111\u1ec3 \u0111\u1ea1t \u0111\u1ec9nh. D\u1ef1a tr\u00ean \u0111\u1ed9 ch\u00ednh x\u00e1c cao c\u1ee7a IL-6 huy\u1ebft thanh, ch\u00fang t\u00f4i k\u1ebft lu\u1eadn r\u1eb1ng IL-6 \u0111\u01b0\u1ee3c \u0111o v\u00e0o DOL (day of life 1, nga\u0300y nu\u00f4i c\u00e2\u0301y th\u01b0\u0301 nh\u00e2\u0301t) r\u1ea5t h\u1eefu \u00edch trong ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng huy\u1ebft b\u1ea9m sinh. Nh\u01b0 c\u0169ng th\u1ec3 hi\u1ec7n trong H\u00ecnh 1, n\u1ed3ng \u0111\u1ed9 IL-6 huy\u1ebft thanh t\u0103ng trong 24\u201348 gi\u1edd tr\u01b0\u1edbc CRP xu\u00e2\u0301t hi\u00ea\u0323n \u01a1\u0309 c\u00e1c \u0111\u1ee3t nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng nu\u00f4i c\u1ea5y sau ng\u00e0y DOL 7. \u0110i\u1ec1u n\u00e0y khi\u1ebfn IL-6 (Interleukin-6) huy\u1ebft thanh tr\u1edf th\u00e0nh th\u00f4ng s\u1ed1 x\u00e9t nghi\u1ec7m ch\u00ednh x\u00e1c nh\u1ea5t v\u00e0 \u0111\u1ea7u ti\u00ean t\u0103ng l\u00ean trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng huy\u1ebft sau tu\u1ea7n \u0111\u1ea7u ti\u00ean c\u1ee7a cu\u1ed9c \u0111\u1eddi. Tzialla v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng n\u1ed3ng \u0111\u1ed9 cytokine thay \u0111\u1ed5i nhanh ch\u00f3ng, ngay c\u1ea3 tr\u01b0\u1edbc khi xu\u1ea5t hi\u1ec7n c\u00e1c ch\u1ea5t ph\u1ea3n \u1ee9ng giai \u0111o\u1ea1n c\u1ea5p.<\/p>\n

Do co\u0301 \u0111\u1ed9 ch\u00ednh x\u00e1c cao v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 gi\u00e1 tr\u1ecb d\u1ef1 b\u00e1o \u00e2m t\u00ednh r\u1ea5t cao c\u1ee7a IL-6 (Interleukin-6) huy\u1ebft thanh, ch\u00fang t\u00f4i k\u1ebft lu\u1eadn r\u1eb1ng IL-6 huy\u1ebft thanh r\u1ea5t h\u1eefu \u00edch trong ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng huy\u1ebft \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb sinh non. H\u01a1n n\u1eefa, IL-6 gi\u1ea3m nhanh ch\u00f3ng sau khi b\u1eaft \u0111\u1ea7u co\u0301 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh, cho ph\u00e9p theo d\u00f5i nhanh ch\u00f3ng li\u1ec7u ph\u00e1p kh\u00e1ng sinh v\u00e0 t\u0103ng ho\u1eb7c gi\u1ea3m li\u1ec1u \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi [4].<\/p>\n

Ph\u1ea7n k\u1ebft lu\u1eadn<\/h2>\n

Nhi\u1ec5m tr\u00f9ng huy\u1ebft l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111e d\u1ecda t\u00ednh m\u1ea1ng v\u00e0 l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t khi\u00ea\u0301n b\u00ea\u0323nh nh\u00e2n pha\u0309i \u0111i\u00ea\u0300u tri\u0323 n\u00f4\u0323i tru\u0301 t\u1ea1i khoa ICU (Intensive Care Unit, \u0110\u01a1n vi\u0323 h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c). Ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00e1ch l\u00e0 \u0111i\u00ea\u0300u c\u1ea7n thi\u1ebft \u0111\u1ec3 gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong do nhi\u1ec5m tr\u00f9ng huy\u1ebft. Tuy nhi\u00ean, ph\u1ea3n \u1ee9ng sinh l\u00fd v\u1edbi nhi\u1ec5m tr\u00f9ng \u1edf m\u1ed7i c\u00e1 nh\u00e2n l\u00e0 r\u1ea5t kh\u00e1c nhau, v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, khi\u1ebfn vi\u1ec7c ch\u1ea9n \u0111o\u00e1n s\u1edbm tr\u1edf n\u00ean kh\u00f3 kh\u0103n. Do \u0111\u00f3, m\u1ed9t s\u1ed1 d\u1ea5u \u1ea5n sinh h\u1ecdc ti\u1ec1m n\u0103ng cho ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. C\u00e1c ph\u00e2n t\u1eed n\u00e0y ch\u1ee7 y\u1ebfu tham gia v\u00e0o qu\u00e1 tr\u00ecnh b\u1ec7nh sinh ban \u0111\u1ea7u c\u1ee7a ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch b\u1ea9m sinh \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng, v\u00e0 trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, ch\u00fang c\u00f3 gi\u00e1 tr\u1ecb ti\u00ean l\u01b0\u1ee3ng c\u0169ng nh\u01b0 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n. C\u00e1c d\u1ea5u \u1ea5n ti\u00ean l\u01b0\u1ee3ng c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u00e1c c\u01a1 quan do nhi\u1ec5m tr\u00f9ng huy\u1ebft g\u00e2y ra, v\u00e0 vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c nh\u00e2n t\u00f4\u0301 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng huy\u1ebft nh\u1eafm v\u00e0o c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc co\u0301 gia\u0301 tri\u0323 ti\u00ean l\u01b0\u1ee3ng n\u00e0y \u0111ang \u0111\u01b0\u1ee3c n\u1ed7 l\u1ef1c th\u1ef1c hi\u1ec7n. Ngo\u00e0i ra, nh\u1eefng ti\u1ebfn b\u1ed9 g\u1ea7n \u0111\u00e2y trong c\u00f4ng ngh\u1ec7 \u0111\u00e3 d\u1eabn \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c lo\u1ea1i d\u1ea5u \u1ea5n sinh h\u1ecdc m\u1edbi nh\u01b0 h\u1ec7 vi sinh v\u1eadt \u0111\u01b0\u1eddng ru\u1ed9t v\u00e0 c\u00e1c RNA kh\u00f4ng m\u00e3 h\u00f3a. H\u1ec7 vi sinh v\u1eadt \u0111\u01b0\u1eddng ru\u1ed9t \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u00ea\u0301n v\u01a1\u0301i vai tr\u00f2 quan tr\u1ecdng trong s\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 tr\u01b0\u1edfng th\u00e0nh c\u1ee7a h\u1ec7 mi\u1ec5n d\u1ecbch v\u00e0 kha\u0309 n\u0103ng b\u1ea3o v\u1ec7 ch\u1ed1ng l\u1ea1i c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh. Do \u0111\u00f3, r\u1ed1i lo\u1ea1n h\u00ea\u0323 vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t d\u1ea5u \u1ea5n sinh h\u1ecdc m\u1ea1nh m\u1ebd cho s\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 ti\u1ebfn tri\u1ec3n c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft. C\u00e1c RNA kh\u00f4ng m\u00e3 h\u00f3a, bao g\u1ed3m miRNA (microRNA, RNA nho\u0309) v\u00e0 RNA kh\u00f4ng m\u00e3 h\u00f3a \u0111oa\u0323n d\u00e0i, \u0111i\u1ec1u h\u00f2a bi\u1ec3u hi\u1ec7n gen theo nhi\u1ec1u c\u00e1ch kh\u00e1c nhau, nh\u01b0ng ch\u1ee9c n\u0103ng v\u00e0 c\u01a1 ch\u1ebf c\u1ee7a ch\u00fang trong qu\u00e1 tr\u00ecnh sinh b\u1ec7nh c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5 ho\u00e0n to\u00e0n.<\/p>\n

Vi\u00ea\u0323c \u0111\u00e1nh gi\u00e1 s\u00e2u h\u01a1n v\u00ea\u0300 vai tr\u00f2 c\u1ee7a c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc m\u1edbi n\u00e0y trong qu\u00e1 tr\u00ecnh b\u1ec7nh sinh c\u1ee7a nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u00e0 ph\u00e1t tri\u1ec3n chi\u1ebfn l\u01b0\u1ee3c chu\u1ea9n h\u00f3a t\u1ed1i \u01b0u \u0111\u1ec3 ph\u00e2n t\u00edch c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc m\u1edbi n\u00e0y s\u1ebd l\u00e0 c\u1ea7n thi\u1ebft cho vi\u1ec7c s\u1eed d\u1ee5ng ca\u0301c d\u00e2\u0301u \u00e2\u0301n l\u00e2m s\u00e0ng na\u0300y trong t\u01b0\u01a1ng lai [5].<\/p>\n

T\u00e0i Li\u1ec7u Tham Kh\u1ea3o:<\/em><\/p>\n

[1] <\/a>Ti\u00eau chu\u1ea9n ch\u0103m s\u00f3c l\u00e2m s\u00e0ng nhi\u1ec5m tr\u00f9ng huy\u1ebft 2022<\/p>\n

[2]<\/a> Nghi\u00ean c\u1ee9u g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt to\u00e0n c\u1ea7u<\/p>\n

[3]<\/a>\u00a0Gregoriano, C. et al. (2020) ‘Vai tr\u00f2 c\u1ee7a vi\u1ec7c s\u1eed d\u1ee5ng procalcitonin trong vi\u1ec7c qu\u1ea3n l\u00fd nhi\u1ec5m tr\u00f9ng huy\u1ebft’, T\u1ea1p ch\u00ed B\u00ea\u0323nh ho\u0323c l\u1ed3ng ng\u1ef1c, 12(S1). doi:10.21037\/jtd.2019.11.63.<\/p>\n

[4]<\/a>\u00a0K\u00fcng, E. et al. (2022) ‘Gi\u00e1 tr\u1ecb ng\u01b0\u1ee1ng c\u1ee7a interleukin-6 huy\u1ebft thanh \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng huy\u1ebft \u1edf tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c x\u00e1c \u0111i\u0323nh b\u1eb1ng ph\u01b0\u01a1ng pha\u0301p nu\u00f4i c\u1ea5y’, Nghi\u00ean c\u1ee9u Nhi khoa, 93(7), trang 1969\u20131974. doi:10.1038\/s41390-022-02329-9.<\/p>\n

[5]\u00a0Kim, M.-H. v\u00e0 Choi, J.-H. (2020) ‘C\u1eadp nh\u1eadt v\u1ec1 c\u00e1c d\u1ea5u \u00e2\u0301n sinh h\u1ecdc cu\u0309a nhi\u1ec5m tr\u00f9ng huy\u1ebft’, Nhi\u1ec5m tr\u00f9ng & H\u00f3a tr\u1ecb, 52(1), trang 1. doi:10.3947\/ic.2020.52.1.1.<\/p>\n

\n

B\u00e0i vi\u1ebft n\u00e0y ban \u0111\u1ea7u xu\u1ea5t hi\u1ec7n tr\u00ean Roche Diagnostics Australia<\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

\u0110\u1ecbnh ngh\u0129a \u0111\u1ed3ng thu\u1eadn qu\u1ed1c t\u1ebf l\u1ea7n th\u1ee9 ba v\u1ec1 nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m tr\u00f9ng huy\u1ebft (Sepsis-3) \u0111\u1ecbnh ngh\u0129a nhi\u1ec5m tr\u00f9ng huy\u1ebft l\u00e0 ‘r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan \u0111e d\u1ecda t\u00ednh m\u1ea1ng do ph\u1ea3n \u1ee9ng kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u h\u00f2a c\u1ee7a v\u1eadt ch\u1ee7 \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng’. S\u1ed1c nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a […]<\/p>\n","protected":false},"author":1,"featured_media":85905,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"tags":[14783,14843],"pillarandcategory":[295,282,317,309],"reporter":[14949],"class_list":["post-147119","acf_article","type-acf_article","status-publish","has-post-thumbnail","hentry","tag-nhiem-trung-huyet","tag-xet-nghiem-mien-dich","pillarandcategory-sepsis","pillarandcategory-disease-area","pillarandcategory-immunoassay","pillarandcategory-operations","reporter-niti-dawar"],"acf":[],"_links":{"self":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article\/147119","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article"}],"about":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/types\/acf_article"}],"author":[{"embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":2,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article\/147119\/revisions"}],"predecessor-version":[{"id":148648,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article\/147119\/revisions\/148648"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/media\/85905"}],"wp:attachment":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/media?parent=147119"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/tags?post=147119"},{"taxonomy":"pillarandcategory","embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/pillarandcategory?post=147119"},{"taxonomy":"reporter","embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/reporter?post=147119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}