89
,{eq
egq
r9oq4
'?gqr
rrglq r4r{,
91
:3wnqd eip
_91
ng-,{
19. €r.rr Bu.gnq
{u.B
op
pl
rgE
9p
Egrt
nrlu
'ifpu
diq
5Eqnrl
8uorl
lxue,
pntlt
nl qcq ,{93
ugqu ue{n€N
'txu€,
ronw rg^
rlrr{r
pl
€gri rrlofi{E

gr
r-xse,
?irl
19.
?€rq
upqu eG
'9r
ursoe nplu rugnrlu 3u!, ffuer
1311.
'lgnq]
4{
g^
4gs
res op
Irpl Igp
,q?Itlu
dnJ
url.{xo1€ruoi{ Illpqd
Q^
rugp quex nFur
lEq
c9p
dpp ,{€q
19w
u9? ugl rugp d€q
'.fl,
qupq? 5onr1 dgl rloq
'19,
1€q
'mq ltr{

19qd
gp
,!ls
€F
liq+
€4. urpl1
IrH t
rutl
u9,
nse
lOuI
gl
FuBc ,{gc oEp
IO$l
lpnp
otx o€l
8u.og
,{9iI1
lrl{ 91
19r
FD{
Eu4,
'rugx
rgoq tuF4 nplll 8uo
!11
9r
ol ogoq
n;p
tugq{ gqu 01 uqrt
qtr{

!q
9p
opq
_$
,9c 3ao4 ctoq
?{
Suorl rxu€c
q
qc-rl
ns
el oG
Fu{mp
utol op €9rI
rxuaC 'I
-(uorlBrrJrrl€,
,r4els€lelu) u9, 11) op
€9r{
rxs€c
-q
rd8
19.{nq
rxuEr
,I
r{u?q 8gp?
ns
u9p u€nb ueII r9q{ Itol
p^
(uoqergrclBc crqdo4sdp)
3u0np utq op e9q rxEe.
fl

'rxu€r
r.o^
l_op
qu€ur
9rI{
,,r{u_rl
I9,, 9r
nr{u
qulq rtrqr
p1
-9s
loul
€r
rpoSN
Iq
rtoq €9r{ rgor{t
nqu
qFqr
qc_r1
IBp
,{Eq1
!q
Ep
opq
91u
Sulrr{u
I
Suop
SEEI
?p

dpa 5qQIIr$ Suop
-
SIIpl
r-cuE3
'opq
gru
I
rxrrBr romu rgc
4l
quOq
Suop
3u9l
irs
EI
€9r{ rxu€C
'
1o,1r"gr"1"C)
egq nuea asonl uQrr{
4l
qulq
rxuer 3u6p SuFI
ns
u9p dp,
gp
IIlt
dpu
]pq
I^
wtqd
'€oII{

1!q.
qug
nr{u,!4
no,{ ,{_€ur op^ rgnr{+ nqd 3uenq4 uq
poq
Sutp
p rjueC
%3ur}I-6
41
Ssgoq{ Suort
lBp
Ieql 3u0nl ruqq'3u,on1
19dnr{
Suort
u€1
€ot{
eC
'n9ur
SuorJ
9q1
rlcip c9c 3uor1 uor 8trgp :urelord
!.0^
l-e{
q?ll
SuEp
p
Stl.on$
'oeq
gltr
,9t trorl

thudn
Iqi cho canxi l6ng
dgng. Song
gi6
thuydt
ndy
cring thi6u nhriag
d6u li6u
aldy
dri dd chring minh
ch6c ch6n. {' ki6n
th6c cho rlag
axit b6o hiah thenh
hong
m6
bdo hoai tt k6t hop
vdi canxi t4o
thdnh
x.iL
phnng
-
canxi, chdt nAy
s6 dud.c
thay thd bdi cdc
g6'c
photphat
ve cacbonat dd tao tfi{i.Dh
c6c mudi cmxi
d6
l6ng

tdng dQ
pH
lem
cho Ca* vd PO, dE
hdt
hd.p tao thenh
cac mu6'i
photphat
vd cacbonat
tich tq l4i. Giri thidt ody
ciing
chua
giei
ihich
du0c sr.r
it l6ag
dgng canxi A c5c cd
quaD
vdn
gidu
eazim
photphataza
ki6m nhu
thAn, ai6m mqc ruQt v.v.
Canxi h6a
do loan
dutng
hay
g{p
6

giun
bao, nang du s6n nlm chdt trong rhO
do
kh6ng hodn
thanh
chu
k;i'
vdng
doi
v.v.
2. Canxi h6a
do fi
cdn
D6 ld
su tich
tq
mu6'i
canxi 0 m6 bdo
c6
li6n
quan
ddn sq tdrg k6o ddi
ham
lrrgng
canxi huy6t. Trong
k}li d6 md bdo bi rinh hufng kh6ng x6y ra
tdn
thudng
trudc
d6.

v6 cd trong huydt
tuong. Tdn thudng
ben
gi6p
thrt
ph6t
xey ra
hong
trulng hgp ndy clidg h6 trg
cho
sg
l6ug
tlong cami;
3- HiCn tuqng canri h6a lan trdn & v6ch dQ.g m4ah
vd cdc t6' chic kh6c
c6 thd
vi €!g canxi huydt do
qud
Dhi€u Vitamia D
troDg
khdu
phdn
thic 5u. O il6ng
vat c6 thd
e{p
d
gia
sric tlugc cho dn
nhidu vitamin
nhdn

Jamaica v.v Ngr:di ia cho ring c6
mQt
s6'cdy,
trong 16 c6
59
chfa
mot hqp
chdt steroid-glycosid
gi6'ag
n}lu
1,25 dihydrocholecalciferol
(hoat
h6a chuydn h6a vitamiD D) c6 vai trd chinh trong nhrlng
trudng hqp bCDh niy.
Sq tich fit canxi trong trudng hqp ndy trudc hdt
vd nhidu nhdt lA
d c6c soi
chun
cria
tim, dOng rrrach chri, dOng mach cd. Ngodi ra cdn
thdy cri
rl
sif chun
nlu m6
phdi,
Lhi
quin,
sqn
phd quin
vd van tim.

Ddy hien chua bi6t 16.
Tdc hqi cria sq
l6ng
dang
canxi byanh li
phu
thuOc vdo vi tri xey ra va muc
dO cia su kdt tra. N6 c6 thd
gay
tr& ngqi v6 chrlc ning,
giem
rn0t
phda
cudag
dO hoat d0ng cria cd
quan
bl 6ah hudng. Nguy hidm
nhdt
]d carlri
h6a xdy ra
6
tim, thdnh m?ch
quan,
de d6n ddn
nhrlng r6'i loan
tudn
hoin, ihem chi
gay
xudt huydt dOt ngot c6 thd d6n d6n tri vong.
VI. BENH

kdt
quanh
c6c
khdp, sgn venh tai
vA ddi khi ce tren thanh mac van tim, than
vi
tui xudng. O c6c kh6p xuobg, c6c
ddm tinh thd Urdt hiah
LinI
dugc
bao
quanh
bdi ving
phdn ring
td bAo
phric
t4p vdi nhtllg td bdo
khdng 16
"dj
v{t",
td
bdo da nhan vd tEDg sinh
m6 li6n k6t
r mg
quanh
thdnh
cuc
git
(Tophus).
BCnh

tr5ng
xam hay vdng LAng,
cung.
Qua
kinh hidn vi thdy trong
6'ng than cec
finh thd urat tri61
quang,
mo bdo
*utg
quaoh
iho6i
hod, hoqi t1i
ho4c tan roa, b6n carh
c6c tinh thd urat c6 c6c
te bao knong l0 or
vai .
Nhdi urat thQn
(Infaretues
uratique)
Thdy 6 d6ng v4t so sinh trong
nhfng ngdy cldu.
D6 la
do
urat tang
nhi6u
trong co thd, chua thAi
h€'t
qua
nudc tidu

bidt
ring axit uric vd urat
ld sen
60
t9
rnq
??1q
uEqd
.9q+
9C
Pr{1
pr
3lro4 r9qrl
Ipu
,9t dpltl
!p
Enp I9r
l_-onu
opq Jnql
r€p
,9r
iq
gu4q,
pI
1,equ
,{_eqt 8uenql Sunqu
'gr{druq
o?q
_?t
r9r EIL13 rugu

_,aqd
19, qce^ .3uo4 urpu 3u4qJ
Igqd
o
oFq uErS
p r!or{ o€-q
_9?
1Jlqr
qurs
uqdn€Il Suorl uleu oqu ueqt rnq
leq
JeJ
:ptfi
6
eA
ueqt
rnq
'rorDl
nerr{u
91
3u+r
f
3s9s
19^
€uop Sullqlt
E^
rarrSu
I
er dFx
3u{nq1

!9q1
p,
oP^ €-o8u
41
uErll
rnq
1tr{
r-€r
9p
8uorl
r{u?q
itol
uEqS
Ihq
quga
(sIsoc€rqluv)
N]rHI INS HNTIS
'uqtlJltLg
'ulleprsouraH 'urprolettteH
qrqi
(ua'ourqolSouaq)
ngur
._93 uoll8u
o?
rgS -
'urxrnJodrl
p^
{uruB{oul)
_91
,9rl

91
lEol
lgur
elr
1_?r1
-or{r
4s
op
'er{l
or
3uor1 er qurs pl J€s JeJ e.I :rgl rQu
9l
c€s cgc
'{-^-^
urtoe,
'rEol
uID{) rnq l€ol
c9c
-
'uEqJ
-
iEp rlorl
Bqrl
n?9
'd_Eq
9q
Suenp €nb
qql
.or
op^ dgr{u rugx e^ rpo8u u?q €1 ugl

"€q1
pc
8uorl
.{_9i{1
.91
,gs
9q
upol u_Qp d9.
9p
Aub^ urEql
9r
Sugqrl
4
SuBqC ob1 ngr
€^
t€r{r
qu4 o^
nqu
S!IB' r,9; ugn-8u e^
n€r{u
Jeq{
ler
Itol
nerqu or ol JeS
^ ^-
er{l
€uPor{
B}c Fup^
npw
'r91 'Fuql 'ep

u
HNd{
gr
cYs cNoc cNY.r
ns
u9r1 p uEql
lBrn
roqu
p^
t!5
quoq
CI
qE.rq u9lP'.9q:l u€ol r_qr 3u8qu dg',o€q
gru
Suorl
rel
Suop
9s
Sulqr
F^ 9u
EFr r_gnur
pA
rrrn
lrxe
nglr{rr
gnb
qupq? qur-q
ns
u€p Enp
urelordoalrnu

I^
upp
FI
Io€
Sugu rlrr{r
4l
r{Ers i^
Epp
lOur
qupql
€t dpq &qrs
oFq
-9?
p^
91
,9r{
oPq
9J
'ugr
UPI 3u4s oFq
,$
,9,
,{€q
!q
8unnq1 opq
91
19, SEss
up,{nqt ,bnp urueleul
'dbq
5u91 ,bnp

aI!.E1 ,9nq1
opq
91
tgc
41
€r qurs tDnG
3s9p Ero1ord dbt{ c4t{d
9I
'€zeulso l
unzEo
€Irr Suirp c91
19np Egrl
{xo iq Fzo
l
€1, ueqd
u9s
FI
ulrrElotr
l
'€q
Ipu
ugp
6u Ips
41
'r9rl{
o€q
91
5E€s
dpu oPq
_??

OT
CYII
'IPqd
nql
8un
'{93
r(I{
9.
'prl+
gr{1l
t9^
uoa wq
rlgqd
px
1'€p ugp
'quJ1
ugrrr 5upnq1
ugc .{9.3 r,otld 5uo4
ngl 14 Egl
f,pu rirq Itol c9C
^-^
(srso4seqsB)
Su9rur€
Fq
r{EOq
P^
(srsourclec)
19^ Inq
qs9q
'(srsoreprs)

qugq
tuop
SIIqI
r{ulrt
gnb
.(Eg d,grl
9q
SsQnp
€nb oP^ 3u4r{t
PI
lFqu
,t-9ql SuanqJ

^'^
ep
'9oq
nell
SuQnp
'd€q
oq SuQnp
'n€qu
39tI{ 5Eo.np
ngrqu enb
9q1
pt
o?^
€4p r.onp
-e^
rqo.8c
II?q SuQrrr?

9nb
.{93
'1!}^ ip
19ur
nqu
3u9p c91
9u
'u9l
Ssbnl
9s
l9^
Pl
+€r{II €^
,{Fr rnq EIrc
Ipp
n91
liur 9c
is
SunqN SrIPs
urgl n?q
n"p
gc
Asgqrl
nqu
SuBr
ugl
rtq ,91
,{93
Sugq{
ueql

,{,9q1 5uanq1
,{9^
rA rcp u€€
@ql
19tu
3tto4
s€q1
iflq c!or{ rgq{
r9qd
1lq
s?{nx SuQnq?
op
"-r
f9x u€ql
dlq quog
'$eq1
rnq
1tq
r9r
rrl'
o€q
cir{1
Pp
nglqu
9c
r.ou
'qacq
4nl
ftqt^
q

'tgrjFt
nprE.{X4
1,9q.
,9.
,toq rgur
Scnp
cgt
Eoq
npul
19ru iq
SuqrFl
5ur.!qt
c4qc
.ol
"9q
dFI{d
Supnqd
rB^
q^
9r
uop
nqru
9c
3u}tlc
gqc q
,9q{
}ol
tls
t93 r9^ sEql
t9

rBs nglr{u 3un4 dgl uruePul
oc 5u+A
di3
1l
r9qrl r4s €r3
'?p 'aq
g dg5 deq (urgur
8ue-ur
0
n9-{
r"rqr)
{q
opu 8u€w p
tlerq .9q quOS
'wg
3II4
ggqd
90
€u4^
SuILqu
.er
dgqu
ulgx .{pu oPq,??
Jgi
IIFI rgc
ox
opq
u9,{n-3u 19?
r9^
uel

-n*
"uU "U;:H
grlr
rgl
ns
op
ugr{1 upol t{uls
rrr€q
_91
rptl Esol
r,9r r{u?q
lgul
-€l
9G
.9qrl uEnb
pc
r9r
_9s
?olu
-€^
ogu
'ss8 'Ilqc
qrtur Ssgp
'r€ru
u91
r€o3s
'IBt{d
Supur
'rpqd
nrlu gq1

3u4tl.
'(sIsouEleIII)
u_grq
r-€q qu0q
'(eulouelow)
g1
,gr{ n :nes d.oq
8upnr1 t9t 5uo4 uOrq
19nx
9rl?
9.
uruETelu
'tuerrql
19q
ug|,l
nglp 3u4qu 3uor1
,{€q
4l
qu?q dbq 3uQnr1 SuorJ
.qu,DI
u.€q]
opq
_??
3uo4
9r
uru€laru op
uap nplrl
9c
ogu
€nt urgx

19nr
B
-g
:r9s nPuI
9t
rtur
r{ctlu
'1glu
3r4ru
oi{r urpl ulu€lel^tr
-t
:rls €13
I€ol
!s
lOuI
r€ur ru?g
q
9c
It
Iq{
9r
sluelall -€
:(sourql€)
8ut? qrEq Sqbnq
uglq
q ro3
'gq]
o,
u?rl .9r{{ ueqd
9q

ugq
jrs
9r
op
pl
tugx €n€N
.3u9r6 op^
rgnr$
nr{d
"ot{1
9r
'Ig^
nqu
3upn1 u6rq
or
augr+l
Iq1
o?ru
'9qt
p
sap €p
9,
9p
g'dl
'ngu
Qq
I
nl{u
5u!lr ngu
9p

9?
p
It
urEq
91
t-es
9i
uep ep
rQn5u rloq uap
nPur
9t
19^
Sugp
O
ru9tu Srgt
',igp
d9l
p uPot
{Poq rgoii
u9i E€qd
'gur
n.glq oFq
-91
19qr
quls
u?,{n5u 3uo4
uap
d€q ngu
nFur gqu
1tq

qqg
'3oNFv
€Fr SEnp
r9?
Ignp
uop
npIII
l{uFql
E^
zOzH
rpq nPru
19ru
SuJtq.u
''oJoroF
tqoq
ugc
pzEq
'1r-x€
rg^ cor{
e9q 3u4
uPqd
eI: ur€ql
Sug(I{
'pt
n4q
rglu Sunp
?uor1
uet
poq'(d) ol{dlot{d
€^

u,Qdni
.ue5
nqu er{t
Jnql
uenb
p,
.9.
1_?q
n9q g :pr
'r.os
€1, oFu
lou nr
lpq
dgql
.?q1
9r
u9^
o, o
:(91-z
I{uY) Egt{u Er.Ir rn? IEI{ p .3uru1 d-4 8unq, ur1
.oi
oEq g}
O
npqu r9l{)l urgp
ltqu
€ue-^ n€rrl
1tq
.8unr{u
€I
;rlQnql

,E, oqr
ule-l
ldns
ogl op oe1 fErl r.Qur dns iq oeq our JeJ p norqr u;q
lenx
urJsnJodlrl
-
^'^
d9€ u_g-{nl
'uPoq
qurt
'ueoq
quq
C{
oEq
9?
Ir{uI1
qrl
rugql
Supnq+
9^
'ue8 'qul1f
lrgt{l oE-q
,?1
'ue^
pt
'u4
or nqs
u€nb
p,

rugnqu'3rdII e+c rqur Sunp
,9,
rpq uq
Foq
iq
€ugqrl
'zOzH
rnr
gunp
c91
iq
qI
'np(rl 19ru
!q ep
ftmqu
'pz€q
€^
llxe
!9^
3u4
upqd
8uqrpl urrsnJodrT uralordod{ dBq
€oq
oEq 5u9q{
ogq
$xe
d.oq 8u+rt
p^
€9rI
dxo

oq,
'€dop,,
5u4 ugr{d
uIPl II{)t tbnp u?rq
19qd
El
ron;N
-o1
J€q
FuQqrl
.01
JEq n
€l
rbA
dpu
dbq .Supnrl
p^
luOq
?gqd
9WM1
.91
rqq uFq
n9H1 cgoq
1r
n_?u Sunr{N uep
ngul
!-L
ieq1
!^
ugt

,{Fx d€q dPu
n
'n€x
Subnl s?r1
9i
5uQnql 3r4qu
'rgp
gr{1
9c
'rluj1
qupl eq1 or
91
igq
o
'(o1.drou€Frll)
o€q
_91
,pq
F^
(?s€Iqoueleru)
_91
,9tI oPq ugln5u el,
n
Pl 9G
(urouBlaE)
gl c9q
I
,6
'r9r{d
up

p^
Sueu gqd qc9^
'4nq1
ngrl r9c BIII€
u&u
;o?
rqq €4qi
E{
u?ll
gru
oPq
.91
,9c
^gq1
gq1
l^
gA
er
uFq Sutp
gl
tuEol
Igqd
oqr IUFI 8uQnq1
qurq 8ul^
qr^
u?l
(lpr{d ,{nq1 ngll tpc
.r.9^
3u4 3un41) urgs
n9u )ioq

'ue?
opq
_4
rgr €Ill€
q{
cnq,
91
'Ee8
Suplu
I
f,-9q1
Pq1
$
191[
9A