BỘ GIÁO DỤC VÀ ĐÀO TẠO BỘ QUỐC PHÒNG
HỌC VIỆN QUÂN Y
NGUYỄN HỮU DŨNG
NGHIÊN CỨU NỒNG ĐỘ BETA2-MICROGLOBULIN MÁU
Ở BỆNH NHÂN SUY THẬN MẠN TÍNH LỌC MÁU CHU
KỲ
LUẬN ÁN TIẾN SĨ Y HỌC
HÀ NỘI - 2014
BỘ GIÁO DỤC VÀ ĐÀO TẠO BỘ QUỐC PHÒNG
HỌC VIỆN QUÂN Y
NGUYỄN HỮU DŨNG
NGHIÊN CỨU NỒNG ĐỘ BETA2-MICROGLOBULINMÁU
Ở BỆNH NHÂN SUY THẬN MẠN TÍNH LỌC MÁU CHU KỲ
 Nội Thận - Tiết niệu
 62.72.01.46
LUẬN ÁN TIẾN SĨ Y HỌC
NGƯỜI HƯỚNG DẪN KHOA HỌC:
1. PGS. TS. Hoàng Trung Vinh
2. PGS. TS. Lê Việt Thắng
HÀ NỘI - 2014
LỜI CAM ĐOAN
 !"#$
%&%"' (%)*)+,
,-!.! 
Tác giả luận án
NGUYỄN HỮU DŨNG
MỤC LỤC
,
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/0$1
22

C88I(J)+
C8CI:*)+
CCE)1K K=Y
CC8ZT@
CCC II ?K:?  [@2
F\
CC=E)1K K[]&
CCFL-;:
Chương 3 59
KẾT QUẢ NGHIÊN CỨU 59
=89^6)+_\
=CD"R7T,NCO,P,&HF
=C8D"R7T,NCO,PS%
S
=CC#37TVC%XT^6
,&
==`&#$JVCP,&[@2K)1%#$JS&
J! a_
==89^6 S)X!&K;A
==CD"RTb ?" K%,"P K
S[@2K)1K K%#$JS&J! 

===`&#$JVC KS[@2K)1J
%#$JS&J! 
Chương 4 87
BÀN LUẬN 87
F89^6)+Ya
FCD"R7T,NCO,%#%XT
P,&!\a
FC8D"R7T,NCO,P,&c

TG: N@
THA: U" K
TNT: ':
UF: jhdcJe
VCTM: Lg':
VTBTM: L',6':
DANH MỤC BẢNG
Bảng Tên bảng Trang
D$88E:':<
D$8CE:'
D$8=E:,&':<
D$8FZ7TVC,)0T@AJ16
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D$=\>"#$Tm&'S,&
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DANH MỤC BIỂU ĐỒ
Biểu đồ Tên biểu đồ Trang
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@2#$JS)1+KJ%&J!~I

b_U^CWUv=Cw?vFWwc'"6'.
T%% +"6^,&
Z@ABJ-p&'^KPX
d8?=8e?P3!%(~S%P3S@T^,&)
)0‚^)0,NvFCw?vFFw?v_Ww?v_8wZUCWWa?Px
S-Kb_8FHFC,&':%Xp&4X=_=
,&ƒ&@TUva8w?vYCw?v88Hwp&1P
)0xK%X!$\\a,&ƒ&@TU%P
)0x@4CaC,&4Xƒ&@TU
3
vHaw?vHYw?vaCw:L&?)+'X4!$_WW,&
s&@sUvaHw
Z':<S;:! ?)0@T
 ,7,&g'?,&!y'?,&
: '?,&,I%@;„vaw?v88w
1.1.2. Biểu hiện lâm sàng, cận lâm sàng của suy thận mạn
tính
* Biểu hiện lâm sàng:@:iNT'%,&
26D&S3,6&P1#,P
'$^-UJ@r"J -T
 ?:&$?,GO,N$)P"-$ 1
#16vCWw?v88\w
…5)0S +@" %J $KI
6 ?S6S@4J
…Ei':@%g':)0Ki?)+:%
'O,6':)0!SKi?P:S6Ki@
6@)†
…" T" )1%XT^
'" @':)0" |4?4"
 ,  )0? !  - ‡ K$   U   7  g  P  p

XHWOYW€p&K:- UNT$U
'?P3,&SJg'_WsKQCH?a€?MP
3,&SJg'*C_"_WsKQ%@)XC_sKQ
p&=W?Y€%F_?C€)1 "K
:- `‰?" ?%@A?)0' K:
K ?:&g!(Tv\\w?v8C=wS?" 
T"#JQI# K:- ZZ@
dCWW\e-?p&K:- P3,&`‰Sc
1;%Xp&P,&`‰SU',)0
dFa?8€%X=8?8F€ev\\w
5
OD&:% ,6&,&:%PDZc
)0!‡?S6$P ,&dDZe !ŠKT
:%?-P3DZK:- ‡?S3)X;
^" ^>$CWOFW€DZcS,&" 
2,Tg^d!‡ &" 1
ev_w
OD&%Z"@%S%%R@)X
%? ,7},&]%R)1%
"P?<!ŠK%. )0^K1$%S% ?
"K"%S%T:NT $?%S%
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Ca?=€P,&c%^K=Y?\€P,&J !.vF8w?
v_Fw?v8C8w
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 evC8w?,&:%?
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KK v\w?v88Fw
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vF=w?vFaw?v\Hw
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* Biểu hiện cận lâm sàng:
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OK`%,, $!S'^
OEN $?K@ U
…lm&)X6
Oc)+)X6,&S&6?)+)X
6,)0;1,
OEN&,0}S"@,&g'KN&!$
CO=sCF0!'MŠ•'^^,&':
)+KN&<Z"@%'O,6':)+KN
&)0-K?@)X8sCF0
O`7g&S7g%6?)"':
)0!S7g&
OD:g&%%!I&!'@%'O,6':
S6S,:g&;%%!I&
O2&S6-2:^2?27g?2,:
g„iN<-R)1g'
Oj?N&-K'^%N&

* Nguồn: theo Nguyễn Văn Xang (2008) [31]
R)1':<"6':S6!m@_
O8WU^1iN($Q)+NKU?,6
&,G$Jg'5(NTM,iKg'
‰,N“q':F:v==w
11
Bảng 1.2: Phân chia giai đoạn suy thận
Giai đoạn
suy thận
MLCT
(ml/phút)
Creatinin máu
(μmol/l)
Chỉ định điều trị
q:,i aW‘F8 u8== D$7
q:M,i FW‘88 8==OaW\ D$7
q:-,i 8W‘_ a8WO8WHF
9;A"
q: u_ ’8WHF
* Nguồn: theo Abuelo J.G. (1995) [33]
>"     N  Z  >@N  z@”  >@N  5NN
kN•o%NdZ>zO>s5k•oeUCWWCv8WWwK:,&
':<@(%Jg')
Bảng 1.3: Phân chia giai đoạn bệnh thận mạn tính
Giai
đoạn
Biểu hiện
MLCT
(ml/phút/1,73m
2

Jg'
8_OC\
I,A K)1K K
;A"'
5 c' u8_
D4,T;A"
d"STUN
 e
* Nguồn:theo NKF-K/DOQI (2002) [100]
12

Trích đoạn Biến đổinồng độ beta2-microglobulin ở bệnh nhân STMT Hiệu quả lọc beta2-microglobulin của các phân nhóm

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