Y HOC VIET NAM THANG 2 • SO 2/2014
- Da xac dinh dac tfnh sinh hoc, ddc hpc
ciia
npc
eac loai ran dpc thffdng xuyen gay nan cho ngffdi
tai Viet Nam, Lao va Campuchia, vdi lieu chet
{LD50
yg/g/TM/)/
chudt
ciia
npc ran ho dat (0,4),
npc ho chiia (1,2), npc cap nong (1,4), npc cap
nia Nam (0,1), npc luc xanh mdi trang (0,5) va
npc Choam quap (6,1). Day la cd sd khoa hpc
can ban gdp phan giai quyet van de y khoa con
tdn tai, dong thdi md ra
chi/dng
trinh ve nghien
cffu che tao thudc
mdi ty
npc ran
Viet
Nam.
TAI LIEU THAM
KHAO
1.
Tr^an
Kien, Nguyin Quoc
Th^ng.,
1995. Cac loai
ran doc

Biochemistry 269, 99.
Warrell,
D.A., Looareesuwan, S., Theakston,
R.D.G.,1983.
Severe neurotoxic envenoming by
the Malayan krait Bungarus candidus. response to
antivenom and anticholinesterase. British Medical
Journal 286:678-680.
WHO Guidelines for the production, control, and
regulation of antivenom immunoglobulins. 2008,
30-210.
NGHIEN CU'U KET QUA
TUY
DO
Of
CAC BENH NHAN THIEU MAU
Nguyen Thi Minh Phuo'ng*,
Tru-ong
Thi Thao Hien*
TOM TAT
Thieu mau la roi loan huyet hpc gap kha thffdng
xuyen
d
tat ca
mgi Iffa
liuoi.
Tuy do dong mot
vai
tro
quan trpng trong chan doan cac nguyen nhan thieu

nhi/pc
sac HC nho
34,6%
va Uu sac HC to
6,1%.
Trong 506 BN thieu mau
dUcfc
lam
tiiy
do tang smh dong piasmocyte
chtem
16,6%.
tang smh dong HC chiem 15,2%; tuy giam
san dong HC
13,1%.
Bach cau cap gap
d
16 BN
(3,1%) trong do 11 BN bach cau tuy cap va 5 BN bach
cau lympho cap. 43,3% thieu mau
nhUng tiiy
do hoan
toan binh
thi/dng.
Ket
luan:
Tiiy
dd la
bUdc
quan trpng

hypochromic 34,6% and Macrocytic
hyperchromic
6,1%.
Out of 506 anemic patients was performed bone
marrow aspiration,
plasmocytic
hyperplasia was sew
m 16,6%,
erythroid
hyperplasia was seen
in
15,2%).
erythroid
hypoplasia was seen
in
13,1%.
Acute
*
Khoa
Huyet hoc lam sang Benh vien
TWQD
108
Phan bien khoa hgc: PGS.TS VQ Van
KhiSn
Y HQC VlgT NAM THANG 2
- SO
2/2014
leukemia was diagnosed in 16 patients (3,1%) 11
cases acute myeloid and 5 acute lymphoid leukemia.
43,3%

lam cac xet can thiet. Tuy nhien trong hau het
cac trffdng hdp chi cd xet nghiem tuy xffdng mdi
khSng
djnh
6\Jdc
chan doan. Dac biet trong
trffdng hdp thieu mau kem theo giam cac ddng
te bao mau va benh bach cau cap thi tuy do cd
vai trd khang dinh chan doan [3].
Tiiy
do cho
biet rd hdn phan ffng ve sff sinh san hong cau
ciia
cd quan tao mau trong tinh trang thieu mau
ma xet nghiem mau ngoai vi ddn thuan khdng
the biet dffdc ddng thdi cung phat hien dffdc cac
te bao la [3]. Tuy do dffpc lam thffdng quy trong
bpnh
vien de chan doan va theo ddi dieu trj cac
roi loan huyet hpc [3],[6]. Day la xet nghiem
xam lan nhffng kha an
toan,
rat ft hoac khdng cd
nguy cd chay mau tham chf ca trong trffdng hdp
cd giam tieu
cSu
nang [3]. Nghien cffu nay dffdc
thffc hien vdi muc dfch danh gia mffc dp thieu
III.
Kgt QUA

nghiem Benh vien
TIjQO
108.
- Tieu chuan chan doan thieu mau; HC dffdi 3,8
T/l;
HST d nam < 130g/l; d nff < 120g/l;
- Mffc dp thieu mau: Nhe: 90 g/l < HST< binh
thffdng;
trung
binh:
70<HST<90 g/l; Nang: <70 g
- Phan loai thieu mau:
+ Thieu mau HC binh thffdng (normocyte):
kich thffdc HC binh thffdng 7 micromet; HST binh
thffdng (dang sac); mpi tinh chat
ciia
HC binh
thffdng chi
sd
Iffdng giam. The
tich
trung binh
hong cau (MCV): 80-100
femtolit
+ Thieu mau HC to, HST nhieu (ffu sac): HC
to (d= 9-12 mm). (MCV) tang >100 femtolit, Gia
trj
HC Idn
hdn 1.
-1-

So lu'dng BN
2
53
124
129
198
280
226
506
Ty
le
%
0,4
10,5
24,5
25,4
39,2
55,3
44,7
100
Tuoi
trung binh
57,8
tuoi (11-91
tuoi).
280 BN (55,3%) la nam va 226 BN (44,7%) la nd: ty le nam:
nit
1,2:1.
SoBN
tren 60

So lu'dng BN
n=506
213
236
57
300
175
31
Ty le
%
42,1
46,6
11,3
59,3
34,6
6,1
Ba so BN thieu mau mdc do nhe (42,1%) va trung binh (46,6%). Chi 11,3% cd thieu mau
mdc
d.
nang.
Loai thieu
mau
dang
sac
hong
cau
binh
thddng
chiem
hdn mot

cd so Iddng ti bao tuy xddng trong gidi
han
binh thddng
(60,1
%).
Co 18,2%
BN
tii/
tang
so
Iddng tebao
va
21,7% tuy
ngheo
tebao.
Bang
4: Ket qua
tiiy
do
ciia
cac
BN
nghien cifu
Chan doan
Tiiy
xu'dng binh thudng
Tang sinh dong hong cau dap irng thieu mau ngoai vi
Tiiy
tang sinh dong piasmocyte
Hoi chirng roi ioan sinh

12
6
506
Ty le
%
43,3
15,2
16,6
1,6
0,9
2,2
0,9
0,9
1,6
13,1
2,4
1,3
100
Ket qua
tiiy
do cho thay
tiiy
tang sinh ddng
piasmocyte trong benh canh da u tuy xffdng la
phd bien nhat chiem 16,6% BN trong dd
b/
le
piasmocyte chiem tff 16% den 77% so Iffdng te
bao cd nhan trong
tiiy

AML-M5 vi
1
ML-M6.
Tat ca
5
BN bach cau lympho cap
deu
li
ALL-L2.
Cd
219
BN chiem 43,3% thieu mau
wB
giam HC hoac huyet sac to nhffng tuy do
hoan
toan binh thffdng.
Y HQC VlgT NAM THANG
2 -
SO 2/2014
IV.
BAN
LU/kN
Tuoi trung binh
ciia
cac BN trong nghien cffu
ciia
Chung tdi la 57,8 tudi (11-91 tuoi) cao hdn
nghien cffu
ciia
Pudasaini d Nepal vdi dp tuoi

Pudasaini,
Jha va cs ddi vdi cac BN cd thieu mau
ffu
she
hong cau to
chimg
tdi khdng dinh Iffdng
dffdc axit folic va vitamin B12 [4]. Ty le thieu
mau ffu sac HC to
ciia
Pudasaini cao hdn kha
nSng
do ty le thieu hut dinh dffSng cao hdn trong
cac doi tffdng nghien
cffu.
Ty le thieu mau nhffdc
sSc
HC nhd 34,6% cao hdn cua Pudasaini ia 7%
va tffdng ty nhff cua Ahmad va cs 23.8% da sd
liin
quan tdi thieu mau do thieu sat [1].
Chi djnh chpc
tiiy
dd phd bien nhat trong
nghien
culi
nay la thieu mau trong nhieu benh canh
khac nhau 202/506 BN chiem 48 % sau khi 6a loai
ffff nguyen nhan mat mau do xuat huyet cac
phii

do
hoan toan
binh
thffdng chiem tdi 43,3% va tang
sinh lanh tinh ddng HC dap ffng vdi thieu mau
ngo^l
vi chiem 15,2%. Tang sinh ddng
piasmocyte trong benh canh da u tuy xffdng
chigm
16,6% vdi ty le piasmocyte chiem tff 16%
den 77% so
Iffdng
te bao cd nhan trong
tiiy
kem
bien doi hinh
thai.
Cac nghien
ciili
khac thay ty le
tang piasmocyte trong benh canh da u tuy xffdng
dao dpng tff 9,04% (Jha va cs den 20,5%
(Laishram va cs) [3], [6]. AsimMomani va cs bao
cao ty le tuy do binh thu'dng d cac BN cd thieu
mau do cac benh ly man tfnh thap hdn trong
nghien cffu
ciia
chung tdi (18%) [2]. Tang sinh
ddng HC dap ffng vdi thieu mau ngoai vi chiem
15,2%.

Trong tat ca 66 BN (13,1%) thieu mau do
tiiy
giam san ddng HC thi sd Iffdng te bao tuy
deu giam va hau het cd ffc che 3 ddng. Ket qua
nay tffdng ty nhff cac nghien cffu khac la 19%,
29%,
14% [4], [5]. Pudasaini va cs phat hien
thieu mau do giam san ddng HC chi d 5,3%. Ca
nghien cffu
ciia
chiing tdi va cua Pudasaini chan
doan giam san
chii
yeu dya tren
tiiy
do ma chffa
cd
dieu kien
lam dffdc smh thiet tuy. Cac khuyen
cao
ciia
cac Hdi Huyet hpc truyen mau Hoa ky va
chau au thi trong trffdng hdp nghi ngd thieu mau
do
giam
san
tiiy
hoac suy
tiiy
can phai lam ddng

cd 1,8% benh Leishmaniasis.
V. KET LUAN
Qua nghien cffu tren 506 BN thieu mau tai
Benh vien
TTjQD
108 chung tdi
riit
ra mpt sd ket
luan sau: thieu mau
myc
dd nhe (42,1%) va
Y HOC VIET
NAM
THANG 2 - SO 2/2014
trung binh (46,6%).
Loai
thieu
mau
dang
sac
hong cau binh thffdng chiem 59,3%. 62.5% thieu
mau khdng
do cac
benh
ly
tiiy
xffdng
vdi
tiiy
dd

of
Bone
Marrow Examination
in
a
Secondary Care Hospital
JRMC
2011;15:40-1.
2.
AsimMomani,
RameKhasawneh
(2012).
Spectrum
of
Bone
Man-ow
aspirabon test resultsat
Prince
Rashid
Hospital/Jordan.
A 3
Year
Experienceint J
Biol Med Res. 2012; 3(2):
1648-1650
Egesie OJ, Joseph DE, Egesie UG,
Ewuga
03.
Epidemiology
of

Cases
of
Pancytopenia.
JIACM
2001;2;55-9.
Laishram
S,
Shimray
R,
Sharma
AB,
Pukhrambam
G,
Singh
AM,
Sharma
LDC
Neoplastic lesions
in the
bone marrow:
a
10 year
study in a teaching hospital. JIACM 2008;9;175-8.
Pudasaini, Prasad
KBR
(2012). Interpretation
of bone marrow aspiration
in
hematological
disorder Journal

tai
thanh phd Ha
Npi.
Ket qua nghien
cyu
cho thay: Ngffdi nghien chfch ma tuy dang doi mat vdi
cac hanh
vi
nguy
cd lay
nhiem
HIV
nhi/
tud'i
bat
d'au
tiem chich
ma
tuy,
sff
dung chung bdm kim tiem
khi
hem chfch
ma tuy va
khdng
sy dyng
bao cao
su cho
tat ca cac lan quan he tinh
dye.

in
Hanoi city.
The
study results
showed
that;
injection drug users who are facing risks
behavior
for
HIV injection such as
mibabon
of
injection
daig
use, sharing needles used
to
inject drugs and
not
Bui Thi Nga*, Nguyen Anh Quang*,
Nguyen Thanh Long**
using condoms
for all sex
times. This
is the
risk
behavior interventions should be aimed
at
reducing the
prevalence
of

65.133 ngffdi
tff
vong
do
AIDS
[1).
Cac dffdng lay truyen HIV
chii
yeu
d
Vi|t
Nam la
diing chung bdm kim tiem (BKT)
khi
tiem chich
ma
tuy
(TCMT)
va
hanh
vi
hoat dpng tinh
due
khdng
an
toan. Khdng
chi co
hanh
vi
tiem chich