{"id":9012,"date":"2021-10-27T10:33:27","date_gmt":"2021-10-27T03:33:27","guid":{"rendered":"https:\/\/www.oucru.vn\/nghien-cuu-tai-dinh-vi-thuoc-cho-thay-tamoxifen-khong-co-ich-trong-viec-dieu-tri-viem-mang-nao-gay-tu-vong-do-nam\/"},"modified":"2021-10-27T10:33:27","modified_gmt":"2021-10-27T03:33:27","slug":"nghien-cuu-tai-dinh-vi-thuoc-cho-thay-tamoxifen-khong-co-ich-trong-viec-dieu-tri-viem-mang-nao-gay-tu-vong-do-nam","status":"publish","type":"post","link":"https:\/\/www.oucru.org\/vi\/nghien-cuu-tai-dinh-vi-thuoc-cho-thay-tamoxifen-khong-co-ich-trong-viec-dieu-tri-viem-mang-nao-gay-tu-vong-do-nam\/","title":{"rendered":"Nghi\u00ean c\u1ee9u t\u00e1i \u0111\u1ecbnh v\u1ecb thu\u1ed1c cho th\u1ea5y Tamoxifen kh\u00f4ng c\u00f3 \u00edch trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o g\u00e2y t\u1eed vong do n\u1ea5m"},"content":{"rendered":"

Nghi\u00ean c\u1ee9u t\u00e1i \u0111\u1ecbnh v\u1ecb thu\u1ed1c cho m\u1ed9t d\u1ea1ng vi\u00eam m\u00e0ng n\u00e3o g\u00e2y t\u1eed vong do n\u1ea5m cho th\u1ea5y Tamoxifen kh\u00f4ng c\u00f3 \u00edch trong vi\u1ec7c \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh lo\u1ea1i b\u1ecf nhi\u1ec5m n\u1ea5m.<\/strong><\/em><\/p>\n

K\u1ebft qu\u1ea3 c\u1ee7a th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 tr\u00ean eLife<\/a> g\u1ea7n \u0111\u00e2y \u0111\u00e3 d\u1eadp t\u1eaft hy v\u1ecdng r\u1eb1ng Tamoxifen c\u00f3 th\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t cho b\u1ec7nh nh\u00e2n m\u1eafc m\u1ed9t d\u1ea1ng vi\u00eam m\u00e0ng n\u00e3o g\u00e2y t\u1eed vong do n\u1ea5m.<\/p>\n

Nghi\u00ean c\u1ee9u cho th\u1ea5y vi\u1ec7c th\u00eam Tamoxifen v\u00e0o ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng n\u1ea5m ti\u00eau chu\u1ea9n kh\u00f4ng gi\u00fap \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh lo\u1ea1i b\u1ecf nhi\u1ec5m n\u1ea5m kh\u1ecfi d\u1ecbch t\u1ee7y s\u1ed1ng c\u1ee7a nh\u1eefng ng\u01b0\u1eddi m\u1eafc vi\u00eam m\u00e0ng n\u00e3o. C\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y nhi\u1ec1u b\u1ec7nh nh\u00e2n g\u1eb7p r\u1ed1i lo\u1ea1n d\u1eabn truy\u1ec1n trong tim khi d\u00f9ng Tamoxifen, m\u1eb7c d\u00f9 c\u1ea3 hai nh\u00f3m nghi\u00ean c\u1ee9u \u0111\u1ec1u kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng.<\/p>\n

Vi\u00eam m\u00e0ng n\u00e3o do Cryptococcus l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong h\u00e0ng \u0111\u1ea7u \u1edf nh\u1eefng ng\u01b0\u1eddi nhi\u1ec5m HIV, nh\u01b0ng c\u0169ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng nhi\u1ec5m HIV, d\u00f9 h\u1ecd c\u00f3 suy gi\u1ea3m mi\u1ec5n d\u1ecbch hay kh\u00f4ng. H\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m \u0111\u1ec1u do m\u1ed9t lo\u1ea1i n\u1ea5m c\u00f3 t\u00ean Cryptococcus neoformans (C. neoformans) v\u00e0 x\u1ea3y ra \u1edf nh\u1eefng khu v\u1ef1c nhi\u1ec7t \u0111\u1edbi, c\u00f3 thu nh\u1eadp th\u1ea5p. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n v\u00e0ng l\u00e0 k\u1ebft h\u1ee3p ba lo\u1ea1i thu\u1ed1c: ban \u0111\u1ea7u l\u00e0 Flucytosine v\u00e0 Amphotericin B, sau \u0111\u00f3 l\u00e0 Fluconazole. Tuy nhi\u00ean, ngay c\u1ea3 khi d\u00f9ng ph\u00e1c \u0111\u1ed3 n\u00e0y, m\u1ed9t ph\u1ea7n ba b\u1ec7nh nh\u00e2n v\u1eabn t\u1eed vong trong v\u00f2ng 10 tu\u1ea7n sau ch\u1ea9n \u0111o\u00e1n. B\u00ean c\u1ea1nh \u0111\u00f3, Flucytosine g\u1eb7p h\u1ea1n ch\u1ebf l\u1edbn v\u1ec1 t\u00ednh s\u1eb5n c\u00f3 v\u00e0 chi ph\u00ed, ngh\u0129a l\u00e0 thu\u1ed1c n\u00e0y hi\u1ebfm khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf nh\u1eefng n\u01a1i c\u00f3 g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt cao nh\u1ea5t.<\/p>\n

\u201cTamoxifen th\u1ec3 hi\u1ec7n ho\u1ea1t t\u00ednh kh\u00e1ng n\u1ea5m ch\u1ed1ng l\u1ea1i c\u00e1c lo\u1ea1i n\u1ea5m men kh\u00e1c nhau trong ph\u00f2ng th\u00ed nghi\u1ec7m; ch\u00fang t\u00f4i c\u0169ng \u0111\u00e3 cho th\u1ea5y r\u1eb1ng thu\u1ed1c c\u00f3 th\u1ec3 ho\u1ea1t \u0111\u1ed9ng hi\u1ec7p \u0111\u1ed3ng v\u1edbi Amphotericin \u0111\u1ec3 kh\u00e1ng 2\/3 s\u1ed1 ph\u00e2n l\u1eadp l\u00e2m s\u00e0ng c\u1ee7a ch\u1ee7ng Cryptococcus trong kho l\u01b0u tr\u1eef c\u1ee7a ch\u00fang t\u00f4i. Ch\u00fang ta hi\u1ec3u r\u00f5 v\u1ec1 Tamoxifen, thu\u1ed1c kh\u00f4ng c\u00f3 b\u1eb1ng s\u00e1ng ch\u1ebf, gi\u00e1 th\u00ec r\u1ebb v\u00e0 ph\u1ed5 bi\u1ebfn r\u1ed9ng r\u00e3i. Do \u0111\u00f3, n\u00f3 l\u00e0 \u1ee9ng c\u1eed vi\u00ean \u0111\u1ea7y h\u1ee9a h\u1eb9n cho vi\u1ec7c \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o do Cryptococcus\u201d, B\u00e1c s\u0129 Nguy\u1ec5n Th\u1ecb Th\u1ee7y Ng\u00e2n, \u0111\u1ed3ng T\u00e1c gi\u1ea3 th\u1ee9 nh\u1ea5t v\u00e0 B\u00e1c s\u0129 l\u00e2m s\u00e0ng t\u1ea1i Khoa B\u1ec7nh Nhi\u1ec7t \u0111\u1edbi, B\u1ec7nh vi\u1ec7n Ch\u1ee3 R\u1eaby v\u00e0 \u0110\u01a1n v\u1ecb Nghi\u00ean c\u1ee9u L\u00e2m s\u00e0ng \u0110\u1ea1i h\u1ecdc Oxford (OUCRU), Th\u00e0nh ph\u1ed1 H\u1ed3 Ch\u00ed Minh, Vi\u1ec7t Nam, cho bi\u1ebft.<\/p>\n

\u201cCh\u00fang t\u00f4i \u0111\u00e3 thi\u1ebft k\u1ebf m\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh xem vi\u1ec7c s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n t\u1ed1c \u0111\u1ed9 kh\u1ecfi nhi\u1ec5m n\u1ea5m Cryptococcus hay kh\u00f4ng – \u1edf c\u1ea3 b\u1ec7nh nh\u00e2n vi\u00eam m\u00e0ng n\u00e3o c\u00f3 HIV v\u00e0 b\u1ec7nh nh\u00e2n vi\u00eam m\u00e0ng n\u00e3o kh\u00f4ng c\u00f3 HIV\u201d, Ti\u1ebfn s\u0129 L\u00ea Thanh Ho\u00e0ng Nh\u1eadt, \u0111\u1ed3ng T\u00e1c gi\u1ea3 th\u1ee9 nh\u1ea5t v\u00e0 Chuy\u00ean gia th\u1ed1ng k\u00ea sinh h\u1ecdc t\u1ea1i OUCRU, cho bi\u1ebft th\u00eam.<\/p>\n

Th\u1eed nghi\u1ec7m c\u00f3 s\u1ef1 tham gia c\u1ee7a 50 b\u1ec7nh nh\u00e2n – 40 ng\u01b0\u1eddi nhi\u1ec5m HIV v\u00e0 10 ng\u01b0\u1eddi kh\u00f4ng nhi\u1ec5m. Trong s\u1ed1 c\u00e1c b\u1ec7nh nh\u00e2n, 24 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng n\u1ea5m ti\u00eau chu\u1ea9n, g\u1ed3m Amphotericin B v\u00e0 Fluconazole, c\u1ed9ng th\u00eam Tamoxifen, v\u00e0 26 ng\u01b0\u1eddi ch\u1ec9 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng n\u1ea5m ti\u00eau chu\u1ea9n. Nh\u00f3m nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111o Ho\u1ea1t \u0111\u1ed9ng Di\u1ec7t n\u1ea5m Ban \u0111\u1ea7u (Early Fungicidal Activity – EFA) c\u1ee7a c\u1ea3 hai nh\u00f3m – t\u1ee9c l\u00e0 \u0111o xem l\u01b0\u1ee3ng C. neoformans trong d\u1ecbch t\u1ee7y s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n gi\u1ea3m nhanh nh\u01b0 th\u1ebf n\u00e0o trong hai tu\u1ea7n sau \u0111i\u1ec1u tr\u1ecb.<\/p>\n

D\u1ef1a tr\u00ean c\u00e1c th\u00ed nghi\u1ec7m tr\u01b0\u1edbc \u0111\u00f3 c\u1ee7a m\u00ecnh, nh\u00f3m \u0111\u00e3 hy v\u1ecdng nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 nh\u1eadn Tamoxifen trong ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng n\u1ea5m s\u1ebd c\u00f3 EFA t\u1ed1t h\u01a1n. Tuy nhi\u00ean, h\u1ecd kh\u00f4ng ph\u00e1t hi\u1ec7n th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0o v\u1ec1 EFA \u1edf hai nh\u00f3m.<\/p>\n

\u0110i\u1ec3m kh\u00e1c bi\u1ec7t duy nh\u1ea5t gi\u1eefa hai nh\u00f3m \u0111i\u1ec1u tr\u1ecb l\u00e0 nh\u00f3m d\u00f9ng Tamoxifen c\u00f3 t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u1ed9c t\u00ednh trong tim. C\u00e1c nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng c\u1ea7n s\u1eed d\u1ee5ng li\u1ec1u Tamoxifen cao g\u1ea5p 5\u201310 l\u1ea7n so v\u1edbi li\u1ec1u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa \u0111\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1ng n\u1ea5m. Nh\u01b0ng li\u1ec1u l\u01b0\u1ee3ng Tamoxifen cao c\u00f3 th\u1ec3 g\u00e2y h\u1ed9i ch\u1ee9ng QT k\u00e9o d\u00e0i cho tim \u2013 h\u1ed9i ch\u1ee9ng QT k\u00e9o d\u00e0i l\u00e0 m\u1ed9t b\u1ea5t th\u01b0\u1eddng c\u00f3 th\u1ec3 g\u00e2y ng\u1eebng tim. Trong nh\u00f3m d\u00f9ng Tamoxifen c\u1ee7a nghi\u00ean c\u1ee9u n\u00e0y, c\u00f3 m\u1ed9t tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed9t t\u1eed, m\u1eb7c d\u00f9 t\u00ecnh tr\u1ea1ng t\u1eed vong di\u1ec5n ra sau kho\u1ea3ng th\u1eddi gian d\u00f9ng Tamoxifen v\u00e0 kh\u00f4ng li\u00ean quan \u0111\u1ebfn nh\u1ecbp tim b\u1ea5t th\u01b0\u1eddng.<\/p>\n

Gi\u00e1o s\u01b0 Jeremy Day<\/a>, T\u00e1c gi\u1ea3 c\u1ea5p cao v\u00e0 Tr\u01b0\u1edfng nh\u00f3m Nh\u00f3m Nghi\u00ean c\u1ee9u Nhi\u1ec5m tr\u00f9ng Th\u1ea7n kinh Trung \u01b0\u01a1ng v\u00e0 HIV c\u1ee7a OUCRU, v\u00e0 Gi\u00e1o s\u01b0 v\u1ec1 B\u1ec7nh truy\u1ec1n nhi\u1ec5m t\u1ea1i Trung t\u00e2m Y h\u1ecdc Nhi\u1ec7t \u0111\u1edbi v\u00e0 S\u1ee9c kh\u1ecfe To\u00e0n c\u1ea7u, \u0110\u1ea1i h\u1ecdc Oxford, V\u01b0\u01a1ng qu\u1ed1c Anh, k\u1ebft lu\u1eadn: \u201cM\u1eb7c d\u00f9 c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng Cryptococcus v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c, Tamoxifen kh\u00f4ng l\u00e0m t\u0103ng t\u1ed1c \u0111\u1ed9 lo\u1ea1i n\u1ea5m men kh\u1ecfi d\u1ecbch t\u1ee7y s\u1ed1ng \u1edf nh\u1eefng ng\u01b0\u1eddi vi\u00eam m\u00e0ng n\u00e3o v\u00e0 kh\u1ea3 n\u0103ng cao l\u00e0 kh\u00f4ng mang l\u1ea1i l\u1ee3i \u00edch l\u00e2m s\u00e0ng\u201d.<\/p>\n

\u201cK\u1ebft qu\u1ea3 c\u1ee7a ch\u00fang t\u00f4i cho th\u1ea5y t\u1ea7m quan tr\u1ecdng c\u1ee7a c\u00e1c th\u1eed nghi\u1ec7m quy m\u00f4 nh\u1ecf nh\u01b0 th\u1ebf n\u00e0y trong vi\u1ec7c \u0111\u00e1nh gi\u00e1 nhanh c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 t\u00e1i \u0111\u1ecbnh v\u1ecb\/t\u00e1i s\u1eed d\u1ee5ng v\u00e0 gi\u00fap ti\u1ebft ki\u1ec7m th\u1eddi gian v\u00e0 chi ph\u00ed cho nh\u1eefng nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng l\u1edbn h\u01a1n m\u00e0 c\u00f3 kh\u1ea3 n\u0103ng kh\u00f4ng th\u00e0nh c\u00f4ng. Tuy nhi\u00ean, \u0111i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 ch\u00fang ta v\u1eabn c\u1ea7n nhanh ch\u00f3ng ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u1eb7c tr\u1ecb Cryptococcus m\u1edbi, v\u00e0 c\u0169ng c\u1ea7n \u0111\u1ea3m b\u1ea3o r\u1eb1ng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7n c\u00f3 v\u1edbi gi\u00e1 ph\u1ea3i ch\u0103ng\u201d.<\/p>\n

\n

\u0110\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin, vui l\u00f2ng li\u00ean h\u1ec7:\u00a0Communications@oucru.org<\/p>\n","protected":false},"excerpt":{"rendered":"

Nghi\u00ean c\u1ee9u t\u00e1i \u0111\u1ecbnh v\u1ecb thu\u1ed1c cho m\u1ed9t d\u1ea1ng vi\u00eam m\u00e0ng n\u00e3o g\u00e2y t\u1eed vong do n\u1ea5m cho th\u1ea5y Tamoxifen kh\u00f4ng c\u00f3 \u00edch trong vi\u1ec7c \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh lo\u1ea1i […]<\/p>\n","protected":false},"author":28,"featured_media":9781,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":"","_wp_rev_ctl_limit":""},"categories":[229],"tags":[],"class_list":["post-9012","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-tin-tuc"],"acf":[],"yoast_head":"\nNghi\u00ean c\u1ee9u t\u00e1i \u0111\u1ecbnh v\u1ecb thu\u1ed1c cho th\u1ea5y Tamoxifen kh\u00f4ng c\u00f3 \u00edch trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o g\u00e2y t\u1eed vong do n\u1ea5m - OUCRU<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.oucru.org\/vi\/nghien-cuu-tai-dinh-vi-thuoc-cho-thay-tamoxifen-khong-co-ich-trong-viec-dieu-tri-viem-mang-nao-gay-tu-vong-do-nam\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nghi\u00ean c\u1ee9u t\u00e1i \u0111\u1ecbnh v\u1ecb thu\u1ed1c cho th\u1ea5y Tamoxifen kh\u00f4ng c\u00f3 \u00edch trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o g\u00e2y t\u1eed vong do n\u1ea5m - 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