{"id":100329,"date":"2024-09-18T11:43:58","date_gmt":"2024-09-18T04:43:58","guid":{"rendered":"https:\/\/vnras.com\/drug\/?p=100329"},"modified":"2024-09-18T21:56:28","modified_gmt":"2024-09-18T14:56:28","slug":"xet-nghiem-mo-mau-bilan-lipid-lam-luc-nao-trong-ngay-la-tot-nhat-lam-luc-doi-co-chinh-xac-hon-khong","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/xet-nghiem-mo-mau-bilan-lipid-lam-luc-nao-trong-ngay-la-tot-nhat-lam-luc-doi-co-chinh-xac-hon-khong\/","title":{"rendered":"X\u00e9t nghi\u1ec7m m\u1ee1 m\u00e1u (bilan lipid) l\u00e0m l\u00fac n\u00e0o trong ng\u00e0y l\u00e0 t\u1ed1t nh\u1ea5t? L\u00e0m l\u00fac \u0111\u00f3i c\u00f3 ch\u00ednh x\u00e1c h\u01a1n kh\u00f4ng?"},"content":{"rendered":"

BS. L\u00ea B\u1ea3o Trung<\/p>\n

Ph\u1ea7n 2: Bilan lipid trong \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch<\/p>\n

M\u1ee1 m\u00e1u l\u00e0m l\u00fac n\u00e0o trong ng\u00e0y l\u00e0 t\u1ed1t nh\u1ea5t?<\/h2>\n

Tr\u1ea3 l\u1eddi c\u00e2u h\u1ecfi n\u00e0y, nhi\u1ec1u sinh vi\u00ean y v\u00e0 b\u00e1c s\u0129 s\u1ebd kh\u00f4ng c\u1ea7n suy ngh\u0129 nhi\u1ec1u v\u00e0 tr\u1ea3 l\u1eddi ngay: \u201cl\u00e0m bu\u1ed5i s\u00e1ng, c\u1ea7n nh\u1ecbn \u0111\u00f3i >8 ti\u1ebfng tr\u01b0\u1edbc x\u00e9t nghi\u1ec7m\u201d. \u0110\u00e2y l\u00e0 nh\u1eefng \u0111i\u1ec1u \u0111\u00e3 \u0111\u01b0\u1ee3c d\u1ea1y ngay tr\u00ean gi\u1ea3ng \u0111\u01b0\u1eddng v\u00e0 vi\u1ebft \u0111i vi\u1ebft l\u1ea1i nhi\u1ec1u l\u1ea7n trong c\u00e1c t\u00e0i li\u1ec7u kinh \u0111i\u1ec3n. Tuy nhi\u00ean, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ef1c s\u1ef1 \u0111\u00fang kh\u00f4ng?<\/p>\n

C\u01a1 s\u1edf l\u00fd lu\u1eadn<\/h3>\n

Tr\u01b0\u1edbc ti\u00ean ph\u1ea3i x\u00e1c \u0111\u1ecbnh r\u1eb1ng, t\u00ecnh tr\u1ea1ng \u201c\u0111\u00f3i\u201d theo ti\u00eau chu\u1ea9n \u0111\u1ec3 l\u1ea5y x\u00e9t nghi\u1ec7m (nh\u1ecbn \u0111\u00f3i 8-12 ti\u1ebfng, kh\u00f4ng n\u1ea1p \u0111\u01b0\u1eddng v\u00e0 ch\u1ea5t b\u00e9o) th\u1ef1c t\u1ebf ch\u1ec9 t\u1ed3n t\u1ea1i trong m\u1ed9t th\u1eddi gian ng\u1eafn v\u00e0o bu\u1ed5i s\u00e1ng tr\u01b0\u1edbc khi ch\u00fang ta \u0103n s\u00e1ng. Trong khi ch\u00fang ta g\u1ea7n nh\u01b0 lu\u00f4n \u1edf t\u00ecnh tr\u1ea1ng \u201ckh\u00f4ng \u0111\u00f3i\u201d trong 24 gi\u1edd m\u1ed7i ng\u00e0y. H\u01a1n n\u1eefa ch\u00fang ta bi\u1ebft r\u1eb1ng, c\u00e1c lipoprotein g\u00e2y x\u01a1 v\u1eefa kh\u00f4ng ch\u1ec9 \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t \u1edf gan (nh\u01b0 LDL-C,VLDL-C, IDL-C) m\u00e0 c\u00f2n t\u1edbi t\u1eeb c\u00e1c h\u1ea1t c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (v\u00ed d\u1ee5 chylomicron t\u00e0n d\u01b0) \u0111i v\u00e0o tu\u1ea7n ho\u00e0n. Nh\u1eefng h\u1ea1t n\u00e0y s\u1ebd b\u1ecb b\u1ecf qua b\u1edfi x\u00e9t nghi\u1ec7m l\u00fac \u0111\u00f3i. Nh\u01b0 v\u1eady, ch\u00fang ta c\u00f3 l\u00fd do \u0111\u1ec3 tin r\u1eb1ng, m\u1ee1 m\u00e1u l\u1ea5y l\u00fac \u201ckh\u00f4ng \u0111\u00f3i\u201d s\u1ebd ph\u1ea3n \u00e1nh \u0111\u00fang h\u01a1n t\u1ed5ng l\u01b0\u1ee3ng lipoprotein g\u00e2y ra t\u00ecnh tr\u1ea1ng x\u01a1 v\u1eefa.<\/p>\n

\"H\u00ecnh<\/a>
H\u00ecnh 4. T\u00ecnh tr\u1ea1ng \u201c\u0111\u00f3i\u201d ch\u1ec9 chi\u1ebfm m\u1ed9t kho\u1ea3ng th\u1eddi gian r\u1ea5t nh\u1ecf trong ng\u00e0y<\/figcaption><\/figure>\n

K\u1ebft qu\u1ea3 bilan lipid l\u00e0m l\u00fac \u0111\u00f3i v\u00e0 l\u00e0m b\u1ea5t k\u00ec c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 hay kh\u00f4ng?<\/h3>\n

M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 n\u0103m 2008 tr\u00ean t\u1ea1p ch\u00ed Circulation \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean 33391 t\u00ecnh nguy\u1ec7n vi\u00ean nh\u1eb1m tr\u1ea3 l\u1eddi c\u00e2u h\u1ecfi n\u00e0y. C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c nh\u00f3m d\u1ef1a v\u00e0o kho\u1ea3ng c\u00e1ch t\u1eeb b\u1eefa \u0103n cu\u1ed1i c\u00f9ng t\u1edbi l\u00fac x\u00e9t nghi\u1ec7m (1 gi\u1edd, 2 gi\u1edd, 3 gi\u1edd,… 8 gi\u1edd v\u00e0 nh\u00f3m >8 gi\u1edd). H\u1ecd \u0111\u01b0\u1ee3c l\u1ea5y m\u00e1u x\u00e9t nghi\u1ec7m trong kho\u1ea3ng th\u1eddi gian t\u1eeb 8 gi\u1edd s\u00e1ng t\u1edbi 7 gi\u1edd t\u1ed1i. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y s\u1ef1 ch\u00eanh l\u1ec7ch r\u1ea5t nh\u1ecf c\u00e1c ch\u1ec9 s\u1ed1 LDL-C (ch\u00eanh l\u1ec7ch t\u1ed1i \u0111a -0.2mmol\/L), HDL-C (ch\u00eanh l\u1ec7ch t\u1ed1i \u0111a -0.1mmol\/L), nonHDL, ApoB, ApoA1 gi\u1eefa c\u00e1c nh\u00f3m v\u00e0 b\u1ea5t k\u1ec3 th\u1eddi \u0111i\u1ec3m l\u1ea5y x\u00e9t nghi\u1ec7m. Ch\u1ec9 s\u1ed1 bi\u1ebfn \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 nh\u1ea5t l\u00e0 triglyceride (ch\u00eanh l\u1ec7ch t\u1ed1i \u0111a +0.3mmol\/L) [10].<\/p>\n

\"H\u00ecnh<\/a>
H\u00ecnh 5. S\u1ef1 bi\u1ebfn \u0111\u1ed9ng c\u00e1c ch\u1ec9 s\u1ed1 cholesterol TP (TC), LDL-C, non HDL-C, HDL- C, ApoA1, ApoB, Triglycerides, Albumin theo c\u00e1c m\u1ed1c th\u1eddi gian trong ng\u00e0y. Ngo\u00e0i s\u1ef1 t\u0103ng triglycerides, nghi\u00ean c\u1ee9u c\u0169ng ghi nh\u1eadn s\u1ef1 gi\u1ea3m LDL-C, TC hay nonHDL-C \u1edf nh\u00f3m kh\u00f4ng \u0111\u00f3i. L\u00fd do \u0111\u01b0\u1ee3c \u0111\u01b0a ra l\u00e0 t\u00ecnh tr\u1ea1ng h\u00f2a lo\u00e3ng m\u00e1u sau khi \u0103n, v\u1edbi b\u1eb1ng ch\u1ee9ng l\u00e0 s\u1ef1 suy gi\u1ea3m \u0111i k\u00e8m c\u1ee7a ch\u1ec9 s\u1ed1 albumin m\u00e1u. Khi \u0111\u01b0\u1ee3c hi\u1ec7u ch\u1ec9nh theo albumin, c\u00e1c ch\u1ec9 s\u1ed1 n\u00e0y kh\u00f4ng c\u00f2n kh\u00e1c bi\u1ec7t gi\u1eefa l\u00fac \u0111\u00f3i v\u00e0 kh\u00f4ng \u0111\u00f3i n\u1eefa. \u0110i\u1ec1u n\u00e0y v\u1eabn c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n \u201c\u0111\u00f3i\u201d khi h\u1ecd u\u1ed1ng n\u01b0\u1edbc hay c\u00e1c ch\u1ea5t l\u1ecfng kh\u00f4ng c\u00f3 ch\u1ea5t b\u00e9o v\u00e0o bu\u1ed5i s\u00e1ng tr\u01b0\u1edbc khi x\u00e9t nghi\u1ec7m [4].<\/figcaption><\/figure>M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u kh\u00e1c c\u0169ng cho k\u1ebft qu\u1ea3 t\u01b0\u01a1ng t\u1ef1 v\u1edbi s\u1ef1 bi\u1ebfn \u0111\u1ed9ng kh\u00f4ng \u0111\u00e1ng k\u1ec3 c\u00e1c ch\u1ec9 s\u1ed1 LDL, HDL, nonHDL v\u00e0 bi\u1ebfn \u0111\u1ed9ng l\u1edbn nh\u1ea5t t\u1edbi t\u1eeb triglyceride [2], [11], [12]. Nghi\u00ean c\u1ee9u t\u1ea1i b\u1ec7nh vi\u1ec7n Tr\u01b0\u1eddng \u0110\u1ea1i H\u1ecdc Copenhagen th\u1eadm ch\u00ed cho th\u1ea5y tr\u1ecb s\u1ed1 triglycerides \u1edf c\u1ea3 2 nh\u00f3m \u0111\u00f3i v\u00e0 kh\u00f4ng \u0111\u00f3i l\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea, k\u1ec3 c\u1ea3 tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 triglycerides r\u1ea5t cao l\u1eabn b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng [14]. Nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean ng\u01b0\u1eddi ch\u00e2u \u00c1 d\u01b0\u1eddng nh\u01b0 ghi nh\u1eadn s\u1ef1 ghi nh\u1eadn s\u1ef1 ch\u00eanh l\u1ec7ch triglycerides v\u00e0 Cholesterol l\u1edbn h\u01a1n [4], [6]. D\u00f9 v\u1eady, triglyceride hi\u1ec7n nay kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t ch\u1ec9 s\u1ed1 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch. Ng\u01b0\u1eddi ta ch\u1ec9 th\u1ef1c s\u1ef1 quan t\u00e2m khi triglycerides cao >4.5mmol\/L (l\u00e0m sai l\u1ec7ch k\u1ebft qu\u1ea3 LDL-C \u0111o gi\u00e1n ti\u1ebfp b\u1eb1ng c\u00f4ng th\u1ee9c Friedewald) v\u00e0 >10mmol\/L (t\u0103ng nguy c\u01a1 vi\u00eam t\u1ee5y c\u1ea5p). V\u00e0 s\u1ef1 ch\u00eanh l\u1ec7ch nh\u1ecf c\u1ee7a LDL-C hay nonHDL kh\u00f4ng l\u00e0m thay \u0111\u1ed5i c\u00e1c quy\u1ebft \u0111\u1ecbnh l\u00e2m s\u00e0ng.<\/p>\n

V\u1eady th\u00ec l\u00e0m l\u00fac \u0111\u00f3i c\u00f3 gi\u00e1 tr\u1ecb h\u01a1n kh\u00f4ng?<\/h3>\n

Tr\u00ean th\u1ef1c t\u1ebf, gi\u00e1 tr\u1ecb c\u1ee7a bilan lipid l\u00fac \u0111\u00f3i ho\u00e0n to\u00e0n d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng d\u1ef1a tr\u00ean nhi\u1ec1u nghi\u00ean c\u1ee9u v\u1edbi s\u1ed1 l\u01b0\u1ee3ng tr\u00ean 300000 ng\u01b0\u1eddi [1]. Ch\u1eb3ng h\u1ea1n nh\u01b0 d\u1eef li\u1ec7u t\u1eeb m\u1ed9t kh\u1ea3o s\u00e1t v\u1ec1 dinh d\u01b0\u1ee1ng v\u00e0 s\u1ee9c kh\u1ecfe qu\u1ed1c gia \u1edf M\u1ef9 t\u1eeb n\u0103m 1988-1994 tr\u00ean 16161 \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 so s\u00e1nh \u00fd ngh\u0129a c\u1ee7a LDL-C trong \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch gi\u1eefa 2 nh\u00f3m \u0111\u00f3i v\u00e0 kh\u00f4ng \u0111\u00f3i. K\u1ebft qu\u1ea3 cho th\u1ea5y, v\u1edbi k\u1ebft c\u1ee5c ti\u00ean ph\u00e1t l\u1eabn th\u1ee9 ph\u00e1t, LDL-C kh\u00f4ng \u0111\u00f3i cho \u00fd ngh\u0129a ti\u00ean l\u01b0\u1ee3ng t\u01b0\u01a1ng \u0111\u01b0\u01a1ng l\u00fac \u0111\u00f3i [1].<\/p>\n

M\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u \u1edf M\u1ef9 l\u1ea5y d\u1eef li\u1ec7u t\u1eeb 26509 \u0111\u1ed1i t\u01b0\u1ee3ng n\u1eef gi\u1edbi kh\u1ecfe m\u1ea1nh v\u1edbi th\u1eddi gian theo d\u00f5i trung b\u00ecnh 11,4 n\u0103m cho th\u1ea5y triglycerides kh\u00f4ng \u0111\u00f3i c\u00f3 gi\u00e1 tr\u1ecb ti\u00ean l\u01b0\u1ee3ng cao h\u01a1n triglycerides l\u1ea5y l\u00fac \u0111\u00f3i [9].<\/p>\n

\"H\u00ecnh<\/a>
H\u00ecnh 6. M\u1ed1i li\u00ean quan gi\u1eefa gi\u00e1 tr\u1ecb triglycerides v\u1edbi nguy c\u01a1 bi\u1ebfn c\u1ed1 tim m\u1ea1ch trong t\u01b0\u01a1ng lai theo t\u1eebng nh\u00f3m theo th\u1eddi \u0111i\u1ec3m l\u1ea5y x\u00e9t nghi\u1ec7m sau b\u1eefa \u0103n.<\/figcaption><\/figure>\n
\"H\u00ecnh<\/a>
H\u00ecnh 7. M\u1ed1i li\u00ean quan gi\u1eefa gi\u00e1 tr\u1ecb triglycerides v\u1edbi c\u00e1c k\u1ebft c\u1ee5c tim m\u1ea1ch theo nh\u00f3m \u201c\u0111\u00f3i\u201d v\u00e0 \u201ckh\u00f4ng \u0111\u00f3i\u201d<\/figcaption><\/figure>\n

Nh\u01b0 v\u1eady, l\u00e0m bilan lipid b\u1ea5t k\u00ec c\u00f3 \u00fd ngh\u0129a t\u01b0\u01a1ng \u0111\u01b0\u01a1ng, th\u1eadm ch\u00ed t\u1ed1t h\u01a1n trong vai tr\u00f2 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch khi so v\u1edbi bilan lipid l\u00fac \u0111\u00f3i.<\/p>\n

\u201cnh\u01b0ng t\u00f4i th\u00edch l\u00e0m l\u00fac \u0111\u00f3i cho ti\u1ec7n\u201d<\/h3>\n

C\u00e1c b\u00e1c s\u0129 hi\u1ec7n nay v\u1eabn th\u00edch th\u1ef1c hi\u1ec7n bilan lipid l\u00fac \u0111\u00f3i v\u00ec ph\u1ea7n nhi\u1ec1u b\u1ec7nh nh\u00e2n s\u1ebd \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh l\u00e0m glucose m\u00e1u \u0111\u00f3i c\u00f9ng l\u00fac khi \u0111i kh\u00e1m \u0111\u1ecbnh k\u00ec. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0 h\u1ee3p l\u00fd v\u1edbi \u0111i\u1ec1u ki\u1ec7n y t\u1ebf t\u1ea1i Vi\u1ec7t Nam. Tuy nhi\u00ean c\u0169ng ph\u1ea3i n\u00f3i r\u1eb1ng, kh\u00f4ng ph\u1ea3i b\u1ec7nh nh\u00e2n n\u00e0o c\u0169ng c\u1ea7n ph\u1ea3i l\u00e0m \u0111\u01b0\u1eddng m\u00e1u \u0111\u00f3i c\u00f9ng l\u00fac v\u1edbi bilan lipid. \u1ede \u0110an M\u1ea1ch, ch\u1ec9 s\u1ed1 HbA1C \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng thay cho \u0111\u01b0\u1eddng m\u00e1u \u0111\u00f3i \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 v\u00ec th\u1ebf h\u1ecd kh\u00f4ng c\u00f3 ch\u1ec9 s\u1ed1 n\u00e0o y\u00eau c\u1ea7u b\u1ec7nh nh\u00e2n ph\u1ea3i nh\u1ecbn \u0111\u00f3i \u0111\u1ec3 \u0111i x\u00e9t nghi\u1ec7m, ngo\u1ea1i tr\u1eeb nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ea7n l\u00e0m nghi\u1ec7m ph\u00e1p dung n\u1ea1p glucose.<\/p>\n

M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u00e3 ghi nh\u1eadn t\u00ecnh tr\u1ea1ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111i kh\u00e1m \u0111\u1ecbnh k\u00ec do b\u1ec7nh nh\u00e2n nh\u1ecbn \u0103n \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m [3]. Nh\u1eefng b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn c\u1ea9n th\u1eadn v\u1ec1 v\u1ea5n \u0111\u1ec1 thay \u0111\u1ed5i li\u1ec1u thu\u1ed1c tr\u01b0\u1edbc nh\u1eefng ng\u00e0y nh\u1ecbn \u0111\u00f3i \u0111i x\u00e9t nghi\u1ec7m, ho\u1eb7c \u0111\u01a1n gi\u1ea3n h\u01a1n l\u00e0 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u1ea7n ph\u1ea3i nh\u1ecbn \u0111\u00f3i khi \u0111i kh\u00e1m \u0111\u1ecbnh k\u00ec n\u1ebfu kh\u00f4ng c\u1ea7n thi\u1ebft. B\u00ean c\u1ea1nh \u0111\u00f3, ch\u00fang ta c\u0169ng c\u1ea7n xem x\u00e9t l\u1ea1i gi\u00e1 tr\u1ecb c\u1ee7a vi\u1ec7c l\u00e0m glucose m\u00e1u \u0111\u00f3i m\u1ed7i l\u1ea7n \u0111i kh\u00e1m \u0111\u1ecbnh k\u00ec.<\/p>\n

Vi\u1ec7c kh\u00f4ng c\u00f2n y\u00eau c\u1ea7u b\u1eaft bu\u1ed9c l\u00e0m bilan lipid l\u00fac \u0111\u00f3i c\u0169ng mang l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch nh\u01b0: Gi\u00fap gi\u00e0n tr\u1ea3i b\u1ec7nh nh\u00e2n \u0111i kh\u00e1m trong ng\u00e0y thay v\u00ec d\u1ed3n h\u1ebft v\u00e0o bu\u1ed5i s\u00e1ng, gi\u00e1n ti\u1ebfp kh\u00f4ng b\u1eaft b\u1ec7nh nh\u00e2n ph\u1ea3i quay l\u1ea1i ch\u1ec9 \u0111\u1ec3 l\u1ea5y k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m (khi t\u1ea5t c\u1ea3 c\u00f9ng l\u00e0m bu\u1ed5i s\u00e1ng v\u00e0 ph\u00f2ng x\u00e9t nghi\u1ec7m kh\u00f4ng th\u1ec3 ch\u1ea1y k\u1ecbp k\u1ebft qu\u1ea3) nh\u1edd \u0111\u00f3 gi\u1ea3m chi ph\u00ed cho b\u1ec7nh nh\u00e2n v\u00e0 gi\u00fap h\u1ea1n ch\u1ebf th\u1eddi gian l\u01b0u tr\u1eef m\u1eabu b\u1ec7nh ph\u1ea9m c\u00f3 th\u1ec3 g\u00e2y sai l\u1ec7ch, kh\u00f4ng l\u00e0m thay \u0111\u1ed5i th\u00f3i quen sinh ho\u1ea1t v\u00e0 d\u00f9ng thu\u1ed1c c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

C\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n t\u1ea1i n\u00f3i g\u00ec v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y?<\/h3>\n

N\u0103m 2009, Hi\u1ec7p h\u1ed9i H\u00f3a Sinh L\u00e2m S\u00e0ng \u0110an M\u1ea1ch \u0111\u00e3 khuy\u1ebfn ngh\u1ecb s\u1eed d\u1ee5ng th\u01b0\u1eddng quy bilan lipid kh\u00f4ng nh\u1ecbn \u0103n [5].<\/p>\n

Ti\u1ebfp theo \u0111\u00f3 l\u00e0 c\u00e1c khuy\u1ebfn ngh\u1ecb t\u01b0\u01a1ng t\u1ef1 v\u00e0o n\u0103m 2016 c\u1ee7a Hi\u1ec7p h\u1ed9i X\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch Ch\u00e2u \u00c2u v\u00e0 Li\u00ean \u0111o\u00e0n H\u00f3a h\u1ecdc L\u00e2m s\u00e0ng v\u00e0 Ph\u00f2ng th\u00ed nghi\u1ec7m Y h\u1ecdc Ch\u00e2u \u00c2u, \u0111\u1ed3ng th\u1eddi c\u0169ng n\u00f3i r\u1eb1ng x\u00e9t nghi\u1ec7m bilan lipid nh\u1ecbn \u0103n v\u00e0 kh\u00f4ng nh\u1ecbn \u0103n c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 l\u1eabn nhau ch\u1ee9 kh\u00f4ng nh\u1eb1m lo\u1ea1i tr\u1eeb nhau [10].<\/p>\n

C\u00f9ng n\u0103m 2016, Hi\u1ec7p H\u1ed9i B\u00e1c S\u0129 Gia \u0110\u00ecnh Canada v\u00e0 H\u1ed9i Tim M\u1ea1ch Canada \u0111\u00e3 \u0111\u01b0a ra c\u00e1c khuy\u1ebfn c\u00e1o li\u00ean quan t\u1edbi v\u1ea5n \u0111\u1ec1 n\u00e0y. Trong \u0111\u00f3, nh\u1ea5n m\u1ea1nh r\u1eb1ng kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i x\u00e9t nghi\u1ec7m bilan lipid l\u00fac \u0111\u00f3i, thay v\u00e0o \u0111\u00f3 c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng bilan lipid l\u00fac kh\u00f4ng \u0111\u00f3i. Khuy\u1ebfn c\u00e1o c\u0169ng \u0111\u1ec1 ngh\u1ecb c\u00e2n nh\u1eafc l\u00e0m bilan lipid l\u00fac \u0111\u00f3i n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed triglycerides >4.5mmol\/L [8], [7].<\/p>\n

Khuy\u1ebfn c\u00e1o c\u1ee7a ESC v\u1ec1 d\u1ef1 ph\u00f2ng nguy c\u01a1 tim m\u1ea1ch n\u0103m 2021 khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng bilan lipid kh\u00f4ng \u0111\u00f3i cho m\u1ee5c \u0111\u00edch theo d\u00f5i th\u01b0\u1eddng quy v\u00e0 \u0111\u1ec1 ngh\u1ecb xem x\u00e9t c\u1ea9n th\u1eadn gi\u00e1 tr\u1ecb LDL-C khi x\u00e9t nghi\u1ec7m bilan lipid kh\u00f4ng \u0111\u00f3i tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng t\u0103ng triglycerides, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, h\u1ed9i ch\u1ee9ng chuy\u1ec3n h\u00f3a [13]. L\u00fd do l\u00e0 ch\u1ec9 s\u1ed1 n\u00e0y c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng khi triglycerides cao > 4.5mmol\/L.<\/p>\n

T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/h2>\n
    \n
  1. Doran B., Guo Y., Xu J., et al (2014), “Prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: insight from the National Health and Nutrition Examination Survey III (NHANES-III)”, Circulation, 130(7), pp. 546-553.<\/li>\n
  2. Sidhu D., Naugler C. (2012), “Fasting time and lipid levels in a community- based population: a cross-sectional study”, Arch Intern Med, 172(22), pp. 1707-1710.<\/li>\n
  3. Aldasouqi S., Sheikh A., Klosterman P., et al (2011), “Hypoglycemia in patients with diabetes on antidiabetic medications who fast for laboratory tests”, Diabetes Care, 34(5), pp. e52.<\/li>\n
  4. Xie Y., Qu P., Guo L., et al (2023), “Comparison between Fasting and Non- Fasting Cut-Off Values of Triglyceride in Diagnosing High Triglyceride in Chinese Hypertensive Outpatients”, J Clin Med, 12(7).<\/li>\n
  5. Nordestgaard B. G., Hilsted L., Stender S. (2009), “[Plasma lipids in non- fasting patients and signal values of laboratory results]”, Ugeskr Laeger, 171(13), pp. 1093.<\/li>\n
  6. Fu Z. F., Liu M. L. (2009), “[Postprandial changes of blood lipid after ordinary Chinese diet and the influencing factors thereof]”, Zhonghua Yi Xue Za Zhi, 89(4), pp. 260-262.<\/li>\n
  7. Allan G Michael, Lindblad Adrienne J, Comeau Ann, et al (2015), “Simplified lipid guidelines: Prevention and management of cardiovascular disease in primary care”, 61(10), pp. 857-867.<\/li>\n
  8. Anderson Todd J, Gr\u00e9goire Jean, Pearson Glen J, et al (2016), “2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult”, 32(11), pp. 1263-1282.<\/li>\n
  9. Bansal Sandeep, Buring Julie E., Rifai Nader, et al (2007), “Fasting Compared With Nonfasting Triglycerides and Risk of Cardiovascular Events in Women”, JAMA, 298(3), pp. 309-316.<\/li>\n
  10. Langsted Anne, Freiberg Jacob J., Nordestgaard B\u00f8rge G. (2008), “Fasting and Nonfasting Lipid Levels”, 118(20), pp. 2047-2056.<\/li>\n
  11. Langsted Anne, Nordestgaard B\u00f8rge G (2011), “Nonfasting Lipids, Lipoproteins, and Apolipoproteins in Individuals with and without Diabetes: 58 434 Individuals from the Copenhagen General Population Study”, Clinical Chemistry, 57(3), pp. 482-489.<\/li>\n
  12. Steiner Michael J., Skinner Asheley Cockrell, Perrin Eliana M. (2011), “Fasting Might Not Be Necessary Before Lipid Screening: A Nationally Representative Cross-sectional Study”, Pediatrics, 128(3), pp. 463-470.<\/li>\n
  13. Visseren Frank LJ, Mach Fran\u00e7ois, Smulders Yvo M, et al (2022), “2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC)”, 29(1), pp. 5- 115.<\/li>\n
  14. Nordestgaard B\u00f8rge G., Langsted Anne, Mora Samia, et al (2016), “Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut- points\u2014a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine”, European Heart Journal, 37(25), pp. 1944-1958.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    BS. L\u00ea B\u1ea3o Trung Ph\u1ea7n 2: Bilan lipid trong \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch M\u1ee1 m\u00e1u l\u00e0m l\u00fac n\u00e0o trong ng\u00e0y l\u00e0 t\u1ed1t nh\u1ea5t? Tr\u1ea3 l\u1eddi c\u00e2u h\u1ecfi n\u00e0y, nhi\u1ec1u sinh vi\u00ean y v\u00e0 b\u00e1c s\u0129 s\u1ebd kh\u00f4ng c\u1ea7n suy ngh\u0129 nhi\u1ec1u v\u00e0 tr\u1ea3 l\u1eddi ngay: \u201cl\u00e0m bu\u1ed5i s\u00e1ng, c\u1ea7n nh\u1ecbn \u0111\u00f3i >8 ti\u1ebfng […]\n","protected":false},"author":1,"featured_media":100331,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-100329","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/100329","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=100329"}],"version-history":[{"count":3,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/100329\/revisions"}],"predecessor-version":[{"id":100338,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/100329\/revisions\/100338"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/100331"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=100329"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=100329"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=100329"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}