{"id":10910,"date":"2019-06-13T09:40:03","date_gmt":"2019-06-13T02:40:03","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=10910"},"modified":"2019-06-13T09:42:01","modified_gmt":"2019-06-13T02:42:01","slug":"diem-tin-nghien-cuu-jama-fluoroquinolon-va-nguy-co-benh-ly-than-kinh-ngoai-bien","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/diem-tin-nghien-cuu-jama-fluoroquinolon-va-nguy-co-benh-ly-than-kinh-ngoai-bien\/","title":{"rendered":"\u0110i\u1ec3m tin nghi\u00ean c\u1ee9u (JAMA): Fluoroquinolon v\u00e0 nguy c\u01a1 b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean"},"content":{"rendered":"<h2>T\u1ea1p ch\u00ed uy t\u00edn JAMA m\u1edbi \u0111\u0103ng t\u1ea3i m\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u gh\u00e9p c\u1eb7p (cases &#8211; controls) v\u1ec1 fluoroquinolon v\u00e0 nguy c\u01a1 b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean.<\/h2>\n<p>\u0110\u00e2y l\u00e0 nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u s\u1eed d\u1ee5ng d\u1eef li\u1ec7u \u0111\u1ecbnh danh t\u1eeb t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u0103ng k\u00fd kh\u00e1m t\u1ea1i c\u00e1c ph\u00f2ng kh\u00e1m b\u00e1c s\u1ef9 gia \u0111\u00ecnh l\u01b0u tr\u1eef trong c\u01a1 s\u1edf d\u1eef li\u1ec7u c\u1ee7a h\u1ec7 th\u1ed1ng y t\u1ebf V\u01b0\u01a1ng qu\u1ed1c Anh (The Health Improvement Network database) t\u1eeb 01\/01\/1999 \u0111\u1ebfn 31\/12\/2015. Cohort g\u1ed3m 1 338 900 b\u1ec7nh nh\u00e2n ng\u01b0\u1eddi l\u1edbn \u0111\u00e3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n \u00edt nh\u1ea5t 1 l\u1ea7n c\u00e1c thu\u1ed1c c\u00f3 ch\u1ee9a fluoroquinolone (34.3%) ho\u1eb7c amoxicillin-clavulanate (65.7%). 01 b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi (peripheral neuropathy) \u0111\u01b0\u1ee3c b\u1eaft c\u1eb7p (v\u1ec1 tu\u1ed5i, gi\u1edbi, th\u1eddi gian d\u00f9ng thu\u1ed1c) v\u1edbi 4 b\u1ec7nh nh\u00e2n nh\u00f3m \u0111\u1ed1i ch\u1ee9ng (controls) t\u1eeb cohort c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00ea fluoroquinolone ho\u1eb7c amoxicillin-clavulanate \u0111\u01b0\u1eddng u\u1ed1ng. Nh\u00f3m nghi\u00ean c\u1ee9u \u0111\u00e3 ti\u1ebfn h\u00e0nh so s\u00e1nh t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi \u1edf hai nh\u00f3m c\u00f3 ph\u01a1i nhi\u1ec5m v\u00e0 kh\u00f4ng ph\u01a1i nhi\u1ec5m v\u1edbi fluoroquinolone v\u00e0 amoxicillin-clavulanate.<\/p>\n<p>K\u1ebft qu\u1ea3 cho th\u1ea5y c\u00f3 t\u1ed5ng s\u1ed1 5357 b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi (Tu\u1ed5i trung b\u00ecnh [SD] l\u00e0 65.6 [14.7] tu\u1ed5i; 2809 n\u1eef [52.4%]) \u0111\u01b0\u1ee3c gh\u00e9p c\u1eb7p v\u1edbi 17 285 b\u1ec7nh nh\u00e2n nh\u00f3m \u0111\u1ed1i ch\u1ee9ng (Tu\u1ed5i trung b\u00ecnh [SD] l\u00e0, 64.4 [15.2] tu\u1ed5i; 9485 n\u1eef [54.9%]) (\u0111\u00e3 lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh nh\u00e2n ti\u1ec3u \u0111\u01b0\u1eddng). Ph\u01a1i nhi\u1ec5m v\u1edbi fluoroquinolone c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u01b0\u01a1ng \u0111\u1ed1i m\u1eafc b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi l\u00ean 47% so v\u1edbi nh\u00f3m kh\u00f4ng ph\u01a1i nhi\u1ec5m (adjusted incident rate ratio, 1.47; 95% CI, 1.13-1.92). M\u1ed7i m\u1ed9t ng\u00e0y k\u00e9o d\u00e0i ph\u01a1i nhi\u1ec5m v\u1edbi fluoroquinolone c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 th\u00eam 3% v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 180 ng\u00e0y sau khi ph\u01a1i nhi\u1ec5m v\u1edbi thu\u1ed1c. Ch\u01b0a ghi nh\u1eadn s\u1ef1 bi\u1ebfn \u0111\u1ed5i v\u1ec1 nguy c\u01a1 li\u00ean quan \u0111\u1ebfn ph\u01a1i nhi\u1ec5m v\u1edbi amoxicillin-clavulanate. Nguy c\u01a1 tuy\u1ec7t \u0111\u1ed1i v\u1edbi ph\u01a1i nhi\u1ec5m fluoroquinolone l\u00e0 2.4 (95% CI, 1.8-3.1) tr\u00ean 10 000 b\u1ec7nh nh\u00e2n &#8211; n\u0103m. Nguy c\u01a1 t\u0103ng l\u00ean \u1edf b\u1ec7nh nh\u00e2n nam gi\u1edbi, tr\u00ean 60 tu\u1ed5i ho\u1eb7c b\u1ec7nh nh\u00e2n b\u1ecb t\u00edch l\u0169y thu\u1ed1c.<\/p>\n<p>Nh\u00ecn chung nghi\u00ean c\u1ee9u \u0111\u00e3 ph\u1ea7n n\u00e0o cho th\u1ea5y m\u1ed1i li\u00ean quan gi\u1eefa fluoroquinolone \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0 nguy c\u01a1 b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean. Nguy c\u01a1 n\u00e0y ph\u1ee5 thuocojo v\u00e0 th\u1eddi gian ph\u01a1i nhi\u1ec5m v\u00e0 li\u1ec1u t\u00edch l\u0169y. C\u00e1n b\u1ed9 y t\u1ebf n\u00ean l\u01b0u \u00fd \u0111\u1ebfn nguy c\u01a1 n\u00e0y khi k\u00ea \u0111\u01a1n kh\u00e1ng sinh fluoroquinolone.<\/p>\n<p>Ngu\u1ed3n:\u00a0<a href=\"https:\/\/jamanetwork.com\/journals\/jamaneurology\/article-abstract\/2731583\" rel=\"noopener\">https:\/\/jamanetwork.com\/journals\/jamaneurology\/article-abstract\/2731583<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u1ea1p ch\u00ed uy t\u00edn JAMA m\u1edbi \u0111\u0103ng t\u1ea3i m\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u gh\u00e9p c\u1eb7p (cases &#8211; controls) v\u1ec1 fluoroquinolon v\u00e0 nguy c\u01a1 b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean. \u0110\u00e2y l\u00e0 nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u s\u1eed d\u1ee5ng d\u1eef li\u1ec7u \u0111\u1ecbnh danh t\u1eeb t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u0103ng k\u00fd kh\u00e1m t\u1ea1i c\u00e1c ph\u00f2ng kh\u00e1m b\u00e1c [&#8230;]\n","protected":false},"author":1,"featured_media":7652,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-10910","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\/10910","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=10910"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/10910\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/7652"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=10910"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=10910"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=10910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}