{"id":157381,"date":"2026-05-11T10:43:20","date_gmt":"2026-05-11T03:43:20","guid":{"rendered":"https:\/\/vnras.com\/drug\/?p=157381"},"modified":"2026-05-11T10:43:20","modified_gmt":"2026-05-11T03:43:20","slug":"phan-ung-viem-giong-nhiem-khuan-o-tre-mac-adenovirus-dan-den-viec-su-dung-khang-sinh-khong-phu-hop-nghien-cuu-doan-he-da-trung-tam","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/phan-ung-viem-giong-nhiem-khuan-o-tre-mac-adenovirus-dan-den-viec-su-dung-khang-sinh-khong-phu-hop-nghien-cuu-doan-he-da-trung-tam\/","title":{"rendered":"PH\u1ea2N \u1ee8NG VI\u00caM GI\u1ed0NG NHI\u1ec4M KHU\u1ea8N \u1ede TR\u1eba M\u1eaeC ADENOVIRUS D\u1eaaN \u0110\u1ebeN VI\u1ec6C S\u1eec D\u1ee4NG KH\u00c1NG SINH KH\u00d4NG PH\u00d9 H\u1ee2P: NGHI\u00caN C\u1ee8U \u0110O\u00c0N H\u1ec6 \u0110A TRUNG T\u00c2M"},"content":{"rendered":"<h2>T\u1ed5ng quan nghi\u00ean c\u1ee9u<\/h2>\n<p><em><strong>M\u1ee5c ti\u00eau: <\/strong><\/em>So s\u00e1nh m\u1ee9c \u0111\u1ed9 n\u1eb7ng tr\u00ean l\u00e2m s\u00e0ng c\u1ee7a nhi\u1ec5m HAdV v\u1edbi c\u00e1c b\u1ec7nh do virus kh\u00e1c \u1edf m\u1ed9t nh\u00f3m tr\u1ebb em, \u0111\u00e1nh gi\u00e1 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, \u0111i\u1ec1u tr\u1ecb v\u00e0 k\u1ebft c\u1ee5c.<\/p>\n<p><em><strong>Ph\u01b0\u01a1ng ph\u00e1p: <\/strong><\/em>Nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7 h\u1ed3i c\u1ee9u \u0111a trung t\u00e2m tr\u00ean tr\u1ebb em t\u1ea1i \u00dd nh\u1eadp vi\u1ec7n t\u1eeb th\u00e1ng 1 \u0111\u1ebfn th\u00e1ng 12 v\u00e0o n\u0103m 2023 v\u00ec c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p. Nghi\u00ean c\u1ee9u bao g\u1ed3m nh\u1eefng tr\u1ebb nhi\u1ec5m HAdV bi\u1ec3u hi\u1ec7n ch\u1ee7 y\u1ebfu v\u1edbi tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p. Nh\u1eefng b\u1ec7nh nh\u00e2n ch\u1ec9 c\u00f3 bi\u1ec3u hi\u1ec7n ti\u00eau h\u00f3a \u0111\u01a1n thu\u1ea9n ho\u1eb7c \u0111\u1ed3ng nhi\u1ec5m vi khu\u1ea9n b\u1ecb lo\u1ea1i tr\u1eeb.<\/p>\n<p><strong><em>K\u1ebft qu\u1ea3:<\/em><\/strong> T\u1ed5ng c\u1ed9ng c\u00f3 171 tr\u1ebb \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o nghi\u00ean c\u1ee9u: 98 tr\u1ebb nhi\u1ec5m HAdV (tu\u1ed5i trung b\u00ecnh 44\/3 \u00b1 37.9 th\u00e1ng) v\u00e0 73 tr\u1ebb nhi\u1ec5m c\u00e1c virus kh\u00e1c (tu\u1ed5i trung b\u00ecnh 20.4 \u00b1 27.2 th\u00e1ng). \u1ede nh\u00f3m \u0111\u1ea7u ti\u00ean, 57.1% c\u00f3 \u0111\u1ed3ng nhi\u1ec5m v\u1edbi m\u1ed9t ho\u1eb7c nhi\u1ec1u virus kh\u00e1c. C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 s\u1ed1t (89.8%), ho (73.5%) v\u00e0 \u0111au h\u1ecdng (52%). Suy h\u00f4 h\u1ea5p v\u00e0 gi\u1ea3m oxy m\u00e1u g\u1eb7p nhi\u1ec1u h\u01a1n \u1edf nh\u00f3m kh\u00f4ng nhi\u1ec5m HADV. Tr\u1ebb nhi\u1ec5m HAdV c\u00f3 n\u1ed3ng \u0111\u1ed9 CRP cao \u0111\u00e1ng k\u1ec3 (50.8 \u00b1 54.2 so v\u1edbi 16.5 \u00b1 33.8 mg\/L; p&lt;0.001), th\u1eddi gian s\u1ed1t k\u00e9o d\u00e0i h\u01a1n (4.9 \u00b1 3.6 so v\u1edbi 3.4 \u00b1 2.3 ng\u00e0y; p = 0.009) v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh cao h\u01a1n (77.6% so v\u1edbi 27.4%; p &lt; 0.001). Kh\u00f4ng ghi nh\u1eadn s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 th\u1eddi gian n\u1eb1m vi\u1ec7n, t\u1ef7 l\u1ec7 bi\u1ebfn ch\u1ee9ng hay t\u1ef7 l\u1ec7 nh\u1eadp ICU.<\/p>\n<p><em><strong>K\u1ebft lu\u1eadn: <\/strong><\/em>\u0110i\u1ec1u \u0111\u00e1ng ch\u00fa \u00fd l\u00e0 d\u1eef li\u1ec7u t\u1eeb nghi\u00ean c\u1ee9u cho th\u1ea5y tr\u1ebb nhi\u1ec5m HAdV c\u00f3 \u0111\u00e1p \u1ee9ng vi\u00eam r\u1ed3 r\u1ec7t h\u01a1n m\u1eb7c d\u00f9 c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p l\u1ea1i \u00edt nghi\u00eam tr\u1ecdng h\u01a1n so v\u1edbi nh\u1eefng tr\u1ebb nhi\u1ec5m c\u00e1c virus kh\u00e1c. T\u00ecnh tr\u1ea1ng s\u1ed1t k\u00e9o d\u00e0i v\u00e0 ph\u1ea3n \u1ee9ng vi\u00eam m\u1ea1nh th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn vi\u1ec7c l\u1ea1m d\u1ee5ng kh\u00e1ng sinh trong giai \u0111o\u1ea1n \u0111\u1ea7u, khi c\u0103n nguy\u00ean virus v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 ch\u00ednh x\u00e1c nhi\u1ec5m HAdV c\u00f3 vai tr\u00f2 r\u1ea5t quan tr\u1ecdng nh\u1eb1m t\u1ed1i \u01b0u h\u00f3a chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m thi\u1ec3u s\u1eedd\u1ee5ng kh\u00e1ng sinh kh\u00f4ng c\u1ea7n thi\u1ebft.<\/p>\n<p>Nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p l\u00e0 nguy\u00ean nh\u00e2n quan tr\u1ecdng g\u00e2y b\u1ec7nh t\u1eadt \u1edf tr\u1ebb em. Trong s\u1ed1 \u0111\u00f3, HAdV \u0111\u1eb7c bi\u1ec7t \u0111\u00e1ng ch\u00fa \u00fd do c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111a d\u1ea1ng v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng di\u1ec5n ti\u1ebfn n\u1eb7ng. HAdV l\u00e0 m\u1ed9t virus DNA s\u1ee3i \u0111\u00f4i kh\u00f4ng c\u00f3 v\u1ecf b\u1ecdc, c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u b\u1ec7nh c\u1ea3nh kh\u00e1c nhau, t\u1eeb c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u1eb9 \u1edf \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi n\u1eb7ng nh\u01b0 vi\u00eam ph\u1ed5i v\u00e0 vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n. HAdV l\u00e2y truy\u1ec1n qua c\u00e1c gi\u1ecdt khi dung ho\u1eb7c do ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi k\u1ebft m\u1ea1c m\u1eaft, ngo\u00e0i ra c\u00f2n c\u00f3 th\u1ec3 l\u00e2y qua \u0111\u01b0\u1eddng ph\u00e2n-mi\u1ec7ng ho\u1eb7c ti\u1ebfp x\u00fac v\u1edbi c\u00e1c v\u1eadt d\u1ee5ng b\u1ecb nhi\u1ec5m virus. Th\u1eddi gian \u1ee7 b\u1ec7nh dao \u0111\u1ed9ng t\u1eeb 2 ng\u00e0y \u0111\u1ebfn 2 tu\u1ea7n, t\u00f9y thu\u1ed9c v\u00e0o type huy\u1ebft thanh v\u00e0 \u0111\u01b0\u1eddng l\u00e2y truy\u1ec1n.<\/p>\n<p>HAdV c\u00f3 th\u1ec3 g\u00e2y c\u00e1c \u0111\u1ee3t d\u1ecbch b\u1ec7nh h\u00f4 h\u1ea5p c\u00f3 s\u1ed1t \u1edf tr\u1ebb em \u0111i h\u1ecdc ho\u1eb7c nh\u00e0 tr\u1ebb. Th\u1ef1c t\u1ebf, do thi\u1ebfu mi\u1ec5n d\u1ecbch d\u1ecbch th\u1ec3, h\u01a1n 80% tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m x\u1ea3y ra \u1edf tr\u1ebb d\u01b0\u1edbi 4 tu\u1ed5i, v\u00e0 HAdV chi\u1ebfm t\u1edbi 10%<\/p>\n<p>c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p trong nh\u00f3m tu\u1ed5i n\u00e0y. Ngo\u00e0i nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p, HAdV c\u00f2n g\u00e2y nhi\u1ec1u b\u1ec7nh kh\u00e1c nh\u01b0 vi\u00eam k\u1ebft m\u1ea1c, vi\u00eam d\u1ea1 d\u00e0y ru\u1ed9t v\u00e0 vi\u00eam b\u00e0ng quang xu\u1ea5t huy\u1ebft.<\/p>\n<p>Nhi\u1ec5m HAdV th\u01b0\u1eddng nh\u1eb9 v\u00e0 t\u1ef1 gi\u1edbi h\u1ea1n, tuy nhi\u00ean, c\u00e1c t\u1ec9nh tr\u1ea1ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf tr\u1ebb nh\u1ecf v\u00e0 b\u1ec7nh nh\u00e2n suy gi\u1ea3m mi\u1ec5n d\u1ecbch, nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng d\u1ec5 ph\u00e1t tri\u1ec3n nhi\u1ec5m tr\u00f9ng lan t\u1ecfa, t\u1ed5n th\u01b0\u01a1ng \u0111a c\u01a1 quan n\u1eb7ng, c\u0169ng nh\u01b0 c\u00e1c bi\u1ec3u hi\u1ec7n hi\u1ebfm g\u1eb7p h\u01a1n nh\u01b0 vi\u00eam m\u00e0ng n\u00e3o, vi\u00eam n\u00e3o, vi\u00eam c\u01a1 tim, lo\u1ea1n s\u1ea3n ph\u1ed1i, l\u1ed3ng ru\u1ed9t v\u00e0 \u0111\u1ed9t t\u1eed \u1edf tr\u1ebb nh\u0169 nhi. H\u01a1n n\u1eefa, b\u1ec7nh nh\u00e2n vi\u00eam ph\u1ed5i n\u1eb7ng c\u00f3 nguy c\u01a1 ph\u00e1t tri\u1ec3n c\u00e1c di ch\u1ee9ng h\u00f4 h\u1ea5p l\u00e2u d\u00e0i l\u00ean \u0111\u1ebfn 30% nh\u01b0 vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n b\u00edt t\u1eafc sau nhi\u1ec5m tr\u00f9ng v\u00e0 gi\u00e3n ph\u1ebf qu\u1ea3n.<\/p>\n<p>N\u1ebfu kh\u00f4ng c\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n th\u00edch h\u1ee3p, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t nhi\u1ec5m HAdV c\u00f3 th\u1ec3 g\u1eb7p kh\u00f3 kh\u0103n. Trong nhi\u1ec5m HAdV, t\u1ec9nh tr\u1ea1ng t\u0103ng CRP, procalcitonin, b\u1ea1ch c\u1ea7u v\u00e0 b\u1ea1ch c\u1ea7u trung b\u00ecnh c\u00f3 th\u1ec3 gi\u1ed1ng v\u1edbi nhi\u1ec5m khu\u1ea9n. Ngo\u00e0i ra, b\u1ec7nh Kawasaki, MIS-C ho\u1eb7c c\u00e1c h\u1ed9i ch\u1ee9ng t\u0103ng vi\u00eam kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 c\u00f3 c\u00f9ng bi\u1ec3u hi\u1ec7n l\u00e2m s\u1ea3ng v\u1edbi HAdV nh\u01b0 s\u1ed1t k\u00e9o d\u00e0i, ph\u00e1t ban v\u00e0 n\u1ed5i h\u1ea1ch. V\u00ec nh\u1eefng l\u00fd do n\u00e0y, c\u00e1c thay \u0111\u1ed5i x\u00e9t nghi\u1ec7m v\u00e0 s\u1ef1 k\u00e9o d\u00e0i tri\u1ec7u ch\u1ee9ng, ngay c\u1ea3 trong nhi\u1ec5m tr\u00f9ng t\u1ef1 gi\u1edbi h\u1ea1n, l\u00e0m gia t\u0103ng s\u1ef1 lo l\u1eafng c\u1ee7a ng\u01b0\u1eddi nh\u00e0 v\u00e0 b\u00e1c s\u0129, d\u1eabn \u0111\u1ebfn nh\u1eadp vi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb kh\u00f4ng c\u1ea7n thi\u1ebft (v\u00ed d\u1ee5: kh\u00e1ng sinh, kh\u00e1ng vi\u00eam, IVIG).<\/p>\n<h2>\u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng<\/h2>\n<p>C\u00e1c \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u1ea3ng c\u1ee7a tr\u1ebb tham gia nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c t\u00f3m t\u1eaft trong B\u1ea3ng 1. S\u1ed1t l\u00e0 bi\u1ec3u hi\u1ec7n l\u00e2m s\u1ea3ng ch\u00ednh \u1edf c\u1ea3 hai nh\u00f3m, nh\u01b0ng g\u1eb7p nhi\u1ec1u h\u01a1n \u1edf tr\u1ebb nhi\u1ec5m HAdV (89.8% so v\u1edbi 74%, p= 0.006), \u0111\u1ed3ng th\u1eddi th\u1eddi gian s\u1ed1t c\u0169ng k\u00e9o d\u00e0i h\u01a1n (4.9 \u00b1 3.6 so v\u1edbi 3.4 \u00b1 2.3 ng\u00e0y; p = 0.009 ) so v\u1edbi nh\u00f3m ch\u1ee9ng. Tr\u1ebb nhi\u1ec5m HAdV th\u01b0\u1eddng b\u1ecb \u0111au h\u1ecdng (52% so v\u1edbi 13.7%; p &lt; 0.001 ) v\u00e0 n\u1ed7i h\u1ea1ch (31.6% so v\u1edbi 12.3%; P = 0.02 ) nhi\u1ec1u h\u01a1n. Ng\u01b0\u1ee3c l\u1ea1i, tr\u1ebb kh\u00f4ng nhi\u1ec5m HAdV c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng h\u1ecf h\u1ea5p n\u1eb7ng h\u01a1n, bao g\u1ed3m suy h\u00f4 h\u1ea5p (45.2% so v\u1edbi 11.2%; p &lt; 0.001 ) v\u00e0 \u0111\u1ed9 b\u00e3o h\u00f2a oxy th\u1ea5p h\u01a1n (96 \u00b1 3.8 so v\u1edbi 98 \u00b1 1.8; p &lt; 0.001 ) v\u1edbi t\u1ef7 l\u1ec7 gi\u1ea3m oxy m\u00e1u \u2264 94% cao h\u01a1n (23.3% so v\u1edbi 3.1%; p &lt; 0.001 ) K\u1ebft qu\u1ea3 n\u00e0y v\u1eabn x\u00e1c nh\u1eadn ngay c\u1ea3 khi lo\u1ea1i tr\u1eeb nh\u1eefng tr\u1ebb c\u00f3 b\u1ec7nh \u0111\u1ed3ng m\u1eafc ra kh\u1ecfi . Co gi\u1eadt do s\u1ed1t ghi nh\u1eadn \u1edf 15\/98 b\u1ec7nh nh\u00e2n nhi\u1ec5m HAdV v\u00e0 \u1edf 5\/73 tr\u1ebb m\u1eafc c\u00e1c b\u1ec7nh kh\u00e1c, m\u1eb7c d\u00f9 s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y ch\u01b0a \u0111\u1ea1t \u00fd ngh\u0129a th\u1ed1ng k\u00ea (p = 0.07) T\u1ea7n su\u1ea5t c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c nh\u01b0 ho, vi\u00eam k\u1ebft m\u1ea1c, tri\u1ec7u ch\u1ee9ng ti\u00eau h\u00f3a v\u00e0 t\u1ed5n th\u01b0\u01a1ng da kh\u00f4ng kh\u00e1c bi\u1ec7t gi\u1eefa hai nh\u00f3m. \u1ede b\u1ec7nh nh\u00e2n HAdV, ban da bao g\u1ed3m d\u00e1t s\u1ea7n, s\u1ea7n v\u00e0 h\u1ed3ng ban. C\u00f3 4 tr\u1ebb nhi\u1ec5m HAdV c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111\u00e1p \u1ee9ng ti\u00eau chu\u1ea9n Kawasaki, trong \u0111\u00f3 IVIG \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u00e0nh c\u00f4ng \u1edf 2 tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<figure id=\"attachment_157387\" aria-describedby=\"caption-attachment-157387\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-157387 size-full\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1.jpg\" alt=\"B\u1ea3ng 1\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-157387\" class=\"wp-caption-text\">B\u1ea3ng 1<\/figcaption><\/figure>\n<h2>X\u00e9t nghi\u1ec7m<\/h2>\n<p>B\u1ea3ng 2 t\u00f3m t\u1eaft c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m sinh h\u00f3a v\u00e0 h\u00ecnh \u1ea3nh h\u1ecdc. Tr\u1ebb nhi\u1ec5m HAdV c\u00f3 c\u00e1c markers vi\u00eam t\u0103ng cao h\u01a1n so v\u1edbi tr\u1ebb m\u1eafc nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p kh\u00e1c, CRP trung b\u00ecnh (50.8 \u00b1 54.2 so v\u1edbi 16.5 \u00b1 33.8 mg\/L; p &lt; 0.001 ), procalcitonin (1.9\u00b13.3 so v\u1edbi 0.7 1.2 ng\/mL; P = 0.047 ) v\u00e0 fibrinogen (461.3 + 126.3 353.2 137 mg\/dL.; p = 0.007 ). Trong s\u1ed1 98 tr\u1ebb nhi\u1ec5m HAdV, c\u00f3 81 tr\u1ebb t\u0103ng CRP so v\u1edbi 33 tr\u1ebb trong nh\u00f3m nhi\u1ec5m c\u00e1c virus h\u00f4 h\u1ea5p kh\u00e1c (p &lt; 0.001) Procalcitonin \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf 140 tr\u1ebb v\u00e0 t\u0103ng \u1edf 35 b\u1ec7nh nh\u00e2n nhi\u1ec5m HAdV so v\u1edbi 9 nhi\u1ec5m c\u00e1c virus h\u00f4 h\u1ea5p kh\u00e1c (p = 0.001). S\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u \u1edf tr\u1ebb nhi\u1ec5m HAdV cao h\u01a1n nhe (13.572\u00b17.541 so v\u1edbi 11.161 \u00b14.908 t\u1ebf b\u00e0o\/mm3; p = 0.02 ), \u0111i k\u00e8m t\u1edbi t\u0103ng b\u1ea1ch c\u1ea7u trung t\u1ec9nh (8.691 \u00b1 6.792 so v\u1edbi 5.349 \u00b14.003 t\u1ebf b\u00e0o\/mm3; p &lt; 0.001 ) v\u00e0 t\u0103ng b\u1ea1ch c\u1ea7u mono (1.369 \u00b1 6.77 so v\u1edbi 972 \u00b1 592 t\u1ebf b\u00e0o\/mm3; p &lt; 0.001). Kh\u00f4ng thi\u1ebfu m\u00e1u hay t\u0103ng ti\u1ec3u c\u1ea7u \u1edf hai nh\u00f3m. Men gan h\u1ea7u nh\u01b0 n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng \u1edf g\u1ea7n nh\u01b0 t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n. Trong nh\u00f3m tr\u1ebb nhi\u1ec5m HAdV, khi so s\u00e1nh b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p tr\u00ean v\u1edbi nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p d\u01b0\u1edbi, kh\u00f4ng ghi nh\u1eadn s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111\u00e1p \u1ee9ng vi\u00eam x\u00e9t theo procalcitonin, s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u trung t\u1ec9nh, lymphocyte v\u00e0 n\u1ed3ng \u0111\u1ed9 fibrinogen. Gi\u00e1 tr\u1ecb CRP h\u01a1i cao h\u01a1n \u1edf tr\u1ebb nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p d\u01b0\u1edbi, tuy nhi\u00ean, s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea. Xquang ng\u1ef1c \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf 58 tr\u1ebb nhi\u1ec5m HAdV, trong \u0111\u00f3 35 tr\u1ebb c\u00f3 b\u1ea5t th\u01b0\u1eddng. H\u00ecnh \u1ea3nh \u0111\u00f4ng \u0111\u1eb7c m\u1ed9t ho\u1eb7c nhi\u1ec1u th\u1ee7y ph\u00e2n th\u1ee7y l\u00e0 ph\u00e1t hi\u1ec7n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t (38%), ti\u1ebfp theo l\u00e0 t\u1ed5n th\u01b0\u01a1ng k\u1ebb (22.4%). Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ea7n su\u1ea5t b\u1ea5t th\u01b0\u1eddng xquang gi\u1eefa nh\u00f3m HAdV v\u00e0 nh\u00f3m kh\u00f4ng nhi\u1ec5m HAdV.<\/p>\n<figure id=\"attachment_157383\" aria-describedby=\"caption-attachment-157383\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-157383\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang.jpg\" alt=\"Bang 2\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-157383\" class=\"wp-caption-text\">Bang 2<\/figcaption><\/figure>\n<h2>\u0110i\u1ec1u tr\u1ecb v\u00e0 k\u1ebft c\u1ee5c<\/h2>\n<p>C\u00f3 24.5% tr\u1ebb nhi\u1ec5m HAdV v\u00e0 17.8% tr\u1ebb m\u1eafc c\u00e1c nhi\u1ec5m tr\u00f9ng kh\u00e1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng corticosteroid to\u00e0n th\u00e2n (p = 0.195), trong khi 41 tr\u1ebb \u1edf nh\u00f3m HAdV v\u00e0 15 tr\u1ebb \u1edf nh\u00f3m ch\u1ee9ng \u0111\u01b0\u1ee3c d\u00f9ng corticosteroid dang khi dung (p = 0.002). S\u1ed1 tr\u1ebb c\u1ea7n h\u1ed7 tr\u1ee3 oxy cao h\u01a1n \u0111\u00e1ng k\u1ec3 \u1edf nh\u00f3m ch\u1ee9ng (37% so v\u1edbi 9.2%; p &lt; 0.001).<\/p>\n<figure id=\"attachment_157388\" aria-describedby=\"caption-attachment-157388\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-157388\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-3.jpg\" alt=\"B\u1ea3ng 3\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-3.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-3-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-3-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-3-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-3-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-157388\" class=\"wp-caption-text\">B\u1ea3ng 3<\/figcaption><\/figure>\n<p>Tr\u1ebb nhi\u1ec5m HAdV \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh th\u01b0\u1eddng xuy\u00ean h\u01a1n so v\u1edbi tr\u1ebb m\u1eafc c\u00e1c nhi\u1ec5m tr\u00f9ng kh\u00e1c, v\u1edbi kh\u1ea3 n\u0103ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb cao g\u1ea5p 9 l\u1ea7n \u1edf nh\u00f3m HAdV. C\u00e1c kh\u00e1ng sinh th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u1ea5t trong nh\u00f3m HAdV l\u00e0 ceftriaxone (35%), amoxicillin ho\u1eb7c amoxicillin\/clavulanic acid (29.8%), ph\u1ed1i h\u1ee3p ceftriaxone v\u1edbi macrolide (15.8%) ho\u1eb7c macrolide \u0111\u01a1n \u0111\u1ed9c (15.8%), tuy c\u1ea3i thi\u1ec7n l\u00e2m s\u1ea3ng trong v\u00f2ng 24-48 gi\u1edd th\u01b0\u1eddng k\u00e9m. \u1ede 14\/76 tr\u1ebb, kh\u00e1ng sinh \u0111\u01b0\u1ee3c ng\u1eebng trong v\u00f2ng 72 gi\u1edd khi c\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m adenovirus d\u01b0\u01a1ng t\u1ec9nh.<\/p>\n<figure id=\"attachment_157385\" aria-describedby=\"caption-attachment-157385\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-157385\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-3.jpg\" alt=\"H\u00ecnh 3\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-3.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-3-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-3-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-3-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-3-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-157385\" class=\"wp-caption-text\">H\u00ecnh 3<\/figcaption><\/figure>\n<p>Tr\u1ebb nhi\u1ec5m HAdV v\u1edbi tr\u1ebb m\u1eafc c\u00e1c nhi\u1ec5m tr\u00f9ng kh\u00e1c kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 th\u1eddi gian n\u1eb1m vi\u1ec7n v\u00e0 t\u1ef7 l\u1ec7 bi\u1ebfn ch\u1ee9ng (p &gt; 0.05). Ch\u1ec9 c\u00f3 m\u1ed9t s\u1ed1 \u00edt tr\u1ebb c\u1ea7n \u0111i\u1ec1u tr\u1ecb h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c, v\u00e0 m\u1eb7c d\u00f9 t\u1ef7 l\u1ec7 nh\u1eadp ICU \u1edf nh\u00f3m nhi\u1ec5m c\u00e1c t\u00e1c nh\u00e2n kh\u00e1c cao h\u01a1n nh\u00f3m HAdV (5.5% so v\u1edbi 1.1%), s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea. Kh\u00f4ng ghi nh\u1eadn tr\u01b0\u1eddng h\u1ee3p t\u1eed vong n\u00e0o \u1edf c\u1ea3 hai nh\u00f3m.<\/p>\n<figure id=\"attachment_157384\" aria-describedby=\"caption-attachment-157384\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-157384\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-4.jpg\" alt=\"H\u00ecnh 4\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-4.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-4-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-4-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-4-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/hinh-4-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-157384\" class=\"wp-caption-text\">H\u00ecnh 4<\/figcaption><\/figure>\n<p>Ph\u00e2n t\u00edch t\u01b0\u01a1ng quan Pearson \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ed7i li\u00ean h\u1ec7 gi\u1eefa th\u1eddi gian n\u1eb1m vi\u1ec7n v\u00e0 c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a \u1edf tr\u1ebb nhi\u1ec5m HAdV. K\u1ebft qu\u1ea3 cho th\u1ea5y m\u1ed1i t\u01b0\u01a1ng quan thu\u1eadn m\u1ee9c \u0111\u1ed9 v\u1eeba gi\u1eefa th\u1eddi gian n\u1eb1m vi\u1ec7n v\u1edbi t\u0103ng b\u1ea1ch c\u1ea7u, b\u1ea1ch c\u1ea7u trung t\u00ednh, CRP v\u00e0 procalcitonin. Ngo\u00e0i ra, vi\u1ec7c s\u1eedd\u1ee5ng kh\u00e1ng sinh c\u0169ng l\u00e0m k\u00e9o d\u00e0i th\u1eddi gian n\u1eb1m vi\u1ec7n. Ng\u01b0\u1ee3c l\u1ea1i, \u1edf nh\u00f3m kh\u00f4ng nhi\u1ec5m HAdV, ph\u00e2n t\u00edch t\u01b0\u01a1ng t\u1ef1 kh\u00f4ng cho th\u1ea5y m\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa th\u1eddi gian n\u1eb1m vi\u1ec7n v\u1edbi t\u0103ng s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u, b\u1ea1ch c\u1ea7u trung tinh, CRP, procalcitonin hay vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh.<\/p>\n<h2>\u0110\u1ed3ng nhi\u1ec5m \u1edf b\u1ec7nh nh\u00e2n HAdV<\/h2>\n<p>Trong nh\u00f3m tr\u1ebb nhi\u1ec5m HADV, c\u00f3 56\/98 tr\u1ebb \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0111\u1ed3ng nhi\u1ec5m virus, v\u1edbi \u00edt nh\u1ea5t m\u1ed9t lo\u1ea1i virus h\u00f3 h\u1ea5p kh\u00e1c ngo\u00e0i HAdV. Trong nh\u00f3m tr\u1ebb \u0111\u1ed3ng nhi\u1ec5m, c\u00e1c virus \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 rhinovirus\/enterovirus, \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf 27\/56 tr\u1ebb, v\u00e0 c\u00fam AB \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u1edf 14 tr\u1ebb. Khi so s\u00e1nh tr\u1ebb ch\u1ec9 nhi\u1ec5m HAdV v\u1edbi tr\u1ebb \u0111\u1ed3ng nhi\u1ec5m virus, kh\u00f4ng ghi nh\u1eadn s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 c\u00e1c ch\u1ec9 s\u1ed1 x\u00e9t nghi\u1ec7m c\u0169ng nh\u01b0 h\u00ecnh \u1ea3nh X-quang ng\u1ef1c gi\u1eefa hai nh\u00f3m. C\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u1ea3ng nh\u00ecn chung c\u0169ng kh\u00f4ng kh\u00e1c bi\u1ec7t, ngo\u1ea1i tr\u1eeb kh\u1ecf kh\u1ebb g\u1eb7p nhi\u1ec1u h\u01a1n \u1edf tr\u1ebb \u0111\u1ed3ng nhi\u1ec5m (p = 0.029) tuy nhi\u00ean kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa tr\u1ebb c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 \u0111\u1ed3ng nhi\u1ec5m rhino\/enterovirus (p = 0.754) Ngo\u00e0i ra, kh\u00f4ng ghi nh\u1eadn s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea v\u1ec1 t\u1ef7 l\u1ec7 s\u1eed d\u1ee5ng kh\u00e1ng sinh gi\u1eefa hai nh\u00f3m. Tuy nhi\u00ean, h\u1ed7 tr\u1ee3 oxy, \u0111i\u1ec1u tr\u1ecb kh\u1ec9 d\u1ee5ng v\u00e0 corticosteroid \u0111\u01b0\u1eddng to\u00e0n th\u00e2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u h\u01a1n \u1edf tr\u1ebb \u0111\u1ed3ng nhi\u1ec5m virus (p &lt; 0.05)<\/p>\n<h2>So s\u00e1nh gi\u1eefa tr\u1ebb ch\u1ec9 nhi\u1ec5m HAdV v\u00e0 tr\u1ebb nhi\u1ec5m c\u00e1c virus kh\u00e1c<\/h2>\n<figure id=\"attachment_157386\" aria-describedby=\"caption-attachment-157386\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-157386\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-4.jpg\" alt=\"B\u1ea3ng 4\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-4.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-4-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-4-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-4-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/05\/bang-4-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption id=\"caption-attachment-157386\" class=\"wp-caption-text\">B\u1ea3ng 4<\/figcaption><\/figure>\n<p>Khi so s\u00e1nh tr\u1ebb ch\u1ec9 nhi\u1ec3m HAdV v\u1edbi tr\u1ebb nhi\u1ec5m c\u00e1c virus kh\u00e1c, sau khi \u0111\u00e3 lo\u1ea1i tr\u1eeb c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed3ng nhi\u1ec5m, v\u1eabn cho k\u1ebft qu\u1ea3 t\u01b0\u01a1ng t\u1ef1. S\u1ed1t g\u1eb7p nhi\u1ec1u h\u01a1n \u1edf nh\u00f3m ch\u1ec9 nhi\u1ec5m HADV (97.7% so v\u1edbi 74%; p &lt; 0.001 ) \u0111\u1ed3ng th\u1eddi th\u1eddi gian s\u1ed1t c\u0169ng k\u00e9o d\u00e0i h\u01a1n (6.2 \u00b1 3.9 so v\u1edbi 3.4 + 2.3 ng\u00e0y: p &lt; 0.001) so v\u1edbi nh\u00f3m ch\u1ee9ng. Tr\u1ebb ch\u1ec9 nhi\u1ec5m HAdV th\u01b0\u1eddng c\u00f3 \u0111au h\u1ecdng (54.5% so v\u1edbi 13.7%; p&lt; 0.001) v\u00e0 n\u1ed7i h\u1ea1ch (43.2% so v\u1edbi 12.3%, p = 0.02 ) nhi\u1ec1u h\u01a1n. Ng\u01b0\u1ee3c l\u1ea1i, tr\u1ebb kh\u00f4ng nhi\u1ec5m HAdV c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p n\u1eb7ng h\u01a1n, bao g\u1ed3m kh\u00f2 kh\u00e8 (23.3% so v\u1edbi 6.8%; p = 0.017 ) suy h\u00f4 h\u1ea5p<\/p>\n<p>(45.2% so v\u1edbi 6.8%; p = 0.001 ) \u0111\u1ed9 b\u00e3o h\u00f2a oxy th\u1ea5p h\u01a1n (96 \u00b1 3.8 so v\u1edbi 98.3\u00b11.2; p &lt; 0.001 ) v\u1edbi t\u1ef7 l\u1ec7 gi\u1ea3m oxy m\u00e1u \u2264 94% cao h\u01a1n (23.3% so v\u1edbi 0%; p &lt; 0.001 ). T\u1ea7n su\u1ea5t c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c kh\u00f4ng kh\u00e1c bi\u1ec7t gi\u1eefa hai nh\u00f3m.<\/p>\n<p>Tr\u1ebb nhi\u1ec5m HAdV c\u00f3 c\u00e1c ch\u1ec9 s\u1ed1 vi\u00eam cao h\u01a1n so v\u1edbi tr\u1ebb m\u1eafc c\u00e1c nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p kh\u00e1c, th\u1ec3 hi\u1ec7n qua CRP cao h\u01a1n (54.1 \u00b1 55.4 so v\u1edbi 16.5 + 33.8 mg\/L; p &lt; 0.001 ) procalcitonin cao h\u01a1n (1.7+ 2.3 so v\u1edbi 0.7 \u00b1 12 ng\/ml; p = 0.0321 fibrinogen cao h\u01a1n (472.5 \u00b1 131.5 so v\u1edbi 352.2 \u00b1 137 mg\/dL; p = 0.008 ) v\u00e0 s\u1ed1 l\u01b0\u1ee3ng trung t\u1ec9nh cao h\u01a1n (8.272 \u00b1 4.745 so v\u1edbi 5.349 \u2013 4.003 t\u1ebf b\u00e0o\/mm3 p &lt; 0.001 ). Ngo\u00e0i ra, kh\u00f4ng ghi nh\u1eadn s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea v\u1ec1 b\u1ea5t th\u01b0\u1eddng tr\u00ean X-quang ng\u1ef1c gi\u1eefa hai nh\u00f3m.<\/p>\n<p>T\u1ec9 l\u1ec7 s\u1eed d\u1ee5ng kh\u00e1ng sinh cao h\u01a1n \u1edf tr\u1ebb ch\u1ec9 nhi\u1ec5m HAdV (70.5% so v\u1edbi 27.4%; p &lt; 0.001 ), trong khi h\u1ed7 tr\u1ee3 oxy th\u01b0\u1eddng g\u1eb7p h\u01a1n \u1edf tr\u1ebb \u0111\u1ed3ng nhi\u1ec5m virus (4.5% so v\u1edbi 37%, p &lt; 0.001 ).<\/p>\n<h2>Th\u1ea3o lu\u1eadn<\/h2>\n<p>HAdV th\u01b0\u1eddng l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p \u1edf tr\u1ebb em, c\u1ea3 \u1edf tr\u1ebb c\u00f3 mi\u1ec5n d\u1ecbch b\u00ecnh th\u01b0\u1eddng l\u1ea7n tr\u1ebb suy gi\u1ea3m mi\u1ec5n d\u1ecbch, \u0111\u1ed3ng th\u1eddi \u0111\u1eb7t ra nhi\u1ec1u th\u00e1ch th\u1ee9c trong ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u00e0 x\u00e2y d\u1ef1ng chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a nhi\u1ec5m HAdV r\u1ea5t \u0111a d\u1ea1ng, t\u1eeb c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u1eb9 \u1edf \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean \u0111\u1ebfn c\u00e1c nhi\u1ec5m tr\u00f9ng n\u1eb7ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi. Kh\u00f3 kh\u0103n trong ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng nhi\u1ec5m HAdV xu\u1ea5t ph\u00e1t t\u1eeb s\u1ef1 ch\u1ed3ng l\u1ea5p tri\u1ec7u ch\u1ee9ng v\u1edbi c\u00e1c t\u00e1c nh\u00e2n h\u00f4 h\u1ea5p kh\u00e1c do vi khu\u1ea9n ho\u1eb7c virus.<\/p>\n<p>M\u1eb7c d\u00f9 nhi\u1ec5m HAdV \u0111\u01b0\u1ee3c ghi nh\u1eadn quanh n\u0103m, ch\u00fang t\u00f4i nh\u1eadn th\u1ea5y t\u1ef7 l\u1ec7 m\u1eafc \u0111\u1ea1t \u0111\u1ec9nh v\u00e0o m\u00f9a xu\u00e2n, kh\u00e1c v\u1edbi m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y. Krajden v\u00e0 c\u00f4ng s\u1ef1 ghi nh\u00e2n kh\u00f4ng c\u00f3 s\u1ef1 thay \u0111\u1ed5i theo m\u00f9a, trong khi Peled v\u00e0 c\u00f4ng s\u1ef1 b\u00e1o c\u00e1o t\u1ef7 l\u1ec7 m\u1eafc cao nh\u1ea5t v\u00e0o m\u00f9a \u0111\u00f4ng (th\u00e1ng 12-2). \u0110i\u1ec1u th\u00fa v\u1ecb l\u00e0 s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn nh\u1eefng thay \u0111\u1ed5i d\u1ecbch t\u1ec5 do \u0111\u1ea1i d\u1ecbch COVID-19 g\u00e2y ra. C\u00e1c n\u1ed7 l\u1ef1c to\u00e0n c\u1ea7u nh\u1ea5m h\u1ea1n ch\u1ebf s\u1ef1 l\u00e2y lan c\u1ee7a COVID-19, bao g\u1ed3m gi\u00e3n c\u00e1ch x\u00e3 h\u1ed9i, \u0111eo kh\u1ea9u trang, \u0111\u00f3ng c\u1eeda tr\u01b0\u1eddng h\u1ecdc v\u00e0 nh\u00e0 tr\u1ebb, c\u0169ng nh\u01b0 h\u1ea1n ch\u1ebf \u0111i l\u1ea1i, \u0111\u00e3 l\u00e0m gi\u00e1n \u0111o\u1ea1n s\u1ef1 l\u01b0u h\u00e0nh c\u1ee7a c\u00e1c virus h\u00f4 h\u1ea5p, d\u1eabn \u0111\u1ebfn gi\u1ea3m ph\u01a1i nhi\u1ec5m c\u00e1c t\u00e1c nh\u00e2n virus c\u1ed5 \u0111i\u1ec3n v\u00e0 l\u00e0m suy gi\u1ea3m mi\u1ec5n d\u1ecbch trong c\u1ed9ng \u0111\u1ed3ng. Sau khi c\u00e1c bi\u1ec7n ph\u00e1p h\u1ea1n ch\u1ebf trong \u0111\u1ea1i \u0111\u1ecbch \u0111\u1ee1 b\u1ecf, s\u1ef1 gia t\u0103ng l\u01b0u h\u00e0nh c\u00e1c virus h\u00f4 h\u1ea5p \u0111\u00e3 l\u00e0m t\u0103ng s\u1ed1 l\u01b0\u1ee3ng tr\u1ebb nh\u1ea1y c\u1ea3m v\u1edbi b\u1ec7nh, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng tr\u1ebb ch\u01b0a t\u1eebng ti\u1ebfp x\u00fac v\u1edbi virus n\u00e0y trong th\u1eddi gian \u0111\u1ea1i d\u1ecbch.<\/p>\n<p>Trong nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7, tr\u1ebb nhi\u1ec5m HAdV nh\u1ecf tu\u1ed5i h\u01a1n tr\u1ebb m\u1eafc c\u00e1c nhi\u1ec5m tr\u00f9ng kh\u00e1c, v\u00e0 ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p HAdV \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u1edf tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i (75%), nh\u1ea5n m\u1ea1nh t\u00ednh d\u1ec5 t\u1ed5n th\u01b0\u01a1ng \u1edf nh\u00f3m tu\u1ed5i n\u00e0y. \u0110\u00e1ng ch\u00fa \u00fd, tu\u1ed5i b\u1ec7nh nh\u00e2n trong nghi\u00ean c\u1ee9u n\u00e0y cao h\u01a1n so v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y, g\u1ee3i \u00fd kh\u1ea3 n\u0103ng ch\u1ecbu \u1ea3nh h\u01b0\u1edfng c\u1ee7a s\u1ef1 kh\u00e1c bi\u1ec7t v\u00f9ng mi\u1ec1n, kh\u00e1c bi\u1ec7t qu\u1ea7n th\u1ec3 nghi\u00ean c\u1ee9u ho\u1eb7c thay \u0111\u1ed5i trong \u0111\u1ed9ng h\u1ecdc l\u01b0u h\u00e0nh virus, \u0111\u1eb7c bi\u1ec7t trong b\u1ed1i c\u1ea3nh h\u1eadu COVID-19. S\u1ef1 suy gi\u1ea3m mi\u1ec5n d\u1ecbch c\u1ed9ng \u0111\u1ed3ng do gi\u1ea3m l\u01b0u h\u00e0nh virus trong th\u1eddi k\u1ef3 \u0111\u1ea1i d\u1ecbch c\u00f3 th\u1ec3 \u0111\u00e3 g\u00f3p ph\u1ea7n l\u00e0m thay \u0111\u1ed5i nh\u00f3m tu\u1ed5i nhi\u1ec5m HAdV. Trong nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7 n\u00e0y, c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p bao g\u1ed3m s\u1ed1t (90%) v\u1edbi th\u1eddi gian trung b\u00ecnh kho\u1ea3ng 5 ng\u00e0y, h\u1ecd (75%), \u0111au h\u1ecdng (52%) v\u00e0 n\u1ed5i h\u1ea1ch (32%). Nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y.<\/p>\n<p>Tr\u1ebb nhi\u1ec5m HAdV c\u00f3 t\u1ea7n su\u1ea5t s\u1ed1t cao h\u01a1n, th\u1eddi gian s\u1ed1t k\u00e9o d\u00e0i h\u01a1n v\u00e0 t\u1ef7 l\u1ec7 co gi\u1eadt do s\u1ed1t cao h\u01a1n (15.3%) so v\u1edbi tr\u1ebb nhi\u1ec5m c\u00e1c virus kh\u00e1c (6.8%). Nh\u1eefng ph\u00e1t hi\u1ec7n n\u00e0y c\u00f9ng c\u1ed1 k\u1ebft qu\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u \u0111a trung t\u00e2m ti\u1ebfn c\u1ee9u v\u1ec1 c\u0103n nguy\u00ean virus c\u1ee7a co gi\u1eadt do s\u1ed1t, trong \u0111\u00f3 nh\u1ea5n m\u1ea1nh vai tr\u00f2 n\u1ed5i b\u1eadt c\u1ee7a HAdV trong s\u1ed1 c\u00e1c virus h\u00f3 h\u1ea5p g\u00e2y co gi\u1eadt do s\u1ed1t (chi\u1ebfm 55.5% t\u1ed5ng s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p). C\u00e1c nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y \u0111\u00e3 x\u00e1c \u0111\u1ecbnh HAdV l\u00e0 m\u1ed9t t\u00e1c nh\u00e2n ti\u1ec1m t\u00e0ng g\u00e2y b\u1ec7nh \u1edf tr\u1ebb suy gi\u1ea3m mi\u1ec5n d\u1ecbch n\u1eb7ng, nh\u1eefng b\u1ec7nh nh\u00e2n th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n vi\u00eam ph\u1ed5i v\u00e0 c\u1ea7n h\u1ed7 tr\u01a1 oxy. Trong nghi\u00ean c\u1ee9u n\u00e0y, \u1edf c\u00e1c b\u1ec7nh nh\u00e2n HAdV c\u00f3 ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch b\u00ecnh th\u01b0\u1eddng, ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi k\u00e8m b\u1ea5t th\u01b0\u1eddng x-quang ng\u1ef1c \u1edf 35 tr\u01b0\u1eddng h\u1ee3p (60%), kh\u00f4 kh\u00e8 \u1edf 16 tr\u01b0\u1eddng h\u1ee3p (16%) v\u00e0 gi\u1ea3m oxy m\u00e1u \u1edf 3 tr\u01b0\u1eddng h\u1ee3p (3%). C\u00e1c ph\u00e1t hi\u1ec7n n\u00e0y kh\u00e1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi nghi\u00ean c\u1ee9u c\u1ee7a Sun v\u00e0 c\u1ed9ng s\u1ef1 v\u00e0 Yao v\u00e0 c\u1ed9ng s\u1ef1, trong \u0111\u00f3 b\u1eaft th\u01b0\u1eddng xquang ng\u1ef1c \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u1ea7n l\u01b0\u1ee3t l\u00e0 48% v\u00e0 86% b\u1ec7nh nh\u00e2n. C\u00e1c \u0111\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh h\u1ecdc kh\u00f4ng kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 gi\u1eefa tr\u1ebb nhi\u1ec5m HAdV v\u00e0 tr\u1ebb nhi\u1ec5m virus h\u00f4 h\u1ea5p kh\u00e1c. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y x-quang ng\u1ef1c c\u00f3 th\u1ec3 c\u00f3 gi\u00e1 tr\u1ecb h\u1ea1n ch\u1ebf trong vi\u1ec7c ph\u00e2n bi\u1ec7t HAdV v\u1edbi c\u00e1c c\u0103n nguy\u00ean virus kh\u00e1c g\u00e2y b\u1ec7nh h\u00f4 h\u1ea5p.<\/p>\n<p>Tr\u1ebb nhi\u1ec5m H\u1ea0dV c\u00f3 t\u1ef7 l\u1ec7 suy h\u00f4 h\u1ea5p, nhu c\u1ea7u h\u1ed7 tr\u1ee3 oxy v\u00e0 nh\u1eadp ICU th\u1ea5p h\u01a1n so v\u1edbi tr\u1ebb nhi\u1ec5m c\u00e1c virus h\u00f4 h\u1ea5p kh\u00e1c. Tuy nhi\u00ean, m\u1eb7c d\u00f9 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u1ec1 h\u00f4 h\u1ea5p tr\u00ean l\u00e2m s\u00e0ng th\u1ea5p h\u01a1n, tr\u1ebb nhi\u1ec5m HAdV l\u1ea1i c\u00f3 \u0111\u00e1p \u1ee9ng vi\u00eam m\u1ea1nh h\u01a1n trong di\u1ec5n ti\u1ebfn b\u1ec7nh, th\u1ec3 hi\u1ec7n qua t\u1ea7n su\u1ea5t v\u00e0 m\u1ee9c \u0111\u1ed9 t\u00e2ng c\u1ee7a c\u00e1c d\u1ea5u \u1ea5n sinh h\u00f3a, cung c\u1ea5p nh\u1eefng hi\u1ec3u bi\u1ebft quan tr\u1ecdng v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh l\u00fd virus n\u00e0y. T\u01b0\u01a1ng t\u1ef1 c\u00e1c t\u00e1c gi\u1ea3 kh\u00e1c \u0111\u00e3 m\u00f4 t\u1ea3, nghi\u00ean c\u1ee9u c\u1ee7a ch\u00fang t\u00f4i ghi nh\u1eadn s\u1ef1 gia t\u0103ng \u0111\u00e1ng k\u1ec3 c\u00e1c d\u1ea7u \u1ea9n vi\u00eam, bao g\u1ed3m CRP, procalcitonin v\u00e0 fibrinogen \u1edf tr\u1ebb nhi\u1ec5m HAdV so v\u1edbi tr\u1ebb nhi\u1ec5m c\u00e1c t\u00e1c nh\u00e2n h\u00f4 h\u1ea5p kh\u00e1c. Nh\u1eefng ph\u00e1t hi\u1ec7n n\u00e0y cho th\u1ea5y \u0111\u00e1p \u1ee9ng vi\u00eam to\u00e0n th\u00e2n \u1edf b\u1ec7nh nh\u00e2n nhi\u1ec5m HAdV m\u1ea1nh h\u01a1n, gi\u1ed1ng v\u1edbi nhi\u1ec3m khu\u1ea9n h\u01a1n l\u00e0 nhi\u1ec5m virus.<\/p>\n<p>H\u1ec7 qu\u1ea3 h\u1ee3p l\u00fd t\u1eeb c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u1ea3ng v\u00e0 sinh h\u1ecfa \u0111\u00e3 m\u00f4 t\u1ea3 l\u00e0 tr\u1ebb nhi\u1ec5m HAdV c\u00f3 kh\u1ea3 n\u0103ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh cao h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi tr\u1ebb m\u1eafc c\u00e1c nhi\u1ec5m tr\u00f9ng kh\u00e1c; \u0111i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c c\u0169ng c\u1ed1 b\u1edfi m\u1ed1i t\u01b0\u01a1ng quan thu\u00e2n gi\u1eefa th\u1eddi gian n\u1eb1m vi\u1ec7n v\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh \u1edf nh\u00f3m tr\u1ebb nhi\u1ec5m HAdV. D\u1eef li\u1ec7u n\u00e0y ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y tr\u00ean qu\u1ea7n th\u1ec3 tr\u1ebb em, trong \u0111\u00f3 ghi nh\u00e2n xu h\u01b0\u1edbng k\u1ebb \u0111\u01a1n kh\u00e1ng sinh qu\u1ea3 m\u1ee9c trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m HAdV. C\u1ee5 th\u1ec3, \u0111\u00e1p \u1ee9ng vi\u00eam gi\u1ed1ng nhi\u1ec5m khu\u1ea9n v\u00e0 vi\u1ec7c thi\u1ebfu c\u00e1c d\u1ea7u \u1ea9n sinh h\u1ecdc \u0111\u1eb7c hi\u1ec7u cho ch\u1ea9n \u0111o\u00e1n HAdV d\u1ea7n \u0111\u1ebfn t\u1ec9nh tr\u1ea1ng l\u1ea1m d\u1ee5ng kh\u00e1ng sinh v\u00e0 nh\u1eadp vi\u1ec7n kh\u00f4ng c\u1ea7n thi\u1ebft, l\u00e0m t\u0103ng g\u00e1nh n\u1eb7ng y t\u1ebf c\u0169ng nh\u01b0 s\u1ef1 lo l\u1eafng cho ng\u01b0\u1eddi nh\u00e0 v\u00e0 b\u00e1c s\u0129. \u0110i\u1ec1u n\u00e0y nh\u1ea5n m\u1ea1nh t\u1ea7m quan trong c\u1ee7a vi\u1ec7c c\u1ea3i thi\u1ec7n c\u00e1c chi\u1ebfn l\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t c\u0103n nguy\u00ean virus v\u00e0 v\u00ec khu\u1ea9n trong nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p \u1edf tr\u1ebb em, t\u1eeb \u0111\u00f3 t\u1ed1i \u01b0u h\u00f3a vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh h\u1ee3p l\u00fd. Vi\u1ec7c tri\u1ec3n khai c\u00e1c b\u1ed9 kit ph\u00e1t hi\u1ec7n kh\u00e1ng nguy\u00ean nhanh \u0111\u01b0\u1ee3c xem l\u00e0 h\u1eefu \u00edch \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean v\u00e0 c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 chi\u1ebfn l\u01b0\u1ee3c \u201ctheo d\u00f5i ch\u1edd \u0111\u1ee3i&#8221; m\u1eb7c d\u00f9 c\u00e1c d\u1ea5u \u1ea5n vi\u00eam huy\u1ebft thanh t\u0103ng cao. G\u1ea7n \u0111\u00e2y, m\u1ed9t thang \u0111i\u1ec3m BV Score nh\u1eb1m ph\u00e2n bi\u1ec7t nhi\u1ec5m khu\u1ea9n v\u1edbi nhi\u1ec5m virus \u2013 d\u1ef1a tr\u00ean s\u1ef1 k\u1ebft h\u1ee3p n\u1ed3ng \u0111\u1ed9 TRAIL, IP-10 v\u00e0 CRP \u0111\u00e3 cho th\u1ea5y hi\u1ec7u qu\u1ea3 trong vi\u1ec7c ph\u00e2n bi\u1ec7t nhi\u1ec5m adenovirus \u0111\u01a1n thu\u1ea7n v\u1edbi \u0111\u1ed3ng nhi\u1ec5m adenovirus-vi khu\u1ea9n \u1edf nh\u00f3m tr\u1ebb c\u00f3 PCR adenovirus d\u01b0\u01a1ng t\u1ec9nh. \u0110i\u1ec1u n\u00e0y g\u1ee3i \u00fd r\u1eb1ng vi\u1ec7c \u00e1p d\u1ee5ng c\u00f4ng c\u1ee5 n\u00e0y c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n c\u1ea3i thi\u1ec7n s\u1eed d\u1ee5ng kh\u00e1ng sinh h\u1ee3p l\u00fd.<\/p>\n<p>\u0110\u00e1p \u1ee9ng vi\u00eam b\u1ea5t th\u01b0\u1eddng \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf tr\u1ebb nhi\u1ec5m HAdV c\u0169ng \u0111\u1eb7t ra nh\u1eefng th\u00e1ch th\u1ee9c \u0111\u00e1ng k\u1ec3 trong vi\u1ec7c ph\u00e2n bi\u1ec7t nhi\u1ec5m HAdV v\u1edbi b\u1ec7nh Kawasaki \u2013 m\u1ed9t b\u1ec7nh l\u00fd vi\u00eam th\u01b0\u1eddng g\u1eb7p \u1edf c\u00f9ng nh\u00f3m tu\u1ed5i. Trong nghi\u00ean c\u1ee9u n\u00e0y, 4% tr\u1ebb trong nh\u00f3m HAdV \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Kawasaki v\u00e0 2% \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb IVIG. Hai t\u1ec9nh trang n\u00e0y c\u00f3 nhi\u1ec1u \u0111i\u1ec3m t\u01b0\u01a1ng \u0111\u1ed3ng v\u1ec1 thay \u0111\u1ed5i c\u00e1c d\u1ea5u \u1ea5n vi\u00eam c\u0169ng nh\u01b0 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng nh\u01b0 s\u1ed1t k\u00e9o d\u00e0i, ph\u00e1t ban, vi\u00eam k\u1ebft m\u1ea1c, thay \u0111\u1ed5i ni\u00eam m\u1ea1c v\u00e0 n\u1ed5i h\u1ea1ch, khi\u1ebfn vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t tr\u1edf n\u00ean kh\u00f3 kh\u0103n. M\u1ed7i li\u00ean quan gi\u1eefa nhi\u1ec5m adenovirus tr\u01b0\u1edbc \u0111\u1ecf v\u00e0 b\u1ec7nh Kawasaki \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t d\u1ef1a tr\u00ean nhi\u1ec1u d\u1eef li\u1ec7u d\u1ecbch t\u1ec5 h\u1ecdc. M\u1eb7c d\u00f9 c\u01a1 ch\u1ebf ch\u00ednh x\u00e1c c\u1ee7a m\u1ed1i li\u00ean h\u1ec7 n\u00e0y v\u1eabn \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u, nghi\u00ean c\u1ee9u c\u1ee7a Zsengeller v\u00e0 c\u00f4ng s\u1ef1 cho th\u1ea5y s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a HAdV v\u00e0o \u0111\u1ea1i th\u1ef1c b\u00e0o ph\u1ebf nang g\u00e2y ho\u1ea1t h\u00f3a s\u1edbm c\u00e1c tin hi\u1ec7u ti\u1ec1n vi\u00eam, khi\u1ec3n virus c\u00f3 kh\u1ea3 n\u0103ng k\u00edch ho\u1ea1t \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c, g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 ph\u00e1t tri\u1ec3n c\u00e1c t\u1ec9nh tr\u1ea1ng gi\u1ed1ng Kawasaki. Hi\u1ec7n v\u1eabn ch\u01b0a r\u00f5 li\u1ec7u HAdV c\u00f3 vai tr\u00f2 nh\u01b0 m\u1ed9t y\u1ebfu t\u1ed1 kh\u1ecfi ph\u00e1t b\u1ec7nh Kawasaki hay Kawasaki don thu\u1ea7n l\u00e0 m\u1ed9t ch\u00e2n \u0111o\u00e1n ph\u00e2n bi\u1ec7t c\u1ee7a nhi\u1ec5m HADV.<\/p>\n<p>Cu\u1ed1i c\u00f9ng, nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed3ng nhi\u1ec5m virus, chi\u1ebfm t\u1edbi m\u1ed9t n\u1eeda nh\u00f3m HAdV. \u0110i\u1ec1u n\u00e0y kh\u1eb3ng \u0111\u1ecbnh kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n virus \u1edf tr\u1ebb nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n nh\u1edd ti\u1ebfn b\u1ed9 c\u1ee7a k\u1ef9 thu\u1eadt PCR. \u0110\u00e1ng ch\u00fa \u00fd, m\u1eb7c d\u00f9 c\u00f3 \u0111\u1ed3ng nhi\u1ec5m virus, kh\u00f4ng ghi nh\u00e2n s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 v\u1ec1 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, c\u00e1c th\u00f4ng s\u1ed1 x\u00e9t nghi\u1ec7m hay h\u00ecnh \u1ea3nh h\u1ecdc gi\u1eefa tr\u1ebb ch\u1ec9 nhi\u1ec5m HAdV v\u00e0 tr\u1ebb c\u00f3 \u0111\u1ed3ng nhi\u1ec5m virus. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y HAdV \u0111\u00f3ng vai tr\u00f2 ch\u1ee7 \u0111\u1ea1o trong vi\u1ec7c bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng, c\u00e1c thay \u0111\u1ed5i sinh h\u1ecfa v\u00e0 \u0111\u00e1p \u1ee9ng vi\u00eam quan s\u00e1t \u0111\u01b0\u1ee3c, b\u1ea5t k\u1ec3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c virus kh\u00e1c. Tuy nhi\u00ean, c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 v\u1ec1 nhu c\u1ea7u \u0111i\u1ec1u tr\u1ecb: corticosteroid to\u00e0n th\u00e2n, thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n khi dung v\u00e0 h\u1ed7 tr\u1ee3 oxy nhi\u1ec1u h\u01a1n \u1edf tr\u1ebb c\u00f3 HAdV k\u00e8m \u0111\u1ed3ng nhi\u1ec5m virus so v\u1edbi tr\u1ebb ch\u1ec9 nhi\u1ec5m HAdV \u0111\u01a1n thu\u1ea7n. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u1ea7n su\u1ea5t kh\u00f2 kh\u00e8 cao h\u01a1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y, g\u1ee3i \u00fd m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh khi x\u00e9t v\u1ec1 nhu c\u1ea7u \u0111i\u1ec1u tr\u1ecb n\u1ebfu c\u00f3 th\u00eam m\u1ed9t t\u00e1c nh\u00e2n virus th\u1ee9 hai, ph\u00f9 h\u1ee3p v\u1edbi k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y v\u1ec1 \u0111\u1ed3ng nhi\u1ec5m SARS-CoV-2 v\u00e0 c\u00e1c virus h\u00f4 h\u1ea5p \u1edf tr\u1ebb cm.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u1ed5ng quan nghi\u00ean c\u1ee9u M\u1ee5c ti\u00eau: So s\u00e1nh m\u1ee9c \u0111\u1ed9 n\u1eb7ng tr\u00ean l\u00e2m s\u00e0ng c\u1ee7a nhi\u1ec5m HAdV v\u1edbi c\u00e1c b\u1ec7nh do virus kh\u00e1c \u1edf m\u1ed9t nh\u00f3m tr\u1ebb em, \u0111\u00e1nh gi\u00e1 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, \u0111i\u1ec1u tr\u1ecb v\u00e0 k\u1ebft c\u1ee5c. Ph\u01b0\u01a1ng ph\u00e1p: Nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7 h\u1ed3i c\u1ee9u \u0111a trung t\u00e2m tr\u00ean tr\u1ebb em t\u1ea1i \u00dd [&#8230;]\n","protected":false},"author":878,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-157381","post","type-post","status-publish","format-standard","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/157381","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\/878"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=157381"}],"version-history":[{"count":1,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/157381\/revisions"}],"predecessor-version":[{"id":157389,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/157381\/revisions\/157389"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=157381"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=157381"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=157381"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}