Amygdale<\/strong> (Tonsils) l\u00e0 hai kh\u1ed1i m\u00f4 m\u1ec1m n\u1eb1m \u1edf m\u1eb7t sau c\u1ee7a h\u1ecdng. Amydale l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a h\u1ec7 b\u1ea1ch huy\u1ebft, gi\u00fap gi\u1eef l\u1ea1i vi khu\u1ea9n hay virus \u0111i xu\u1ed1ng ph\u00eda d\u01b0\u1edbi h\u1ecdng v\u00e0 ph\u1ed5i, ch\u1ed1ng nhi\u1ec5m tr\u00f9ng.<\/p>\n Vi\u00eam amygdale<\/strong> ( tonsillitis ) \u1edf tr\u1ebb em th\u01b0\u1eddng do nhi\u1ec5m virus nh\u01b0ng c\u00f3 th\u1ec3 do li\u00ean c\u1ea7u khu\u1ea9n Streptococcus pyogenes A.<\/p>\n Vi\u00eam h\u1ecdng do li\u00ean c\u1ea7u khu\u1ea9n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 v\u1edbi kh\u00e1ng sinh ( penicillins, cephalosporine, macrolides, clindamycin ), vi\u00eam h\u1ecdng virus kh\u00f4ng d\u00f9ng kh\u00e1ng sinh v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng h\u1ed5 tr\u1ee3 dinh d\u01b0\u1ee1ng, gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t… kh\u00f4ng hi\u1ec3u t\u1ea1i sao \u1edf m\u1ed9t s\u1ed1 tr\u1ebb em l\u1ea1i m\u1eafc b\u1ec7nh nhi\u1ec1u l\u1ea7n ( vi\u00eam amygdale t\u00e1i ph\u00e1t, recurrent tonsillitis ) h\u01a1n c\u00e1c tr\u1ebb em kh\u00e1c ?<\/p>\n \u0110\u1ec3 hi\u1ec3u r\u00f5 v\u1ea5n \u0111\u1ec1 n\u00e0y, m\u1ed9t nh\u00f3m c\u00e1c nh\u00e0 khoa h\u1ecdc d\u1eabn \u0111\u1ea7u b\u1edfi Dr. Shane Crotty t\u1eeb h\u1ecdc vi\u1ec7n La Jolla Institute for Immunology, CA, USA v\u00e0 Division of Infectious Diseases, University of California, San Diego (UCSD) trong m\u1ed9t nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7 \u0111\u1ed9c l\u1eadp \u0111\u00e3 l\u1ea5y m\u1eabu m\u00f4 amygdale c\u1ee7a 66 tr\u1ebb em \u0111\u01b0\u1ee3c c\u1eaft b\u1ecf v\u00ec vi\u00eam amygdale t\u00e1i ph\u00e1t do group A Streptococcus (GAS) v\u00e0 80 tr\u1ebb \u0111\u00e3 c\u1eaft b\u1ecf v\u00ec l\u00fd do kh\u00e1c, v\u00ed d\u1ee5 b\u1ec7nh ng\u01b0ng th\u1edf khi ng\u1ee7 (do tuy\u1ebfn qu\u00e1 ph\u00e1t) nh\u1eb1m nghi\u00ean c\u1ee9u v\u1ec1 ki\u1ec3u gene, ki\u1ec3u h\u00ecnh v\u00e0 ch\u1ee9c n\u0103ng tuy\u1ebfn. K\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 ng\u00e0y 6 th\u00e1ng 2 n\u0103m 2019, tr\u00ean t\u1ea1p ch\u00ed y khoa Science Translational Medicine.<\/p>\n Nh\u00f3m nghi\u00ean c\u1ee9u nh\u1eadn th\u1ea5y trong m\u00f4 amygdale c\u1ee7a tr\u1ebb em b\u1ecb vi\u00eam t\u00e1i ph\u00e1t th\u00ec c\u00e1c “m\u1ea7m mi\u1ec5n d\u1ecbch trung t\u00e2m” ( Germinal Centers, GC l\u00e0 c\u00e1c v\u1ecb tr\u00ed trong h\u1ec7 b\u1ea1ch huy\u1ebft n\u01a1i c\u00e1c t\u1ebf b\u00e0o B tr\u01b0\u1edfng th\u00e0nh v\u00e0 bi\u1ec7t h\u00f3a ) c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf h\u01a1n, ngo\u00e0i ra c\u00f3 \u00edt kh\u00e1ng th\u1ec3 \u0111\u01b0\u01a1c t\u1ea1o th\u00e0nh h\u01a1n. M\u1eb7c kh\u00e1c c\u00e1c t\u1ebf b\u00e0o nang T follicular helper ( TFH, C\u00e1c t\u1ebf b\u00e0o nang T tr\u1ee3 gi\u00fap: l\u00e0 m\u1ed9t nh\u00f3m \u0111\u1eb7c bi\u1ec7t c\u1ee7a c\u00e1c t\u1ebf b\u00e0o CD4+ \u0111i\u1ec1u h\u00f2a mi\u1ec5n d\u1ecbch, c\u00f3 trong amydale, l\u00e1ch v\u00e0 c\u00e1c h\u1ea1ch b\u1ea1ch huy\u1ebft ) thay v\u00ec tr\u01a1 gi\u00fap t\u1ebf b\u00e0o B t\u1ea1o kh\u00e1ng th\u1ec3 l\u1ea1i g\u00e2y \u0111\u1ed9c v\u00e0 gi\u1ebft t\u1ebf b\u00e0o B.<\/p>\n Khi tr\u1ebb em nhi\u1ec5m c\u00e1c li\u00ean c\u1ea7u khu\u1ea9n nh\u00f3m A th\u00ec vi khu\u1ea9n n\u1ea7y ti\u1ebft ra m\u1ed9t lo\u1ea1i protein \u0111\u1ed9c t\u1ed1 c\u00f3 t\u00ean l\u00e0 SpeA (streptococcal pyrogenic exotoxin A), ch\u00ednh c\u00e1c SpeA l\u00e0m r\u1ed1i lo\u1ea1n mi\u1ec5n d\u1ecbch, SpeA khi\u1ebfn c\u00e1c t\u1ebf b\u00e0o TFH ti\u00eau di\u1ec7t t\u1ebf b\u00e0o B thay v\u00ec gi\u00fap t\u1ebf b\u00e0o B t\u1ea1o ra c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1ec3 trung h\u00f2a ho\u1eb7c b\u1ea5t ho\u1ea1t \u0111\u1ed9c t\u1ed1, \u0111\u1ed3ng th\u1eddi SpeA l\u00e0m r\u1ed1i lo\u1ea1n ho\u1ea1t \u0111\u1ed9ng c\u00e1c Germinal Centers, \u0111\u00e2y ch\u00ednh l\u00e0 l\u00fd do sau \u0111\u00f3 amygdale \u1edf c\u00e1c tr\u1ebb n\u1ea7y th\u01b0\u1eddng d\u1ec3 b\u1ecb t\u00e1i nhi\u1ec5m tr\u00f9ng.<\/p>\n Nh\u00f3m nghi\u00ean c\u1ee9u c\u0169ng \u0111\u00e3 t\u00ecm th\u1ea5y tr\u00ean h\u1ec7 gene HLA l\u1edbp II (human leukocyte antigen class II, m\u1ed9t h\u1ec7 th\u1ed1ng ph\u1ee9c h\u1ee3p kh\u00e1ng nguy\u00ean t\u01b0\u01a1ng h\u1ee3p m\u00f4 tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o T) c\u00f3 c\u00e1c \u0111o\u1ea1n gene bi\u1ebfn th\u1ec3 (allens) nh\u1ea1y c\u1ea3m v\u1edbi SpeA g\u00e2y r\u1ed1i lo\u1ea1n mi\u1ec5n d\u1ecbch, \u0111i\u1ec1u n\u00e0y cho ph\u00e9p gi\u1ea3i th\u00edch vi\u00eam amygdale t\u00e1i ph\u00e1t c\u00f3 th\u1ec3 c\u00f3 t\u00ednh ch\u1ea5t di truy\u1ec1n, nh\u00f3m nghi\u00ean c\u1ee9u nh\u1eadn th\u1ea5y nhi\u1ec1u tr\u1ebb em trong nghi\u00ean c\u1ee9u c\u1ee7a h\u1ecd c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh b\u1ecb vi\u00eam amygdale t\u00e1i ph\u00e1t.<\/p>\n C\u00e1c chuy\u00ean gia cho r\u1eb1ng ph\u00e1t hi\u1ec7n c\u1ee7a nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00e3 x\u00e1c \u0111\u1ecbnh c\u00e1c bi\u1ebfn th\u1ec3 di truy\u1ec1n c\u1ee5 th\u1ec3 trong h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch c\u00f3 li\u00ean quan \u0111\u1ebfn nguy c\u01a1 vi\u00eam amidan t\u00e1i ph\u00e1t t\u1eeb \u0111\u00f3 ch\u1ec9 ra \u0111\u1ecbnh h\u01b0\u1edbng trong vi\u1ec7c ph\u00f2ng ng\u1eeba hay ch\u1ebf ta\u1ecd c\u00e1c vaccin k\u00edch ho\u1ea1t h\u1ec7 mi\u1ec5n d\u1ecbch ch\u1ed1ng li\u00ean c\u1ea7u nh\u00f3m A, l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng c\u1ee7a vi\u1ec7c t\u00e1i ph\u00e1t vi\u00eam amygdale \u1edf tr\u1ebb em.<\/p>\n Hi\u1ec7n nay, vi\u1ec7c ph\u1ea9u thu\u1eadt c\u1eaft b\u1ecf amygdale \u0111\u01b0\u1ee3c k\u1ebft lu\u1eadn l\u00e0 an to\u00e0n ( l\u01b0u \u00fd bi\u1ebfn ch\u1ee9ng ch\u1ea3y m\u00e1u ), kh\u00f4ng g\u00e2y \u1ea3nh h\u01b0\u1edfng g\u00ec \u0111\u1ebfn vi\u1ec7c d\u1ec3 b\u1ecb nhi\u1ec5m tr\u00f9ng c\u1ee7a v\u00f9ng h\u1ea7u h\u1ecdng. H\u1ed9i ph\u1ea9u thu\u1eadt Tai m\u0169i h\u1ecdng v\u00e0 \u0111\u1ea7u c\u1ed5 Hoa k\u1ef3 ( American Academy of Otolaryngology – Head and Neck Surgery ) trong guidelines 2019 v\u1edbi \u0111\u1ed3ng thu\u1eadn c\u1ee7a nhi\u1ec1u H\u1ed9i y khoa li\u00ean quan khuy\u1ebfn c\u00e1o ch\u1ec9 \u0111\u1ecbnh ph\u1ea9u thu\u1eadt c\u1eaft b\u1ecf amygdale cho ng\u01b0\u1eddi tr\u1ebb d\u01b0\u1edbi 18 tu\u1ed5i khi c\u00f3 nhi\u1ec1u h\u01a1n 6 l\u1ea7n vi\u00eam trong m\u1ed9t n\u0103m, ho\u1eb7c 5 l\u1ea7n vi\u00eam m\u1ed7i n\u0103m trong hai n\u0103m li\u00ean ti\u1ebfp, ho\u1eb7c 3 l\u1ea7n vi\u00eam m\u1ed7i n\u0103m trong 3 n\u0103m li\u00ean ti\u1ebfp, ho\u1eb7c l\u00e0 c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng g\u00e2y \u1ea3nh h\u01b0\u1eddng nghi\u00eam tr\u1ecdng nh\u01b0 abscess hay ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf…\/.<\/p>\n Ngu\u1ed3n:<\/p>\n Amygdale l\u00e0 g\u00ec? Amygdale (Tonsils) l\u00e0 hai kh\u1ed1i m\u00f4 m\u1ec1m n\u1eb1m \u1edf m\u1eb7t sau c\u1ee7a h\u1ecdng. Amydale l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a h\u1ec7 b\u1ea1ch huy\u1ebft, gi\u00fap gi\u1eef l\u1ea1i vi khu\u1ea9n hay virus \u0111i xu\u1ed1ng ph\u00eda d\u01b0\u1edbi h\u1ecdng v\u00e0 ph\u1ed5i, ch\u1ed1ng nhi\u1ec5m tr\u00f9ng. Vi\u00eam amygdale ( tonsillitis ) \u1edf tr\u1ebb em th\u01b0\u1eddng do nhi\u1ec5m virus nh\u01b0ng c\u00f3 […]\n","protected":false},"author":1,"featured_media":5710,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5709","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\/5709","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=5709"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5709\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5710"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5709"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5709"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5709"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n