B\u00e1c s\u0129 V\u00f5 Th\u1ecb Minh Th\u01b0 – \u0110\u01a1n nguy\u00ean S\u01a1 sinh \u2013 B\u1ec7nh vi\u1ec7n M\u1ef9 \u0110\u1ee9c<\/p>\n
Trong m\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean 160 tr\u1ebb \u0111\u1ee7 th\u00e1ng, 2 vi RNA \u0111\u1eb7c hi\u1ec7u (miR-374a-5p v\u00e0 miR-376c-3p) ph\u00e2n bi\u1ec7t c\u1ea3 tr\u1ebb s\u01a1 sinh b\u1ecb ng\u1ea1t chu sinh (PA) v\u00e0 tr\u1ebb s\u01a1 sinh m\u1eafc HIE t\u1eeb tr\u1ebb s\u01a1 sinh kh\u1ecfe m\u1ea1nh.<\/p>\n
\u0110\u1ec3 t\u0103ng \u1ee9ng d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng, c\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u c\u0169ng x\u00e1c \u0111\u1ecbnh m\u1ed9t vi RNA th\u1ee9 ba (miR-181b-5p) c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh tr\u1ebb s\u01a1 sinh n\u00e0o s\u1ebd \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb phu\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ea1 th\u00e2n nhi\u1ec7t.<\/p>\n
Mong mu\u1ed1n m\u1ed9t bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb HIE t\u1ed1t h\u01a1n sau b\u1ecb khi tr\u1ebb b\u1ecb ng\u1ea1t \u0111\u00e3 th\u00fac \u0111\u1ea9y c\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u t\u00ecm ki\u1ebfm m\u1ed9t x\u00e9t nghi\u1ec7m \u0111\u1ecbnh l\u01b0\u1ee3ng c\u00f3 \u0111\u1ed9 tin c\u1eady m\u1ea1nh v\u00e0 ph\u00e1t hi\u1ec7n s\u1edbm \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb trong v\u00e0i gi\u1edd \u0111\u1ea7u sau khi sinh.<\/p>\n
“\u0110i\u1ec3m s\u1ed1 Apgar v\u1eabn l\u00e0 ph\u01b0\u01a1ng ph\u00e1p t\u1ed1t nh\u1ea5t hi\u1ec7n t\u1ea1i c\u1ee7a ch\u00fang t\u00f4i, nh\u01b0ng mang t\u00ednh ch\u1ee7 quan”, nh\u00e0 nghi\u00ean c\u1ee9u Deirdre M. Murray, Ti\u1ebfn s\u0129, gi\u00e1o s\u01b0 t\u1ea1i Khoa Nhi v\u00e0 S\u1ee9c kh\u1ecfe Tr\u1ebb em, \u0110\u1ea1i h\u1ecdc Cork, Ireland, ph\u00e1t bi\u1ec3u – “C\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng th\u1ea5y kh\u00f3 d\u1ef1a v\u00e0o \u0111i\u1ec3m s\u1ed1 Apgar \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh b\u1edfi ng\u01b0\u1eddi kh\u00e1c, \u0111\u1eb7c bi\u1ec7t l\u00e0 t\u1eeb m\u1ed9t trung t\u00e2m kh\u00e1c”.<\/p>\n
C\u00e1c chi\u1ebfn l\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n HIE hi\u1ec7n t\u1ea1i bao g\u1ed3m thang \u0111i\u1ec3m Apgar, ch\u1ec9 s\u1ed1 lactate v\u00e0 ki\u1ec1m m\u00e1u, nh\u01b0ng nh\u1eefng “ch\u1ec9 s\u1ed1 n\u00e0y mang gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n d\u01b0\u01a1ng k\u00e9m”, c\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u cho bi\u1ebft.<\/p>\n
Ngo\u00e0i ra, thang \u0111i\u1ec3m Sarnat c\u1ee7a HIE v\u1edbi \u0111i\u1ec7n n\u00e3o \u0111\u1ed3 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c khi \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n sau 24 gi\u1edd sau sinh – nh\u01b0ng \u0111i\u1ec1u \u0111\u00f3 c\u00f3 th\u1ec3 l\u00e0 qu\u00e1 mu\u1ed9n \u0111\u1ec3 b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb.<\/p>\n
“M\u1eb7c d\u00f9 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ea1 th\u00e2n nhi\u1ec7t gi\u00fap c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3, nh\u01b0ng n\u00f3 ch\u1ec9 hi\u1ec7u qu\u1ea3 n\u1ebfu b\u1eaft \u0111\u1ea7u trong v\u00f2ng 6 gi\u1edd sau sinh. Trong th\u1eddi gian h\u1ea1n h\u1eb9p n\u00e0y, tr\u1ebb s\u01a1 sinh c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, \u1ed5n \u0111\u1ecbnh v\u00e0 chuy\u1ec3n s\u1edbm \u0111\u1ebfn trung t\u00e2m l\u00e0m m\u00e1t”, Dierdre M. Murray n\u00f3i – “Ch\u00fang t\u00f4i hi\u1ec7n \u0111ang b\u1ecf l\u1ee1 kho\u1ea3ng 20% \u200b\u200btr\u1ebb s\u01a1 sinh kh\u00f4ng \u0111\u01b0\u1ee3c l\u00e0m m\u00e1t, v\u00ec ch\u00fang kh\u00f4ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c ch\u1ec9 d\u1ef1a tr\u00ean kh\u00e1m l\u00e2m s\u00e0ng m\u00e0 kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u s\u1edbm \u0111\u1ee7 tin c\u1eady, kh\u00f4ng c\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ecbnh l\u01b0\u1ee3ng, \u0111\u1ec3 h\u1ed7 tr\u1ee3 c\u00e1c quy\u1ebft \u0111\u1ecbnh l\u00e2m s\u00e0ng”.<\/p>\n
C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u c\u00f2n l\u01b0u \u00fd, gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n \u00e2m c\u1ee7a miR-181b l\u00e0 99%, n\u00ean c\u00f3 th\u1ec3 vi RNA n\u00e0y tr\u1edf th\u00e0nh m\u1ed9t c\u00f4ng c\u1ee5 h\u1eefu \u00edch trong \u1ee9ng d\u1ee5ng l\u00e2m s\u00e0ng.<\/p>\n
“\u0110\u1ec3 k\u1ebft lu\u1eadn, c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc m\u1edbi \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong nghi\u00ean c\u1ee9u n\u00e0y r\u1ea5t h\u1ee9a h\u1eb9n, nh\u01b0ng c\u1ea7n m\u1ed9t nghi\u00ean c\u1ee9u \u0111o\u00e0n h\u1ec7 kh\u00e1c l\u1edbn h\u01a1n \u0111\u1ec3 x\u00e1c nh\u1eadn r\u1eb1ng c\u00e1c vi RNA n\u00e0y l\u00e0 d\u1ea5u \u1ea5n sinh h\u1ecdc \u0111\u00e1ng tin c\u1eady cho s\u1eed d\u1ee5ng l\u00e2m s\u00e0ng”, Pospisilova – m\u1ed9t t\u00e1c gi\u1ea3 kh\u00e1c n\u00f3i th\u00eam.<\/p>\n