{"id":7526,"date":"2023-03-13T12:18:34","date_gmt":"2023-03-13T04:48:34","guid":{"rendered":"https:\/\/abtvn.com\/?p=7526"},"modified":"2023-04-06T14:40:06","modified_gmt":"2023-04-06T07:10:06","slug":"virus-viem-gan-b","status":"publish","type":"post","link":"https:\/\/abtvn.com\/en\/virus-viem-gan-b\/","title":{"rendered":"Vi\u00eam gan B – T\u1ed5ng qu\u00e1t v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/strong>"},"content":{"rendered":"

\u01af\u1edbc t\u00ednh m\u1ed7i n\u0103m c\u00f3 kho\u1ea3ng 350 tri\u1ec7u ng\u01b0\u1eddi b\u1ecb vi\u00eam gan B m\u00e3n t\u00ednh c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan v\u00e0 ung th\u01b0 gan. V\u00ec v\u1eady, vi\u1ec7c x\u00e9t nghi\u1ec7m Vi\u00eam Gan B nh\u1eb1m ph\u00e1t hi\u1ec7n v\u00e0 \u0111\u1ecbnh l\u01b0\u1ee3ng ch\u00ednh x\u00e1c HBV trong m\u00e1u s\u1ebd gi\u00fap \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n d\u1ec5 d\u00e0ng v\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n. <\/p>\n\n\n\n

C\u1ea5u tr\u00fac virus vi\u00eam gan B<\/strong><\/h2>\n\n\n\n

Hepatitis B Virus (HBV) hay c\u00f2n g\u1ecdi l\u00e0 Virus vi\u00eam gan B, \u0111\u00e2y l\u00e0 virus thu\u1ed9c h\u1ecd Hepadnaviridae c\u00f3 c\u1ea5u tr\u00fac DNA m\u1ea1ch \u0111\u00f4i. Virus c\u00f3 h\u00ecnh c\u1ea7u nh\u1ecf, \u0111\u01b0\u1eddng k\u00ednh 40 nm, g\u1ed3m 3 l\u1edbp bao b\u1ecdc b\u00ean ngo\u00e0i d\u00e0y kho\u1ea3ng 7 nm, v\u1ecf capsid h\u00ecnh h\u1ed9p c\u00f3 \u0111\u01b0\u1eddng k\u00ednh kho\u1ea3ng 27 – 28 nm v\u00e0 l\u00f5i ch\u1ee9a b\u1ed9 gen c\u1ee7a vi r\u00fat. <\/p>\n\n\n\n

Vi r\u00fat vi\u00eam gan B c\u00f3 3 lo\u1ea1i kh\u00e1ng nguy\u00ean ch\u00ednh: HBsAg, HBeAg v\u00e0 HBcAg t\u01b0\u01a1ng \u1ee9ng v\u1edbi 3 lo\u1ea1i kh\u00e1ng th\u1ec3, l\u1ea7n l\u01b0\u1ee3t l\u00e0: Anti-HBs, Anti-HBe v\u00e0 Anti-HBc. X\u00e9t nghi\u1ec7m ph\u00e1t hi\u1ec7n c\u00e1c kh\u00e1ng nguy\u00ean, kh\u00e1ng th\u1ec3 n\u00e0y c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh b\u1ec7nh, th\u1ec3 b\u1ec7nh c\u0169ng nh\u01b0 di\u1ec5n bi\u1ebfn b\u1ec7nh. Hi\u1ec7n t\u1ea1i HBV c\u00f3 8 ki\u1ec3u gen ( genotype) l\u00e0 A,B,C,D,E,F,G,H ph\u00e2n b\u1ed1 tr\u00ean th\u1ebf gi\u1edbi,  Vi\u1ec7t Nam ch\u1ee7 y\u1ebfu nhi\u1ec5m ki\u1ec3u B v\u00e0 C.<\/p>\n\n\n\n

\"C\u1ea5u
H\u00ecnh 1: C\u1ea5u tr\u00fac HBV<\/em><\/figcaption><\/figure>\n\n\n\n

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HBV b\u1ec1n v\u1ec1 nhi\u1ec7t, lo\u1ea1i virus n\u00e0y c\u00f3 th\u1ec3 s\u1ed1ng \u0111\u01b0\u1ee3c 30 ph\u00fat \u1edf nhi\u1ec7t \u0111\u1ed9 100o<\/sup>C; \u1edf nhi\u1ec7t \u0111\u1ed9 -20o<\/sup> C c\u00f3 th\u1ec3 s\u1ed1ng 20 n\u0103m. HBV B c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i b\u00ean ngo\u00e0i c\u01a1 th\u1ec3 \u00edt nh\u1ea5t trong 7 ng\u00e0y. Trong th\u1eddi gian n\u00e0y, virus v\u1eabn c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec5m b\u1ec7nh n\u1ebfu x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 c\u1ee7a ng\u01b0\u1eddi ch\u01b0a ti\u00eam v\u1eafc-xin. Th\u1eddi gian \u1ee7 b\u1ec7nh c\u1ee7a virus vi\u00eam gan B trung b\u00ecnh l\u00e0 75 ng\u00e0y, nh\u01b0ng c\u00f3 th\u1ec3 dao \u0111\u1ed9ng t\u1eeb 30 \u0111\u1ebfn 180 ng\u00e0y.<\/p>\n\n\n\n

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T\u00ecnh h\u00ecnh nhi\u1ec5m HBV<\/strong><\/h2>\n\n\n\n

Theo t\u1ed5 ch\u1ee9c y t\u1ebf th\u1ebf gi\u1edbi (World Health Organization- WHO), tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, c\u00f3 kho\u1ea3ng 240 tri\u1ec7u ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m HBV m\u1ea1n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf c\u00e1c n\u01b0\u1edbc thu nh\u1eadp th\u1ea5p v\u00e0 trung b\u00ecnh. M\u1ed7i n\u0103m tr\u00ean th\u1ebf gi\u1edbi c\u00f3 kho\u1ea3ng 650000 ng\u01b0\u1eddi t\u1eed vong do bi\u1ebfn ch\u1ee9ng c\u1ee7a vi\u00eam gan B m\u00e3n t\u00ednh, c\u00e1c bi\u1ebfn ch\u1ee9ng ch\u00ednh c\u1ee7a vi\u00eam gan B l\u00e0 x\u01a1 gan v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan.<\/p>\n\n\n\n

\"T\u1ef7
H\u00ecnh 2: T\u1ef7 l\u1ec7 ph\u00e2n b\u1ed1 genotype HBV tr\u00ean to\u00e0n c\u1ea7u<\/em><\/figcaption><\/figure>\n\n\n\n

Vi\u1ec7t Nam l\u00e0 qu\u1ed1c gia c\u00f3 g\u00e1nh n\u1eb7ng cao v\u1ec1 b\u1ec7nh vi\u00eam gan vi r\u00fat, v\u1edbi vi\u00eam gan B v\u00e0 C l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra x\u01a1 gan, ung th\u01b0 gan v\u00e0 t\u1eed vong li\u00ean quan \u0111\u1ebfn gan. N\u0103m 2018, Vi\u1ec7t Nam \u0111\u1ee9ng th\u1ee9 s\u00e1u v\u1ec1 t\u1ef7 l\u1ec7 m\u1eafc ung th\u01b0 gan v\u00e0 c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong do ung th\u01b0 gan cao th\u1ee9 ba tr\u00ean th\u1ebf gi\u1edbi v\u00e0o n\u0103m 2018. M\u1ed9t d\u1ef1 b\u00e1o g\u1ea7n \u0111\u00e2y c\u1ee7a B\u1ed9 Y t\u1ebf, Trung t\u00e2m Ph\u00e2n t\u00edch D\u1ecbch b\u1ec7nh v\u00e0 T\u1ed5 ch\u1ee9c Y t\u1ebf Th\u1ebf gi\u1edbi (WHO) cho bi\u1ebft c\u1ee9 11 ng\u01b0\u1eddi \u1edf Vi\u1ec7t Nam th\u00ec c\u00f3 1 ng\u01b0\u1eddi \u0111ang s\u1ed1ng v\u1edbi b\u1ec7nh vi\u00eam gan B ho\u1eb7c C m\u00e3n t\u00ednh. <\/p>\n\n\n\n

N\u1ebfu kh\u00f4ng c\u00f3 c\u00e1c bi\u1ec7n ph\u00e1p can thi\u1ec7p t\u0103ng c\u01b0\u1eddng, c\u00e1c bi\u1ebfn ch\u1ee9ng v\u00e0 t\u1eed vong li\u00ean quan \u0111\u1ebfn gan do vi\u00eam gan vi r\u00fat s\u1ebd ti\u1ebfp t\u1ee5c gia t\u0103ng. Qua nhi\u1ec1u nghi\u00ean c\u1ee9u c\u1ee7a m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 trong n\u01b0\u1edbc cho bi\u1ebft r\u1eb1ng t\u1ec9 l\u1ec7 nhi\u1ec5m HBV \u1edf Vi\u1ec7t Nam trung b\u00ecnh v\u00e0o kho\u1ea3ng 15%, nh\u01b0 v\u1eady t\u00ednh ra c\u00f3 kho\u1ea3ng 10- 12 tri\u1ec7u ng\u01b0\u1eddi \u0111ang mang m\u1ea7m b\u1ec7nh. Trong khu v\u1ef1c l\u01b0u h\u00e0nh cao nh\u01b0 n\u01b0\u1edbc ta h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p l\u00e2y nhi\u1ec5m qua \u0111\u01b0\u1eddng m\u1eb9 truy\u1ec1n sang con.<\/p>\n\n\n\n

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C\u00e1c con \u0111\u01b0\u1eddng l\u00e2y nhi\u1ec5m HBV<\/strong><\/h2>\n\n\n\n

S\u1ef1 ph\u00e2n b\u1ed1 c\u1ee7a nh\u1eefng ng\u01b0\u1eddi nhi\u1ec5m vi r\u00fat HBV kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u tr\u00ean t\u1eebng v\u00f9ng, mi\u1ec1n v\u00e0 l\u1ee9a tu\u1ed5i. HBV c\u00f3 th\u1ec3 l\u00e2y nhi\u1ec5m theo chi\u1ec1u d\u1ecdc ho\u1eb7c l\u00e2y nhi\u1ec5m theo chi\u1ec1u ngang qua nhi\u1ec1u con \u0111\u01b0\u1eddng.<\/p>\n\n\n\n

M\u1eb9 truy\u1ec1n sang con: Ph\u1ee5 n\u1eef mang thai nhi\u1ec5m HBV c\u00f3 t\u1ef7 l\u1ec7 l\u00e2y nhi\u1ec5m sang cho thai nhi r\u1ea5t cao. Theo th\u1ed1ng k\u00ea h\u00e0ng n\u0103m c\u00f3 kho\u1ea3ng t\u1eeb 10-13% ph\u1ee5 n\u1eef \u0111ang mang thai nhi\u1ec5m Virus vi\u00eam gan B. Ng\u01b0\u1eddi m\u1eb9 b\u1ecb vi\u00eam gan B \u1edf th\u1eddi k\u00ec \u0111\u1ea7u c\u1ee7a thai k\u00ec (3 th\u00e1ng \u0111\u1ea7u) th\u00ec c\u00f3 t\u1ec9 l\u1ec7 m\u1eb9 truy\u1ec1n m\u1ea7m b\u1ec7nh cho con kho\u1ea3ng 1%, v\u00e0o 3 th\u00e1ng gi\u1eefa c\u1ee7a thai k\u00ec l\u00ean \u0111\u1ebfn 10%, \u0111\u1eb7c bi\u1ec7t n\u1ebfu v\u00e0o giai \u0111o\u1ea1n 3 th\u00e1ng cu\u1ed1i l\u00e0 t\u1eeb 60-70%<\/p>\n\n\n\n

\u0110\u01b0\u1eddng t\u00ecnh d\u1ee5c: Quan h\u1ec7 t\u00ecnh d\u1ee5c kh\u00f4ng an to\u00e0n l\u00e0 nguy\u00ean nh\u00e2n l\u00e2y nhi\u1ec5m nhi\u1ec1u m\u1ea7m b\u1ec7nh trong \u0111\u00f3 c\u00f3 HBV. Khi quan h\u1ec7 t\u00ecnh d\u1ee5c kh\u00f4ng an v\u1edbi ng\u01b0\u1eddi b\u1ecb vi\u00eam gan si\u00eau vi B, \u0111\u1ed1i ph\u01b0\u01a1ng s\u1ebd c\u00f3 kh\u1ea3 n\u0103ng b\u1ecb nhi\u1ec5m HBV. Virus c\u00f3 trong d\u1ecbch ti\u1ebft c\u1ee7a ng\u01b0\u1eddi nhi\u1ec5m s\u1ebd th\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 b\u1ea1n t\u00ecnh th\u00f4ng qua c\u00e1c v\u1ebft x\u01b0\u1edbc nh\u1ecf, sau \u0111\u00f3 x\u00e2m nh\u1eadp v\u00e0o m\u00e1u v\u00e0 g\u00e2y nhi\u1ec5m HBV. H\u00ecnh th\u1ee9c l\u00e2y nhi\u1ec5m n\u00e0y ph\u1ed5i bi\u1ebfn v\u1edbi nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng kh\u00f4ng ti\u00eam vaccine HBV quan h\u1ec7 \u0111\u1ed3ng gi\u1edbi kh\u00f4ng an to\u00e0n, c\u00f3 nhi\u1ec1u b\u1ea1n t\u00ecnh ho\u1eb7c quan h\u1ec7 v\u1edbi g\u00e1i m\u1ea1i d\u00e2m.<\/p>\n\n\n\n

\u0110\u01b0\u1eddng m\u00e1u: HBV c\u0169ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong d\u1ecbch c\u01a1 th\u1ec3 kh\u00e1c nh\u01b0 d\u1ecbch \u00e2m \u0111\u1ea1o, tinh d\u1ecbch, s\u1eefa m\u1eb9, n\u01b0\u1edbc b\u1ecdt, m\u1ed3 h\u00f4i, n\u01b0\u1edbc ti\u1ec3u, ph\u00e2n, d\u1ecbch m\u1eadt v\u00ec v\u1eady khi da ho\u1eb7c ni\u00eam m\u1ea1c b\u1ecb t\u1ed5n th\u01b0\u01a1ng m\u00e0 ti\u1ebfp x\u00fac v\u1edbi c\u00e1c d\u1ecbch n\u00e0y th\u00ec c\u0169ng c\u00f3 th\u1ec3 b\u1ecb l\u00e2y nhi\u1ec5m HBV nh\u01b0ng v\u1edbi t\u1ec9 l\u1ec7 r\u1ea5t th\u1ea5p.<\/p>\n\n\n\n

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Ph\u00f2ng ng\u1eeba<\/strong> <\/h2>\n\n\n\n

Hi\u1ec7n nay c\u00e1ch ph\u00f2ng ng\u1eeba hi\u1ec7u qu\u1ea3 nh\u1ea5t HBV \u0111\u01b0\u1ee3c t\u1ed5 ch\u1ee9c y t\u1ebf th\u1ebf gi\u1edbi WHO khuy\u1ebfn c\u00e1o l\u00e0 ti\u00eam vaccine. Tr\u1ebb em sau sinh c\u1ea7n \u0111\u01b0\u1ee3c ti\u00eam v\u00e0 c\u00e1c m\u0169i ti\u1ebfp theo l\u00fac 2, 3 v\u00e0 4 th\u00e1ng. Ti\u00eam v\u1eafc-xin vi\u00eam gan B c\u00f3 t\u00e1c d\u1ee5ng t\u1ea1o ra kh\u00e1ng th\u1ec3 b\u1ea3o v\u1ec7 \u1edf h\u01a1n 95% tr\u1ebb s\u01a1 sinh, tr\u1ebb em v\u00e0 thanh ni\u00ean. Hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 cao, k\u00e9o d\u00e0i \u00edt nh\u1ea5t 20 n\u0103m v\u00e0 c\u00f3 th\u1ec3 l\u00e0 su\u1ed1t \u0111\u1eddi n\u1ebfu n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 kh\u00e1ng virus \u0111\u01b0\u1ee3c t\u1ea1o ra sau ch\u00edch ng\u1eeba l\u1edbn > 1000 IU\/L.<\/p>\n\n\n\n

B\u00ean c\u1ea1nh \u0111\u00f3, nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 cao c\u1ea7n \u0111\u01b0\u1ee3c ti\u00eam ch\u1ee7ng c\u00f2n c\u00f3 nh\u1eefng ng\u01b0\u1eddi ch\u01b0a c\u00f3 kh\u00e1ng th\u1ec3 ch\u1ed1ng vi khu\u1ea9n vi\u00eam gan B (Anti – HBs), n\u00ean ti\u00eam ph\u00f2ng v\u1eafc xin vi\u00eam gan B c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi s\u1ed1ng \u1edf c\u00e1c qu\u1ed1c gia c\u00f3 t\u1ef7 l\u1ec7 l\u01b0u h\u00e0nh HBV cao trong \u0111\u00f3 c\u00f3 Vi\u1ec7t Nam<\/p>\n\n\n\n

Ngo\u00e0i ra vi\u1ec7c c\u00f3 m\u1ed9t l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh nh\u01b0 h\u1ea1n ch\u1ebf u\u1ed1ng bia, r\u01b0\u1ee3u, c\u00f3 ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng l\u00e0nh m\u1ea1nh nhi\u1ec1u rau qu\u1ea3 \u00edt d\u1ea7u m\u1ee1 c\u0169ng gi\u1ea3m b\u1edbt t\u1ef7 l\u1ec7 m\u1eafc ph\u1ea3i b\u1ec7nh vi\u00eam gan.<\/p>\n\n\n\n

Khi s\u1eed d\u1ee5ng c\u00e1c th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng, thu\u1ed1c c\u0169ng c\u1ea7n ph\u1ea3i l\u01b0u \u00fd v\u1ec1 th\u00e0nh ph\u1ea7n, xu\u1ea5t x\u1ee9, li\u1ec1u d\u00f9ng \u0111\u1ec3 tr\u00e1nh g\u00e2y h\u1ea1i cho gan.<\/p>\n\n\n\n

Khi b\u1ecb th\u01b0\u01a1ng, ch\u1ea3y m\u00e1u c\u1ea7n s\u00e1t tr\u00f9ng ngay. S\u1eed d\u1ee5ng bi\u1ec7n ph\u00e1p b\u1ea3o v\u1ec7 khi quan h\u1ec7 t\u00ecnh d\u1ee5c \u0111\u1ec3 tr\u00e1nh l\u00e2y nhi\u1ec5m HBV cho ch\u00ednh m\u00ecnh v\u00e0 \u0111\u1ed1i ph\u01b0\u01a1ng. Kh\u00f4ng d\u00f9ng chung kim ti\u00eam, kh\u00f4ng s\u1eed d\u1ee5ng chung d\u1ee5ng c\u1ee5 ho\u1eb7c ph\u1ea3i \u0111\u01b0\u1ee3c s\u00e1t tr\u00f9ng tr\u01b0\u1edbc khi x\u0103m ng\u01b0\u1eddi, ch\u00e2m c\u1ee9u, x\u1ecf l\u1ed7 tai,…<\/p>\n\n\n\n

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X\u00e9t nghi\u1ec7m<\/strong> virus vi\u00eam gan B<\/strong><\/h2>\n\n\n\n

Mi\u1ec5n d\u1ecbch h\u1ecdc <\/em><\/h3>\n\n\n\n

Ph\u01b0\u01a1ng ph\u00e1p mi\u1ec5n d\u1ecbch h\u1ecdc l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n c\u00f3 b\u1ecb nhi\u1ec5m virus vi\u00eam gan B (HBV) hay kh\u00f4ng. Trong ph\u01b0\u01a1ng ph\u00e1p n\u00e0y, c\u00e1c kh\u00e1ng th\u1ec3 mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a virus trong m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n. <\/p>\n\n\n\n

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H\u00ecnh 3: L\u01b0u \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n vi\u00eam gan B<\/em> (ngu\u1ed3n: b\u1ec7nh vi\u1ec7n trung \u01b0\u01a1ng qu\u00e2n \u0111\u1ed9i <\/em> 108)<\/figcaption><\/figure>\n\n\n\n

C\u00e1c kh\u00e1ng th\u1ec3 mi\u1ec5n d\u1ecbch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn trong x\u00e9t nghi\u1ec7m HBV bao g\u1ed3m kh\u00e1ng th\u1ec3 anti-HBs (kh\u00e1ng th\u1ec3 b\u1ea3o v\u1ec7 b\u1ec1 m\u1eb7t), kh\u00e1ng th\u1ec3 anti-HBc (kh\u00e1ng th\u1ec3 trung gian c\u1ee7a vi\u00eam gan B) v\u00e0 kh\u00e1ng th\u1ec3 IgM anti-HBc (kh\u00e1ng th\u1ec3 IgM \u0111\u1eb7c hi\u1ec7u c\u1ee7a vi\u00eam gan B).<\/p>\n\n\n\n

Kh\u00e1ng th\u1ec3 anti-HBs \u0111\u01b0\u1ee3c t\u1ea1o ra sau khi b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u00eam v\u1eafc xin ph\u00f2ng ng\u1eeba vi\u00eam gan B ho\u1eb7c sau khi b\u1ec7nh nh\u00e2n \u0111\u00e3 kh\u1ecfi b\u1ec7nh. Kh\u00e1ng th\u1ec3 anti-HBs c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh xem li\u1ec7u b\u1ec7nh nh\u00e2n \u0111\u00e3 t\u1eebng b\u1ecb nhi\u1ec5m virus HBV hay kh\u00f4ng. N\u1ebfu kh\u00e1ng th\u1ec3 anti-HBs \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n, \u0111i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 b\u1ec7nh nh\u00e2n \u0111\u00e3 t\u1eebng ti\u00eam v\u1eafc xin ho\u1eb7c \u0111\u00e3 kh\u1ecfi b\u1ec7nh.<\/p>\n\n\n\n

Kh\u00e1ng th\u1ec3 anti-HBc l\u00e0 kh\u00e1ng th\u1ec3 trung gian c\u1ee7a vi\u00eam gan B. Ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n nhi\u1ec5m HBV trong giai \u0111o\u1ea1n s\u1edbm nh\u1ea5t c\u1ee7a b\u1ec7nh. Nghi\u00ean c\u1ee9u cho th\u1ea5y kh\u00e1ng th\u1ec3 anti-HBc c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u t\u01b0\u01a1ng \u0111\u1ed1i cao trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n nhi\u1ec5m HBV.<\/p>\n\n\n\n

Kh\u00e1ng th\u1ec3 IgM anti-HBc l\u00e0 kh\u00e1ng th\u1ec3 IgM \u0111\u1eb7c hi\u1ec7u c\u1ee7a vi\u00eam gan B. Ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n trong giai \u0111o\u1ea1n s\u1edbm nh\u1ea5t c\u1ee7a b\u1ec7nh v\u00e0 l\u00e0 m\u1ed9t ch\u1ec9 b\u00e1o c\u1ee7a nhi\u1ec5m tr\u00f9ng m\u1edbi.<\/p>\n\n\n\n

C\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m kh\u00e1c nhau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c kh\u00e1ng th\u1ec3 n\u00e0y, bao g\u1ed3m x\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch tr\u1ef1c ti\u1ebfp (ELISA), x\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch l\u1ecdc, v\u00e0 x\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch \u00e1nh s\u00e1ng.<\/p>\n\n\n\n

T\u00f3m l\u1ea1i, ph\u01b0\u01a1ng ph\u00e1p mi\u1ec5n d\u1ecbch h\u1ecdc l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u00e1c \u0111\u1ecbnh<\/p>\n\n\n\n

X\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed (Real-time PCR)<\/em><\/h3>\n\n\n\n

Ph\u01b0\u01a1ng ph\u00e1p di truy\u1ec1n l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n c\u00f3 b\u1ecb nhi\u1ec5m virus vi\u00eam gan B (HBV) hay kh\u00f4ng. K\u1ef9 thu\u1eadt Real-time PCR <\/strong>(qPCR) l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p di truy\u1ec1n ti\u00ean ti\u1ebfn nh\u1ea5t v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u00e9t nghi\u1ec7m HBV.<\/p>\n\n\n\n

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H\u00ecnh 4: M\u1eabu b\u1ec7nh ph\u1ea9m HBV \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh khu\u1ebfch \u0111\u1ea1i b\u1eb1ng m\u00e1y Real-time PCR<\/em><\/figcaption><\/figure>\n\n\n\n

Hi\u1ec7u qu\u1ea3 c\u1ee7a qPCR \u0111\u1eb7c bi\u1ec7t n\u1eb1m \u1edf kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n c\u00e1c l\u01b0\u1ee3ng nh\u1ecf c\u1ee7a DNA HBV trong m\u1eabu m\u00e1u. K\u1ef9 thu\u1eadt qPCR c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c v\u00e0 ph\u00e2n t\u00edch s\u1ed1 l\u01b0\u1ee3ng DNA HBV c\u1ee5 th\u1ec3 c\u00f3 trong m\u1eabu m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n. K\u1ef9 thu\u1eadt n\u00e0y c\u0169ng cho ph\u00e9p x\u00e1c \u0111\u1ecbnh \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao, gi\u00fap ph\u00e1t hi\u1ec7n v\u00e0 ph\u00e2n t\u00edch ch\u00ednh x\u00e1c nh\u1eefng tr\u01b0\u1eddng h\u1ee3p d\u01b0\u01a1ng t\u00ednh v\u1edbi HBV.<\/p>\n\n\n\n

M\u1ed9t trong nh\u1eefng \u01b0u \u0111i\u1ec3m c\u1ee7a qPCR l\u00e0 n\u00f3 l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt nhanh, \u0111\u00e1ng tin c\u1eady v\u00e0 ti\u1ebft ki\u1ec7m th\u1eddi gian, gi\u00fap b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u01b0a ra k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m trong th\u1eddi gian ng\u1eafn. K\u1ef9 thu\u1eadt qPCR c\u0169ng c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao, gi\u00fap tr\u00e1nh \u0111\u01b0\u1ee3c nh\u1eefng sai s\u00f3t trong qu\u00e1 tr\u00ecnh x\u00e1c \u0111\u1ecbnh k\u1ebft qu\u1ea3.<\/p>\n\n\n\n

Vi\u1ec7c s\u1eed d\u1ee5ng qPCR c\u0169ng gi\u00fap t\u0103ng kh\u1ea3 n\u0103ng x\u00e1c \u0111\u1ecbnh virus HBV \u1edf c\u00e1c giai \u0111o\u1ea1n s\u1edbm c\u1ee7a b\u1ec7nh, gi\u00fap \u0111i\u1ec1u tr\u1ecb s\u1edbm v\u00e0 c\u1ea3i thi\u1ec7n d\u1ef1 \u0111o\u00e1n k\u1ebft qu\u1ea3 c\u1ee7a b\u1ec7nh. Ngo\u00e0i ra, k\u1ef9 thu\u1eadt qPCR c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a b\u1ec7nh, gi\u00fap b\u00e1c s\u0129 theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n theo th\u1eddi gian.<\/p>\n\n\n\n

Tuy nhi\u00ean, vi\u1ec7c \u00e1p d\u1ee5ng k\u1ef9 thu\u1eadt qPCR trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u00e9t nghi\u1ec7m HBV c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf. K\u1ef9 thu\u1eadt n\u00e0y \u0111\u00f2i h\u1ecfi s\u1ef1 chuy\u00ean m\u00f4n v\u00e0 k\u1ef9 n\u0103ng cao \u0111\u1ec3 th\u1ef1c hi\u1ec7n v\u00e0 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3. Ngo\u00e0i ra, k\u1ef9 thu\u1eadt qPCR c\u0169ng \u0111\u00f2i h\u1ecfi m\u1ed9t s\u1ed1 trang thi\u1ebft b\u1ecb v\u00e0 d\u1ee5ng c\u1ee5 \u0111\u1eaft ti\u1ec1n \u0111\u1ec3 th\u1ef1c hi\u1ec7n x\u00e9t nghi\u1ec7m.<\/p>\n\n\n\n

ABT cung c\u1ea5p tr\u1ecdn b\u1ed9 quy tr\u00ecnh ch\u1ea9n \u0111o\u00e1n HBV b\u00e0o g\u1ed3m: kit t\u00e1ch chi\u1ebft<\/strong><\/a>, Kit Real-time<\/strong><\/a> v\u00e0 v\u1eadt t\u01b0 ti\u00eau hao \u0111i k\u00e8m cho c\u1ea3 gi\u1ea3i ph\u00e1p ch\u1ea9n \u0111o\u00e1n. <\/em><\/p>\n\n\n\n

X\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan<\/em><\/h3>\n\n\n\n

Ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p quan tr\u1ecdng trong vi\u1ec7c \u0111\u00e1nh gi\u00e1 s\u1ee9c kh\u1ecfe c\u1ee7a gan v\u00e0 ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn gan. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y s\u1eed d\u1ee5ng c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u1ecdc \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan, bao g\u1ed3m c\u00e1c ch\u1ec9 s\u1ed1 v\u1ec1 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a men gan, m\u1ee9c \u0111\u1ed9 chuy\u1ec3n h\u00f3a v\u00e0 s\u1ea3n xu\u1ea5t ch\u1ea5t b\u00e0i ti\u1ebft, c\u0169ng nh\u01b0 c\u00e1c ch\u1ec9 s\u1ed1 v\u1ec1 chuy\u1ec3n h\u00f3a ch\u1ea5t x\u01a1, \u0111\u01b0\u1eddng v\u00e0 ch\u1ea5t b\u00e9o.
M\u1ed9t s\u1ed1 ch\u1ec9 s\u1ed1 ch\u1ee9c n\u0103ng gan th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan bao g\u1ed3m:<\/p>\n\n\n\n

    \n
  1. Enzyme aminotransferase (ALT) v\u00e0 enzyme aspartat aminotransferase (AST): \u0110\u00e2y l\u00e0 c\u00e1c men gan ch\u00ednh tham gia v\u00e0o qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a ch\u1ea5t b\u00e0i ti\u1ebft trong gan. Khi men gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng, ch\u00fang s\u1ebd \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng v\u00e0o m\u00e1u, g\u00e2y t\u0103ng cao c\u00e1c ch\u1ec9 s\u1ed1 ALT v\u00e0 AST trong m\u00e1u. Tuy nhi\u00ean, ch\u1ec9 s\u1ed1 n\u00e0y c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c nhau, bao g\u1ed3m c\u00e1c lo\u1ea1i thu\u1ed1c, vi\u00eam gan, nhi\u1ec5m khu\u1ea9n v\u00e0 c\u00e1c b\u1ec7nh kh\u00e1c.<\/li>\n\n\n\n
  2. Bilirubin: \u0110\u00e2y l\u00e0 s\u1ea3n ph\u1ea9m ph\u00e2n hu\u1ef7 c\u1ee7a huy\u1ebft thanh, \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a v\u00e0 ti\u1ebft ra b\u1edfi gan. Khi gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng, qu\u00e1 tr\u00ecnh ti\u1ebft bilirubin c\u00f3 th\u1ec3 b\u1ecb gi\u00e1n \u0111o\u1ea1n, d\u1eabn \u0111\u1ebfn t\u0103ng cao n\u1ed3ng \u0111\u1ed9 bilirubin trong m\u00e1u.<\/li>\n\n\n\n
  3. Protein gan: Ch\u1ee9c n\u0103ng s\u1ea3n xu\u1ea5t protein gan c\u0169ng l\u00e0 m\u1ed9t ch\u1ec9 s\u1ed1 quan tr\u1ecdng trong x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan. Khi gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng, s\u1ea3n xu\u1ea5t protein gan c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng, d\u1eabn \u0111\u1ebfn gi\u1ea3m n\u1ed3ng \u0111\u1ed9 protein gan trong m\u00e1u.<\/li>\n\n\n\n
  4. Albumin: \u0110\u00e2y l\u00e0 m\u1ed9t trong c\u00e1c lo\u1ea1i protein gan quan tr\u1ecdng, \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi t\u1ebf b\u00e0o gan. Gi\u1ea3m n\u1ed3ng \u0111\u1ed9 albumin trong m\u00e1u c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a vi\u1ec7c ch\u1ee9c n\u0103ng gan b\u1ecb gi\u1ea3m.<\/li>\n<\/ol>\n\n\n\n
    \"\"
    H\u00ecnh 5: m\u1ed9t k\u1ebf qu\u1ea3 ch\u1ee7a b\u1ec7nh nh\u00e2n x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan<\/em> (ngu\u1ed3n: Medlatec)<\/em><\/figcaption><\/figure>\n\n\n\n

    Vi\u1ec7c \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111\u01a1n gi\u1ea3n, nh\u01b0ng c\u1ef1c k\u1ef3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn gan. Tuy nhi\u00ean, n\u00f3 kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c m\u1ed9t c\u00e1ch \u0111\u1ea7y \u0111\u1ee7 v\u00ec c\u00e1c ch\u1ec9 s\u1ed1 ch\u1ee9c n\u0103ng gan c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c nhau. Do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m kh\u00e1c nh\u01b0 si\u00eau \u00e2m gan, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CT) hay c\u00e1ch th\u1ee7y s\u1ea3n kh\u00e1c c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c.<\/p>\n\n\n\n

    Tuy nhi\u00ean, s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan l\u00e0 r\u1ea5t h\u1eefu \u00edch trong vi\u1ec7c gi\u00e1m s\u00e1t s\u1ee9c kh\u1ecfe gan trong c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh l\u00fd gan, b\u1ec7nh nh\u00e2n d\u00f9ng thu\u1ed1c ho\u1eb7c c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao m\u1eafc b\u1ec7nh l\u00fd gan. N\u00f3 c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng ch\u1ee9c n\u0103ng gan c\u1ee7a b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc v\u00e0 sau khi \u0111i\u1ec1u tr\u1ecb, gi\u00fap \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a \u0111i\u1ec1u tr\u1ecb v\u00e0 th\u1ef1c hi\u1ec7n c\u00e1c \u0111i\u1ec1u ch\u1ec9nh c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng gan.<\/p>\n\n\n\n

    Si\u00eau \u00e2m gan<\/em><\/h3>\n\n\n\n

    Si\u00eau \u00e2m gan l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh kh\u00f4ng x\u00e2m l\u1ea5n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc, h\u00ecnh d\u1ea1ng, c\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a gan b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng s\u00f3ng si\u00eau \u00e2m. Si\u00eau \u00e2m gan \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong c\u00e1c c\u01a1 s\u1edf y t\u1ebf \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd gan v\u00e0 gi\u00fap theo d\u00f5i s\u1ee9c kh\u1ecfe c\u1ee7a gan trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n

    Ph\u01b0\u01a1ng ph\u00e1p si\u00eau \u00e2m gan kh\u00f4ng \u0111\u00f2i h\u1ecfi b\u1ea5t k\u1ef3 lo\u1ea1i ch\u1ea5t t\u01b0\u01a1ng ph\u1ea3n n\u00e0o, gi\u00fap h\u00ecnh \u1ea3nh si\u00eau \u00e2m r\u00f5 n\u00e9t v\u00e0 kh\u00f4ng g\u00e2y \u0111au \u0111\u1edbn cho b\u1ec7nh nh\u00e2n. Trong qu\u00e1 tr\u00ecnh th\u1ef1c hi\u1ec7n, b\u00e1c s\u0129 s\u1ebd s\u1eed d\u1ee5ng m\u1ed9t m\u00e1y si\u00eau \u00e2m, m\u00e0 bao g\u1ed3m m\u1ed9t \u0111\u1ea7u d\u00f2 si\u00eau \u00e2m \u0111\u01b0\u1ee3c \u0111\u1eb7t tr\u1ef1c ti\u1ebfp tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a da c\u1ee7a b\u1ec7nh nh\u00e2n, t\u1ea1i v\u1ecb tr\u00ed c\u1ee7a gan. S\u00f3ng si\u00eau \u00e2m s\u1ebd \u0111\u01b0\u1ee3c ph\u00e1t ra t\u1eeb \u0111\u1ea7u d\u00f2 n\u00e0y, \u0111i qua c\u00e1c m\u00f4 v\u00e0 c\u01a1 quan trong c\u01a1 th\u1ec3, v\u00e0 \u0111\u01b0\u1ee3c thu l\u1ea1i b\u1edfi \u0111\u1ea7u d\u00f2 sau \u0111\u00f3 \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ed5i th\u00e0nh h\u00ecnh \u1ea3nh tr\u00ean m\u00e0n h\u00ecnh.<\/p>\n\n\n\n

    \"\"
    H\u00ecnh 6: H\u00ecnh \u1ea3nh x\u01a1 gan: Si\u00eau \u00e2m c\u1eaft \u0111\u1ee9ng d\u1ecdc (A) b\u1ed9c l\u1ed9 n\u1ed1t b\u1ec1 m\u1eb7t, d\u1ecbch \u1ed5 b\u1ee5ng v\u00e0 nhu m\u00f4 th\u00f4. C\u00e1c \u1ea3nh \u0111\u1ee9ng d\u1ecdc cho th\u1ea5y (B) ph\u00ec \u0111\u1ea1i ph\u00e2n th\u00f9y ngo\u00e0i, (C) ph\u00ec \u0111\u1ea1i th\u00f9y \u0111u\u00f4i, v\u00e0 (D) teo th\u00f9y ph\u1ea3i. Ngu\u1ed3n: Vinmec <\/a><\/em><\/figcaption><\/figure>\n\n\n\n

    B\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng si\u00eau \u00e2m gan, b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00e1c th\u00f4ng s\u1ed1 nh\u01b0 k\u00edch th\u01b0\u1edbc, h\u00ecnh d\u1ea1ng, m\u1eadt \u0111\u1ed9 v\u00e0 c\u1ea5u tr\u00fac c\u1ee7a gan, \u0111\u1ed3ng th\u1eddi ki\u1ec3m tra c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh l\u00fd gan nh\u01b0 u gan, t\u0103ng k\u00edch th\u01b0\u1edbc gan, s\u1ecfi gan, t\u0103ng v\u00e2n m\u1ea1ch gan, c\u00e1c u tuy\u1ebfn v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c. Si\u00eau \u00e2m gan c\u0169ng c\u00f3 th\u1ec3 gi\u00fap \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan b\u1eb1ng c\u00e1ch \u0111o k\u00edch th\u01b0\u1edbc c\u1ee7a c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn, ki\u1ec3m tra l\u01b0u l\u01b0\u1ee3ng m\u00e1u trong gan v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng ti\u1ebft m\u1eadt c\u1ee7a gan.<\/p>\n\n\n\n

    Si\u00eau \u00e2m gan l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh an to\u00e0n v\u00e0 kh\u00f4ng x\u00e2m l\u1ea5n, kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 \u0111\u00e1ng k\u1ec3. Tuy nhi\u00ean, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf, bao g\u1ed3m kh\u1ea3 n\u0103ng kh\u00f4ng th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c kh\u1ed1i u nh\u1ecf ho\u1eb7c c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1ea9n, c\u0169ng nh\u01b0 kh\u00f4ng th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a gan. Do \u0111\u00f3, si\u00eau \u00e2m gan c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m v\u00e0 \u0111o\u00e1n kh\u00e1c \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c.<\/p>\n\n\n\n

    Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, si\u00eau \u00e2m gan c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb. V\u00ed d\u1ee5, trong qu\u00e1 tr\u00ecnh ti\u00eam ch\u1ea5t l\u1ecfng v\u00e0o c\u00e1c v\u00f9ng kh\u00e1c nhau c\u1ee7a gan \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c kh\u1ed1i u hay c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c, si\u00eau \u00e2m gan c\u00f3 th\u1ec3 gi\u00fap h\u01b0\u1edbng d\u1eabn \u0111\u1eb7t ch\u00ednh x\u00e1c kim ti\u00eam v\u00e0o v\u1ecb tr\u00ed c\u1ea7n thi\u1ebft.<\/p>\n\n\n\n

    Trong t\u1ed5ng th\u1ec3, si\u00eau \u00e2m gan l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh quan tr\u1ecdng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ee9c kh\u1ecfe v\u00e0 ch\u1ee9c n\u0103ng gan. Tuy nhi\u00ean, \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c v\u00e0 \u0111\u1ea7y \u0111\u1ee7, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi. N\u1ebfu b\u1ea1n c\u00f3 b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng n\u00e0o li\u00ean quan \u0111\u1ebfn gan ho\u1eb7c lo l\u1eafng v\u1ec1 s\u1ee9c kh\u1ecfe c\u1ee7a gan c\u1ee7a m\u00ecnh, h\u00e3y tham kh\u1ea3o \u00fd ki\u1ebfn \u200b\u200bb\u00e1c s\u0129 \u0111\u1ec3 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u00e0 ch\u1ea9n \u0111o\u00e1n k\u1ecbp th\u1eddi.<\/p>\n\n\n\n

    <\/p>","protected":false},"excerpt":{"rendered":"

    Vi r\u00fat vi\u00eam gan B c\u00f3 3 lo\u1ea1i kh\u00e1ng nguy\u00ean ch\u00ednh: HBsAg, HBeAg v\u00e0 HBcAg t\u01b0\u01a1ng \u1ee9ng v\u1edbi 3 lo\u1ea1i kh\u00e1ng th\u1ec3, l\u1ea7n l\u01b0\u1ee3t l\u00e0: Anti-HBs, Anti-HBe v\u00e0 Anti-HBc. X\u00e9t nghi\u1ec7m ph\u00e1t hi\u1ec7n c\u00e1c kh\u00e1ng nguy\u00ean, kh\u00e1ng th\u1ec3 n\u00e0y c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh b\u1ec7nh, th\u1ec3 b\u1ec7nh c\u0169ng nh\u01b0 di\u1ec5n bi\u1ebfn b\u1ec7nh. Hi\u1ec7n t\u1ea1i HBV c\u00f3 8 ki\u1ec3u gen ( genotype) l\u00e0 A,B,C,D,E,F,G,H ph\u00e2n b\u1ed1 tr\u00ean th\u1ebf gi\u1edbi,\u00a0 Vi\u1ec7t Nam ch\u1ee7 y\u1ebfu nhi\u1ec5m ki\u1ec3u B v\u00e0 C.<\/p>","protected":false},"author":1,"featured_media":7673,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"boxed-container","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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Team","author_link":"https:\/\/abtvn.com\/en\/author\/admin\/"},"uagb_comment_info":1,"uagb_excerpt":"Vi r\u00fat vi\u00eam gan B c\u00f3 3 lo\u1ea1i kh\u00e1ng nguy\u00ean ch\u00ednh: HBsAg, HBeAg v\u00e0 HBcAg t\u01b0\u01a1ng \u1ee9ng v\u1edbi 3 lo\u1ea1i kh\u00e1ng th\u1ec3, l\u1ea7n l\u01b0\u1ee3t l\u00e0: Anti-HBs, Anti-HBe v\u00e0 Anti-HBc. X\u00e9t nghi\u1ec7m ph\u00e1t hi\u1ec7n c\u00e1c kh\u00e1ng nguy\u00ean, kh\u00e1ng th\u1ec3 n\u00e0y c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh b\u1ec7nh, th\u1ec3 b\u1ec7nh c\u0169ng nh\u01b0 di\u1ec5n bi\u1ebfn…","_links":{"self":[{"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts\/7526","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/comments?post=7526"}],"version-history":[{"count":15,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts\/7526\/revisions"}],"predecessor-version":[{"id":7852,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts\/7526\/revisions\/7852"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/media\/7673"}],"wp:attachment":[{"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/media?parent=7526"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/categories?post=7526"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/tags?post=7526"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}