{"id":7709,"date":"2023-03-24T11:25:30","date_gmt":"2023-03-24T03:55:30","guid":{"rendered":"https:\/\/abtvn.com\/?p=7709"},"modified":"2024-02-23T14:06:18","modified_gmt":"2024-02-23T06:36:18","slug":"cac-xet-nghiem-voi-helicobacter-pylori","status":"publish","type":"post","link":"https:\/\/abtvn.com\/en\/cac-xet-nghiem-voi-helicobacter-pylori\/","title":{"rendered":"<strong>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m v\u1edbi vi khu\u1ea9n HP (Helicobacter pylori)<\/strong>"},"content":{"rendered":"<p class=\"wp-block-paragraph\">B\u1ec7nh vi\u00eam nhi\u1ec5m do vi khu\u1ea9n Helicobacter pylori (HP) l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 y t\u1ebf quan tr\u1ecdng to\u00e0n c\u1ea7u, t\u00e1c \u0111\u1ed9ng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a h\u00e0ng tri\u1ec7u ng\u01b0\u1eddi. C\u1ee5 th\u1ec3, vi\u00eam d\u1ea1 d\u00e0y, lo\u00e9t d\u1ea1 d\u00e0y, ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y v\u00e0 u lympho \u1edf d\u1ea1 d\u00e0y m\u1ee9c \u0111\u1ed9 th\u1ea5p \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u v\u00e0 cho th\u1ea5y c\u00f3 li\u00ean quan \u0111\u1ebfn vi khu\u1ea9n <em>Helicobacter Pylori.<\/em> T\u00ecnh tr\u1ea1ng nhi\u1ec5m <em>Helicobacter Pylori<\/em> g\u00e2y kh\u00f3 ti\u00eau tuy nhi\u00ean n\u1ebfu k\u00e9o d\u00e0i, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eefng h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng nh\u01b0 ung th\u01b0 ho\u1eb7c th\u1ee7ng d\u1ea1 d\u00e0y, g\u00e2y \u1ea3nh h\u01b0\u1edfng l\u1edbn cho s\u1ee9c kh\u1ecfe b\u1ec7nh nh\u00e2n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hi\u1ec7n nay, nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng \u0111\u1ec3 x\u00e9t nghi\u1ec7m vi khu\u1ea9n <em><em> Helicobacter pylori <\/em> <\/em>. D\u1ef1a v\u00e0o nguy\u00ean l\u00ed x\u00e9t nghi\u1ec7m, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c chia th\u00e0nh hai d\u1ea1ng ch\u00ednh v\u1edbi m\u1ee5c \u0111\u00edch v\u00e0 ch\u1ec9 \u0111\u1ecbnh kh\u00e1c nhau, bao g\u1ed3m: 1) X\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n v\u00e0 2) X\u00e9t nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n.\u00a0B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p ki\u1ebfn th\u1ee9c t\u1ed5ng quan v\u1ec1 <em>H. Pylori<\/em> v\u00e0 c\u00e1c ki\u1ebfn th\u1ee9c quan tr\u1ecdng tr\u01b0\u1edbc khi l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m ph\u00f9 h\u1ee3p. <\/p>\n\n\n\n<h2 class=\"wp-block-heading has-large-font-size\"><strong>1. Nhi\u1ec5m khu\u1ea9n<\/strong> <strong><em><em> Helicobacter pylori <\/em><\/em> l\u00e0 g\u00ec?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Helicobacter Pylori <\/em>(<em>H. Pylori<\/em>) l\u00e0 m\u1ed9t xo\u1eafn khu\u1ea9n, gram \u00e2m \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf l\u1edbp ni\u00eam th\u01b0\u1ee3ng b\u00ec d\u1ea1 d\u00e0y c\u1ee7a ng\u01b0\u1eddi. \u0110\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0o nh\u1eefng n\u0103m 1980 b\u1edfi Warren v\u00e0 Marshall[1], HP nhanh ch\u00f3ng tr\u1edf th\u00e0nh m\u1ed9t trong nh\u1eefng nguy\u00ean t\u00e1c g\u00e2y b\u1ec7nh ph\u1ed5 bi\u1ebfn nh\u1ea5t \u0111\u1ed1i v\u1edbi h\u1ec7 ti\u00eau h\u00f3a.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nhi\u1ec5m khu\u1ea9n HP th\u01b0\u1eddng di\u1ec5n ra qua \u0111\u01b0\u1eddng n\u01b0\u1edbc m\u1eaft ho\u1eb7c n\u01b0\u1edbc \u0103n nhi\u1ec5m khu\u1ea9n, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong m\u00f4i tr\u01b0\u1eddng \u00f4 nhi\u1ec5m n\u01b0\u1edbc. M\u1ed9t khi nhi\u1ec5m khu\u1ea9n, HP c\u00f3 kh\u1ea3 n\u0103ng th\u00e2m nh\u1eadp v\u00e0o ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y v\u00e0 g\u1eafn k\u1ebft ch\u1eb7t b\u1eb1ng c\u00e1c c\u1ea5u tr\u00fac adhesive tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ch\u00fang.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img fetchpriority=\"high\" decoding=\"async\" width=\"572\" height=\"397\" src=\"https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-3.png\" alt=\" C\u1ea5u t\u1ea1o vi khu\u1ea9n Helicobacter Pylori\" class=\"wp-image-7710\" style=\"width:779px;height:541px\" srcset=\"https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-3.png 572w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-3-64x44.png 64w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-3-300x208.png 300w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-3-18x12.png 18w\" sizes=\"(max-width: 572px) 100vw, 572px\" \/><figcaption class=\"wp-element-caption\"><em>H\u00ecnh 1. C\u1ea5u t\u1ea1o vi khu\u1ea9n H. pylori [2]<\/em><\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Vi\u1ec7c <em>H. pylori<\/em> v\u01b0\u1ee3t qua h\u00e0ng r\u00e0o d\u1ecbch v\u1ecb \u0111\u1ec3 t\u1ed3n t\u1ea1i v\u00e0 g\u00e2y b\u1ec7nh trong d\u1ea1 d\u00e0y qua h\u00e0ng tri\u1ec7u n\u0103m l\u00e0 m\u1ed9t \u0111i\u1ec1u v\u01b0\u1ee3t ngo\u00e0i t\u01b0\u1edfng t\u01b0\u1ee3ng c\u1ee7a c\u00e1c nh\u00e0 khoa h\u1ecdc. C\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c c\u0169ng cho th\u1ea5y r\u1eb1ng <em>H. heilmannii<\/em> and <em>H. felis <\/em>c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng n\u00e0y v\u00e0 cho th\u1ea5y m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa vi khu\u1ea9n n\u00e0y v\u1edbi vi\u00eam hang v\u1ecb d\u1ea1 d\u00e0y m\u00e3n t\u00ednh v\u00e0 lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng.\u00a0[3]<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tuy nhi\u00ean, m\u1ed9t s\u1ed1 ng\u01b0\u1eddi nhi\u1ec5m khu\u1ea9n HP kh\u00f4ng ph\u00e1t hi\u1ec7n b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng n\u00e0o, trong khi \u1edf nh\u1eefng ng\u01b0\u1eddi kh\u00e1c, nhi\u1ec5m khu\u1ea9n c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe n\u1eb7ng n\u1ec1. Vi\u1ec7c nhi\u1ec5m khu\u1ea9n HP th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn c\u00e1c b\u1ec7nh nh\u01b0 vi\u00eam d\u1ea1 d\u00e0y v\u00e0 lo\u00e9t d\u1ea1 d\u00e0y, v\u00e0 c\u0169ng \u0111\u01b0\u1ee3c xem x\u00e9t trong m\u1ed1i li\u00ean quan v\u1edbi c\u00e1c b\u1ec7nh l\u00fd d\u1ea1 d\u00e0y ti\u00eau bi\u1ec3u nh\u01b0 ung th\u01b0 d\u1ea1 d\u00e0y.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>H. pylori<\/em> th\u00edch nghi \u0111\u01b0\u1ee3c v\u1edbi m\u00f4i tr\u01b0\u1eddng c\u00f3 n\u1ed3ng \u0111\u1ed9 HCl cao (d\u1ea1 d\u00e0y ng\u01b0\u1eddi) nh\u1edd c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m<\/strong>:<\/h4>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>a. \u1ee8ng ph\u00f3 v\u1edbi m\u00f4i tr\u01b0\u1eddng axit c\u1ee7a d\u1ea1 d\u00e0y &#8211; Enzyme urease c\u1ee7a H. pylori<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">\u1ede d\u1ea1 d\u00e0y, t\u1ebf b\u00e0o vi\u1ec1n th\u01b0\u1eddng xuy\u00ean ti\u1ebft ra HCl t\u1ea1o m\u00f4i tr\u01b0\u1eddng r\u1ea5t acid (pH &lt; 2) gi\u00fap h\u1ed7 tr\u1ee3 ti\u00eau h\u00f3a nhanh th\u1ee9c \u0103n, \u0111\u1ed3ng th\u1eddi acid n\u00e0y c\u00f2n \u0111\u00f3ng vai tr\u00f2 l\u00e0 h\u00e0ng r\u00e0o hi\u1ec7u l\u1ef1c nh\u1ea5t trong vi\u1ec7c ng\u0103n c\u00e1c vi khu\u1ea9n kh\u00e1c t\u1ed3n t\u1ea1i. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 vi khu\u1ea9n c\u00f3 th\u1ec3 bi\u1ec7t h\u00f3a v\u00e0 ti\u1ebfn h\u00f3a b\u1ea3n th\u00e2n tr\u1edf n\u00ean ph\u00f9 h\u1ee3p \u0111\u1ec3 t\u1ed3n t\u1ea1i trong m\u00f4i tr\u01b0\u1eddng kh\u1eafc nghi\u1ec7t n\u00e0y, trong \u0111\u00f3 c\u00f3 <em>H. Pylori<\/em>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Enzyme urease c\u00f3 kh\u1ea3 n\u0103ng x\u00e2m nh\u1eadp tr\u1ef1c ti\u1ebfp v\u00e0o d\u1ecbch v\u1ecb \u0111\u1ec3 s\u1eed d\u1ee5ng ur\u00ea. Th\u00f4ng qua m\u1ed9t h\u1ec7 th\u1ed1ng enzyme urease \u0111\u1eb7c bi\u1ec7t duy nh\u1ea5t t\u1eeb \u200b\u200b\u200b\u200bn\u1ed9i b\u00e0o \u0111\u1ebfn ngo\u1ea1i b\u00e0o, <em>H. pylori <\/em>nhanh ch\u00f3ng s\u1eed d\u1ee5ng ur\u00ea \u0111\u1ec3 chuy\u1ec3n h\u00f3a th\u00e0nh hai ch\u1ea5t ki\u1ec1m l\u00e0 amoniac v\u00e0 bicacbonat t\u1ea1o ra t\u00ednh ki\u1ec1m xung quanh (c\u00e2n b\u1eb1ng m\u00f4i tr\u01b0\u1eddng axit) v\u00e0 chui v\u00e0o l\u1edbp ch\u1ea5t nh\u1ea7y c\u00f3 t\u00ednh ki\u1ec1m h\u01a1n ngay tr\u00ean bi\u1ec3u m\u00f4 ni\u00eam m\u1ea1c r\u1ed3i l\u1eb7n v\u00e0o trong. \u0110i\u1ec1u n\u00e0y t\u1ea1o n\u00ean s\u1ef1 kh\u00e1c bi\u1ec7t c\u1ee7a <em>H. pylori <\/em>so v\u1edbi c\u00e1c vi khu\u1ea9n s\u1eed d\u1ee5ng h\u1ec7 th\u1ed1ng urease s\u1ed1ng trong ru\u1ed9t kh\u00e1c [4].<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>b. L\u00f4ng v\u00e0 s\u1ef1 di \u0111\u1ed9ng c\u1ee7a vi khu\u1ea9n H. pylori<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">V\u1edbi c\u1ea5u tr\u00fac c\u00f3 t\u1eeb hai \u0111\u1ebfn s\u00e1u roi gi\u00fap <em>H. pylori<\/em> di chuy\u1ec3n r\u1ea5t nhanh so v\u1edbi c\u00e1c vi khu\u1ea9n di \u0111\u1ed9ng kh\u00e1c, \u0111\u00e2y l\u00e0 m\u1ed9t \u0111\u1eb7c t\u00ednh sinh h\u1ecdc quan tr\u1ecdng gi\u00fap ch\u00fang<em> <\/em>tho\u00e1t kh\u1ecfi m\u00f4i tr\u01b0\u1eddng axit cao c\u1ee7a d\u1ecbch v\u1ecb. Ngo\u00e0i ra, nh\u1edd c\u1ea5u tr\u00fac t\u1ebf b\u00e0o xo\u1eafn \u1ed1c v\u00e0 ti\u00ean mao n\u0103ng l\u01b0\u1ee3ng cao \u0111\u1eb7c tr\u01b0ng h\u1ed7 tr\u1ee3 cho vi\u1ec7c di chuy\u1ec3n.\u00a0[4]<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><em><strong> c. X\u00e2m nh\u1eadp v\u00e0 \u0111\u1ed9c l\u1ef1c<\/strong><\/em><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Sau khi x\u00e2m nh\u1eadp v\u00e0o d\u1ea1 d\u00e0y th\u00ec <em>H. pylori<\/em> s\u1ebd\u00a0di chuy\u1ec3n \u0111\u1ebfn m\u00f4n v\u1ecb, ti\u1ebft ra men urease t\u1ea1o ra m\u00f4i tr\u01b0\u1eddng th\u00edch h\u1ee3p \u0111\u1ec3 t\u1ed3n t\u1ea1i. Urease ph\u1ea3n \u1ee9ng v\u1edbi th\u00e0nh ph\u1ea7n trong m\u00e0ng nh\u1ea7y l\u00e0m gi\u1ea3m \u0111\u1ed9 keo d\u00ednh c\u1ee7a d\u1ecbch v\u1ecb, gi\u00fap vi khu\u1ea9n c\u00f3 th\u1ec3 chui qua l\u1edbp b\u1ea3o v\u1ec7 v\u00e0 l\u1edbp ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y. Khi \u0111\u1ebfn ni\u00eam m\u1ea1c, <em>H. pylori<\/em> s\u1eed d\u1ee5ng c\u01a1 ch\u1ebf b\u00e1m d\u00ednh th\u00f4ng qua li\u00ean k\u1ebft gi\u1eefa adhensins c\u1ee7a vi khu\u1ea9n v\u00e0 th\u1ee5 th\u1ec3 tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o t\u1ea1i d\u1ea1 d\u00e0y v\u00e0 x\u00e2m nh\u1eadp v\u00e0o b\u00ean trong, nh\u00e2n l\u00ean v\u00e0 ti\u1ebft ra \u0111\u1ed9c l\u1ef1c g\u00e2y vi\u00eam, lo\u00e9t v\u00e0 th\u1eadm ch\u00ed l\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>H. pylori<\/em> c\u00f3 2 lo\u1ea1i \u0111\u1ed9c t\u1ed1 ch\u00ednh l\u00e0 VacA v\u00e0 CagA trong \u0111\u00f3:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u25ba VacA l\u00e0 ngo\u1ea1i \u0111\u1ed9c t\u1ed1 ch\u00ednh c\u1ee7a vi khu\u1ea9n, \u0111\u1ed9c t\u1ed1 g\u1eafn v\u00e0o m\u00e0ng t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 c\u00f3 ch\u1ee9c n\u0103ng nh\u01b0 k\u00eanh ch\u1ecdn l\u1ecdc anion hexameric g\u00e2y kh\u00f4ng b\u00e0o bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y l\u00e0m \u1ee9c ch\u1ebf s\u1ef1 ho\u1ea1t h\u00f3a n\u0103ng l\u01b0\u1ee3ng do t\u1ed5n th\u01b0\u01a1ng ty l\u1ea1p th\u1ec3 v\u00e0 l\u00e0m t\u1ed5n th\u01b0\u01a1ng chu tr\u00ecnh t\u1ebf b\u00e0o. VacA c\u00f2n ph\u00f3ng th\u00edch cytochrome C t\u1eeb ty th\u1ec3 v\u00e0o t\u1ebf b\u00e0o ch\u1ea5t v\u00e0 l\u00e0m ch\u1ebft t\u1ebf b\u00e0o ch\u01b0\u01a1ng tr\u00ecnh th\u00f4ng qua vi\u1ec7c k\u00edch ho\u1ea1t h\u00e0ng lo\u1ea1t pro-caspases.[5]<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u25ba CagA c\u00f3 \u0111\u1ed9c t\u00ednh cao h\u01a1n. \u0110\u00e2y l\u00e0 gen ch\u1ec9 \u0111i\u1ec3m cho \u0111o\u1ea1n DNA 40kb g\u00e2y t\u1ed5n th\u01b0\u01a1ng v\u00e0 th\u01b0\u1eddng ph\u1ed1i h\u1ee3p v\u1edbi lo\u00e9t v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y. Khi x\u00e2m nh\u1eadp, CagA \u0111\u01b0\u1ee3c phosphoryl h\u00f3a l\u00e0m r\u1ed1i lo\u1ea1n qu\u00e1 tr\u00ecnh s\u1eafp x\u1ebfp l\u1ea1i khung t\u1ebf b\u00e0o actin trong t\u1ebf b\u1ea3o ch\u1ee7 v\u00e0 t\u01b0\u01a1ng t\u00e1c v\u1edbi SHP-2 tyrosine phosphatase (ti\u1ec1n ung th\u01b0) v\u00e0 kinase PAR1\/MARK (\u0111i\u1ec1u h\u00f2a ph\u00e2n c\u1ef1c) th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh bi\u1ebfn \u0111\u1ed5i t\u00e2n sinh c\u1ee7a c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 d\u1ea1y d\u00e0y. \u0110\u00e2y l\u00e0 \u0111\u01b0\u1ee3c xem l\u00e0 lo\u1ea1i protein c\u00f3 kh\u1ea3 n\u0103ng k\u00edch th\u00edch qu\u00e1 tr\u00ecnh sinh ung th\u01b0 \u1edf \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa v\u00e0 t\u1ea1o ra cytokine g\u00e2y vi\u00eam t\u1ebf b\u00e0o k\u00fd ch\u1ee7.[6]<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" width=\"599\" height=\"449\" data-src=\"https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-4.png\" alt=\"\u0110\u1ed9c t\u1ed1 v\u00e0 ph\u01b0\u01a1ng th\u1ee9c x\u00e2m nh\u1eadp c\u1ee7a H.pylori\" class=\"wp-image-7711 lazyload\" style=\"--smush-placeholder-width: 599px; --smush-placeholder-aspect-ratio: 599\/449;width:779px;height:541px\" data-srcset=\"https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-4.png 599w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-4-64x48.png 64w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-4-300x225.png 300w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-4-16x12.png 16w\" data-sizes=\"(max-width: 599px) 100vw, 599px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" \/><figcaption class=\"wp-element-caption\"><em><strong>Figure 2. <\/strong>\u0110\u1ed9c t\u1ed1 v\u00e0 ph\u01b0\u01a1ng th\u1ee9c x\u00e2m nh\u1eadp c\u1ee7a H.pylori<\/em><\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading has-large-font-size\"><strong>2. \u0110\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc nhi\u1ec5m Helicobacter pylori\u00a0<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cho \u0111\u1ebfn nay, T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi \u0111\u00e3 x\u1ebfp <em>H. pylori<\/em> l\u00e0 t\u00e1c nh\u00e2n g\u00e2y ung th\u01b0 d\u1ea1 d\u00e0y nh\u00f3m A. Nh\u1eefng ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m c\u00f3 nguy c\u01a1 ph\u00e1t tri\u1ec3n ung th\u01b0 d\u1ea1 d\u00e0y v\u00e0 ung th\u01b0 h\u1ea1ch b\u1ea1ch huy\u1ebft cao g\u1ea5p 2-6 l\u1ea7n so v\u1edbi ng\u01b0\u1eddi kh\u00f4ng b\u1ecb nhi\u1ec5m. C\u00f3 kho\u1ea3ng 50% d\u00e2n s\u1ed1 tr\u00ean th\u1ebf gi\u1edbi nhi\u1ec5m <em>H. pylori<\/em>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ea7n su\u1ea5t nhi\u1ec5m <em>H. pylori<\/em> thay \u0111\u1ed5i theo t\u1eebng ch\u00e2u l\u1ee5c v\u00e0 c\u00e1c qu\u1ed1c gia kh\u00e1c nhau. Vi\u1ec7t Nam l\u00e0 m\u1ed9t qu\u1ed1c gia c\u00f3 t\u1ef7 l\u1ec7 nhi\u1ec5m <em>H. pylori<\/em> cao trong c\u1ed9ng \u0111\u1ed3ng (kho\u1ea3ng 70%). Kh\u1ea3 n\u0103ng g\u00e2y b\u1ec7nh c\u1ee7a <em>H. pylori<\/em> ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o c\u00e1c y\u1ebfu t\u1ed1 \u0111\u1ed9c l\u1ef1c c\u1ee7a ch\u00fang. C\u00e1c y\u1ebfu t\u1ed1 \u0111\u1ed9c l\u1ef1c c\u1ee7a <em>H. pylori<\/em> nh\u01b0: cag-PAI, cagA, vacA, babA, opiA, iceA, dupA v\u00e0 homB. Tuy nhi\u00ean, ch\u1ec9 c\u00f3 2 gen cagA v\u00e0 vacA \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u nhi\u1ec1u nh\u1ea5t trong c\u00e1c b\u1ec7nh l\u00fd d\u1ea1 d\u00e0y kh\u00e1c nhau, trong \u0111\u00f3 c\u00f3 vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n [7].<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" width=\"940\" height=\"438\" data-src=\"https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-5.png\" alt=\"T\u00ecnh h\u00ecnh nhi\u1ec5m H. pylori tr\u00ean th\u1ebf gi\u1edbi\" class=\"wp-image-7712 lazyload\" data-srcset=\"https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-5.png 940w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-5-64x30.png 64w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-5-300x140.png 300w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-5-768x358.png 768w, https:\/\/abtvn.com\/wp-content\/uploads\/2023\/03\/image-5-18x8.png 18w\" data-sizes=\"(max-width: 940px) 100vw, 940px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 940px; --smush-placeholder-aspect-ratio: 940\/438;\" \/><figcaption class=\"wp-element-caption\"><em><strong>Figure 3. <\/strong>T\u00ecnh h\u00ecnh nhi\u1ec5m H. pylori tr\u00ean th\u1ebf gi\u1edbi<\/em><\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading has-large-font-size\"><strong>3. Ch\u1ea9n \u0111o\u00e1n vi khu\u1ea9n Helicobacter Pylori<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Hi\u1ec7n nay c\u00f3 r\u1ea5t nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n vi khu\u1ea9n <em>H. pylori<\/em> v\u00e0 c\u0103n c\u1ee9 v\u00e0o c\u00e1ch l\u1ea5y m\u1eabu chia th\u00e0nh 2 nh\u00f3m: <strong>x\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n<\/strong> <em><span style=\"text-decoration: underline;\">(Khi l\u1ea5y m\u1eabu c\u00f3 t\u1ea1o ra v\u1ebft n\u1ee9t tr\u00ean da, ti\u1ebfp x\u00fac v\u1edbi ni\u00eam m\u1ea1c, v\u1ebft r\u00e1ch da, khoan b\u00ean trong c\u01a1 th\u1ec3)<\/span><\/em> and <strong>x\u00e9t nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n<\/strong> <em><span style=\"text-decoration: underline;\">(ng\u01b0\u1ee3c l\u1ea1i)<\/span><\/em>. C\u1ee5 th\u1ec3, ph\u01b0\u01a1ng ph\u00e1p test nhanh urease, nu\u00f4i c\u1ea5y, m\u00f4 b\u1ec7nh h\u1ecdc v\u00e0 x\u00e9t nghi\u1ec7m kh\u00e1ng th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 x\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n. Ph\u01b0\u01a1ng ph\u00e1p test nhanh t\u00ecm kh\u00e1ng nguy\u00ean trong ph\u00e2n, Test h\u01a1i th\u1edf CO<sub>2<\/sub> ph\u00f3ng x\u1ea1 v\u00e0 Real-time PCR l\u00e0 x\u00e9t nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n [4].<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" style=\"font-size:25px\"><strong>3.1 X\u00e9t nghi\u1ec7m <em>H. Pylori<\/em> kh\u00f4ng x\u00e2m l\u1ea5n : <\/strong><\/h3>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong>a. Ph\u01b0\u01a1ng ph\u00e1p real-time PCR<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Vi\u1ec7c ki\u1ec3m tra urease trong m\u1eabu sinh thi\u1ebft c\u1ee7a b\u1ec7nh nh\u00e2n, c\u00e1c nh\u00e0 khoa h\u1ecdc \u0111\u00e3 \u1ee9ng d\u1ee5ng <a href=\"https:\/\/abtvn.com\/en\/ky-thuat-xet-nghiem-pcr-va-ung-dung-trong-chuan-doan-sinh-hoc-phan-tu\/\" data-type=\"URL\" data-id=\"https:\/\/abtvn.com\/ky-thuat-xet-nghiem-pcr-va-ung-dung-trong-chuan-doan-sinh-hoc-phan-tu\/\">ph\u01b0\u01a1ng ph\u00e1p real-time PCR<\/a> v\u00e0o ch\u1ea9n \u0111o\u00e1n <em>H. pylori<\/em> b\u1eb1ng c\u00e1ch thi\u1ebft k\u1ebf c\u1eb7p m\u1ed3i \u0111\u1eb7c hi\u1ec7u \u0111\u1ec3 khu\u1ebfch \u0111\u1ea1i \u0111o\u1ea1n gen urease c\u1ee7a <em>H. pylori<\/em> v\u00e0 m\u1eabu d\u00f2 \u0111\u01b0\u1ee3c g\u1eafn k\u00eanh m\u00e0u FAM. Trong \u0111\u00f3, s\u1eed d\u1ee5ng ch\u1ee9ng n\u1ed9i IC \u2013 \u0111o\u1ea1n gen t\u1eeb <em>Chlamydia trachomatis<\/em> c\u00f3 k\u00edch th\u01b0\u1edbc 166 bp, \u0111\u1ec3 ki\u1ec3m so\u00e1t quy tr\u00ecnh. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u1ecbnh l\u01b0\u1ee3ng b\u1eb1ng c\u00e1ch x\u00e2y d\u1ef1ng \u0111\u01b0\u1eddng chu\u1ea9n t\u1eeb ch\u1ee7ng <em>H. pylori <\/em>(ATCC 43504) \u0111\u00e3 bi\u1ebft tr\u01b0\u1edbc n\u1ed3ng \u0111\u1ed9 [9]. Ph\u01b0\u01a1ng ph\u00e1p ch\u1ec9 khu\u1ebfch \u0111\u1ea1i \u0111\u01b0\u1ee3c \u0111\u00fang gen m\u1ee5c ti\u00eau, \u0111\u1ed3ng th\u1eddi \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t b\u1eb1ng ch\u1ee9ng n\u1ed9i v\u00e0 \u0111\u1ecbnh l\u01b0\u1ee3ng th\u00f4ng qua \u0111\u01b0\u1eddng chu\u1ea9n t\u1eeb ch\u1ee7ng <em>H. pylori<\/em> \u0111\u00e3 bi\u1ebft n\u1ed3ng \u0111\u1ed9 cho th\u1ea5y ph\u01b0\u01a1ng ph\u00e1p c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c cao. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ngo\u00e0i ra, ph\u01b0\u01a1ng ph\u00e1p real-time PCR k\u1ebft h\u1ee3p v\u1edbi ph\u00e2n t\u00edch \u0111i\u1ec3m n\u00f3ng ch\u1ea3y \u0111\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn \u0111i\u1ec3m tr\u00ean gen 23S rRNA c\u1ee7a <em>H. pylori<\/em> t\u1eeb m\u1eabu ph\u00e2n (ho\u00e0n to\u00e0n lo\u1ea1i b\u1ecf vi\u1ec7c x\u00e2m l\u1ea5n th\u00f4ng qua n\u1ed9i soi d\u1ea1 d\u00e0y). Ch\u1ec9 khi s\u1eed d\u1ee5ng PCR th\u00ec n\u0103m trong s\u1ed1 s\u00e1u tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m <em>H. pylori<\/em> \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y real-time PCR l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p kh\u00f4ng x\u00e2m l\u1ea5n, c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c cao \u0111\u1ec3 ph\u00e1t hi\u1ec7n <em>H. pylori<\/em> [8].<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>M\u1ed9t s\u1ed1 s\u1ea3n ph\u1ea9m ABT d\u00f9ng trong x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n<\/em><\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u25ba <strong>Kit t\u00e1ch chi\u1ebft DNA\/RNA: <\/strong><br><strong><a href=\"https:\/\/abtvn.com\/en\/product\/toppure-genomic-dna-extraction-kit\/\" data-type=\"link\" data-id=\"https:\/\/abtvn.com\/san-pham\/toppure-genomic-dna-extraction-kit\/\">TopPURE \u00ae Genomic DNA extraction kit (HI-112)<\/a><\/strong> s\u1eed d\u1ee5ng cho t\u00e1ch chi\u1ebft DNA virus t\u1eeb m\u1eabu huy\u1ec5n d\u1ecbch 10%.<br><strong><a href=\"https:\/\/abtvn.com\/en\/product\/toppure-stool-dna-extraction-kit\/\" data-type=\"link\" data-id=\"https:\/\/abtvn.com\/san-pham\/toppure-blood-dna-extraction-kit\/\">TopPURE\u00ae Stool DNA extraction kit (HI-192)<\/a><\/strong> s\u1eed d\u1ee5ng cho t\u00e1ch chi\u1ebft DNA v\u1eadt ch\u1ee7 v\u00e0 vi sinh v\u1eadt t\u1eeb m\u1eabu ph\u00e2n t\u01b0\u01a1i ho\u1eb7c \u0111\u00f4ng l\u1ea1nh b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p t\u00e1ch chi\u1ebft c\u1ed9t silica.<br><strong><a href=\"https:\/\/abtvn.com\/en\/product\/toppure-maga-genomic-dna-rna-extraction-kit\/\">TopPURE\u00ae Maga Genomic DNA\/RNA extraction kit (HI-612)<\/a><\/strong> s\u1eed d\u1ee5ng cho t\u00e1ch chi\u1ebft DNA\/RNA t\u1eeb t\u1ebf b\u00e0o nu\u00f4i c\u1ea5y, vi khu\u1ea9n gram (-) v\u00e0 gram (+), huy\u1ec5n d\u1ecbch (huy\u1ec1n ph\u00f9), m\u1eabu qu\u00e9t b\u1ec1 m\u1eb7t, m\u1eabu d\u1ecbch ph\u1ebft.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u25ba<\/strong> <strong>Kit Real-time PCR: <\/strong><br><strong><a href=\"https:\/\/abtvn.com\/en\/product\/topsensi-helicobacter-pylori-qpcr-kit-sqh-123\/\" data-type=\"link\" data-id=\"https:\/\/abtvn.com\/san-pham\/topspec-asfv-qpcr-kit-sqv-101\/\">TopSENSI\u00ae Helicobacter pylori qPCR kit (SQH-123)<\/a><\/strong><br>Quantitative detection\u00a0<em><em> Helicobacter pylori <\/em><\/em>\u00a0t\u1eeb m\u1eabu sinh thi\u1ebft, d\u1ecbch d\u1ea1 d\u00e0y v\u00e0 ph\u00e2n. b\u1eb1ng k\u1ef9 thu\u1eadt real-time PCR.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u25ba<\/strong> <strong>Urease test kit: <\/strong><br><a href=\"https:\/\/abtvn.com\/en\/product\/topsensi-urease-test-kit-sqh-139\/\" data-type=\"link\" data-id=\"https:\/\/abtvn.com\/san-pham\/topsensi-urease-test-kit-sqh-139\/\"><strong>TopSENSI\u00ae Urease Test Kit (SQH-139)<\/strong><\/a> t\u1ea7m so\u00e1t <em><em> Helicobacter pylori <\/em><\/em>\u00a0(<em>H. pylori<\/em>) d\u1ef1a v\u00e0o kh\u1ea3 n\u0103ng sinh enzyme urease r\u1ea5t m\u1ea1nh c\u1ee7a vi khu\u1ea9n n\u00e0y.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong>b. Test th\u1edf CO<sub>2<\/sub> ph\u00f3ng x\u1ea1<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">S\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y d\u1ef1a tr\u00ean kh\u1ea3 n\u0103ng ph\u00e2n h\u1ee7y urea c\u1ee7a <em>H. pylori<\/em> th\u00e0nh amoniac v\u00e0 CO<sub>2.<\/sub><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nguy\u00ean l\u00fd x\u00e9t nghi\u1ec7m: Urea b\u1ecb th\u1ee7y ph\u00e2n b\u1edfi urease t\u1ea1o th\u00e0nh ammonium v\u00e0 carbonate.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Urea + 2&nbsp;H<sub>2<\/sub>O -&gt;2 NH<sub>4<\/sub><sup>+<\/sup> + CO<sub>3<\/sub><sup>2-<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Trong ph\u1ea3n \u1ee9ng th\u1ee9 hai, 2\u2011oxoglutarate ph\u1ea3n \u1ee9ng v\u1edbi ammonium v\u1edbi s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a glutamate dehydrogenase (GLDH) v\u00e0 coenzyme NADH t\u1ea1o th\u00e0nh L\u2011glutamate. Trong ph\u1ea3n \u1ee9ng n\u00e0y hai mol NADH b\u1ecb oxy h\u00f3a th\u00e0nh NAD<sup>+<\/sup> \u1ee9ng v\u1edbi m\u1ed9t mol urea b\u1ecb th\u1ee7y ph\u00e2n.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">GLDH NH4<sup>+<\/sup> + 2\u2011oxoglutarate + NADH L\u2011glutamate + NAD<sup>+<\/sup> + H2O<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ed1c \u0111\u1ed9 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 NADH t\u1ef7 l\u1ec7 thu\u1eadn v\u1edbi n\u1ed3ng \u0111\u1ed9 urea trong m\u1eabu th\u1eed v\u00e0 \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p \u0111o quang.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ti\u1ebfn h\u00e0nh cho b\u1ec7nh nh\u00e2n u\u1ed1ng m\u1ed9t dung d\u1ecbch urea ph\u00f3ng x\u1ea1 C<sup>13<\/sup> ho\u1eb7c C<sup>14<\/sup>, khi c\u00f3 m\u1eb7t <em>H. pylori <\/em>th\u00ec urea ph\u00f3ng x\u1ea1 n\u00e0y s\u1ebd b\u1ecb ph\u00e2n h\u1ee7y v\u00e0 gi\u1ea3i ph\u00f3ng ra CO<sub>2<\/sub> ph\u00f3ng x\u1ea1, ch\u1ea5t n\u00e0y \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 v\u00e0o m\u00e1u v\u00e0 \u0111\u01b0\u1ee3c th\u1ea3i ra qua ph\u1ed5i trong kh\u00ed th\u1edf ra, sau \u0111\u00f3 ng\u01b0\u1eddi ta \u0111o CO<sub>2<\/sub> ph\u00f3ng x\u1ea1 trong v\u00f2ng 1 gi\u1edd. C\u00e1c m\u1eabu kh\u00ed th\u1edf ra \u01b0\u1ee3c ph\u00e2n t\u00edch t\u00ecm ph\u00f3ng x\u1ea1 b\u1eb1ng m\u00e1y \u0111\u1ebfm nh\u1ea5p nh\u00e1y. Ph\u01b0\u01a1ng ph\u00e1p cho \u0111\u1ed9 nh\u1ea1y 85% , \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 79%.<\/p>\n\n\n\n<h5 class=\"wp-block-heading has-medium-font-size\"><strong>\u25ba<\/strong> <strong>Test th\u1edf v\u1edbi urea ph\u00f3ng x\u1ea1 C<sup>13<\/sup><\/strong><\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">\u01afu \u0111i\u1ec3m l\u00e0 kh\u00f4ng b\u1ecb nhi\u1ec5m x\u1ea1, an to\u00e0n nh\u01b0ng c\u1ea7n ph\u1ea3i ph\u00e2n t\u00edch qua m\u00e1y quang ph\u1ed5 k\u1ebf. C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef mang thai, cho con b\u00fa v\u00e0 tr\u1ebb em. \u0110\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 b\u1eb1ng ch\u1ec9 s\u1ed1 DOB, n\u1ebfu DOB >4% l\u00e0 c\u00f3 nhi\u1ec5m <em>H. pylori<\/em> v\u00e0 DOB &lt;4% l\u00e0 kh\u00f4ng nhi\u1ec5m <em>H. pylori<\/em>. Tr\u01b0\u1edbc khi l\u00e0m test h\u01a1i th\u1edf, b\u1ea1n c\u00f3 th\u1ec3 y\u00eau c\u1ea7u k\u1ef9 thu\u1eadt vi\u00ean cho bi\u1ebft, b\u1ea1n \u0111ang chu\u1ea9n b\u1ecb \u0111\u01b0\u1ee3c l\u00e0m x\u00e9t nghi\u1ec7m h\u01a1i th\u1edf v\u1edbi ch\u1ea5t c\u00f3 ph\u00f3ng x\u1ea1 hay kh\u00f4ng.<\/p>\n\n\n\n<h5 class=\"wp-block-heading has-medium-font-size\"><strong>\u25ba<\/strong> <strong>Test h\u01a1i th\u1edf v\u1edbi urea C<sup>14<\/sup><\/strong><\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Ph\u00e2n t\u00edch v\u1edbi m\u00e1y \u0111\u1ebfm nh\u1ea5p nh\u00e1y c\u00f3 gi\u00e1 th\u00e0nh r\u1ebb h\u01a1n nh\u01b0ng c\u00f3 nhi\u1ec5m x\u1ea1 v\u1edbi li\u1ec1u nh\u1ecf (1\/1000 l\u1ea7n so v\u1edbi ch\u1ee5p Xquang). Kh\u00f4ng n\u00ean d\u00f9ng test n\u00e0y cho ph\u1ee5 n\u1eef trong tu\u1ed5i sinh n\u1edf, c\u00f3 thai, cho con b\u00fa v\u00e0 tr\u1ebb nh\u1ecf v\u00ec b\u1ea3n ch\u1ea5t C<sup>14<\/sup> l\u00e0 ch\u1ea5t ph\u00f3ng x\u1ea1.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Note: <\/em><\/strong>Tr\u01b0\u1edbc khi l\u00e0m c\u00e1c ki\u1ec3m tra nhi\u1ec5m <em>H. pylori<\/em> b\u1eb1ng test th\u1edf b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i ng\u01b0ng c\u00e1c thu\u1ed1c kh\u00e1ng sinh v\u00e0 thu\u1ed1c ch\u1ee9a bismuth 4 tu\u1ea7n; ng\u01b0ng thu\u1ed1c sucralfat v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton 2 tu\u1ea7n; ph\u1ea3i nh\u1ecbn \u0111\u00f3i 6 gi\u1edd tr\u01b0\u1edbc khi l\u00e0m test.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">K\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 qua th\u00f4ng s\u1ed1 DPM (\u0111\u1ed9 ph\u00e2n gi\u1ea3i c\u1ee7a ch\u1ea5t ph\u00f3ng x\u1ea1 trong m\u1ed9t ph\u00fat)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>DPM &lt; 50: Kh\u00f4ng nhi\u1ec5m <em>H. pylori<\/em><\/li>\n\n\n\n<li>DPM 50 \u2013 199: kh\u00f4ng x\u00e1c \u0111\u1ecbnh c\u00f3 nhi\u1ec5m <em>H. pylori<\/em><\/li>\n\n\n\n<li>DPM &gt; 200: c\u00f3 nhi\u1ec5m <em>H. pylori<\/em><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Khi s\u1eed d\u1ee5ng ure C<sup>13<\/sup> v\u1edbi li\u1ec1u l\u00e0 1 \u03bcCi (0,2 mL) h\u00f2a v\u1edbi 50 mL axit citric \u0111\u1ec3 u\u1ed1ng, m\u1ed9t m\u1eabu h\u01a1i th\u1edf \u0111\u01b0\u1ee3c l\u1ea5y tr\u01b0\u1edbc khi u\u1ed1ng v\u00e0 m\u1ed9t m\u1eabu h\u01a1i th\u1edf \u0111\u01b0\u1ee3c l\u1ea5y \u1edf ph\u00fat th\u1ee9 10-15 sau khi u\u1ed1ng ure C<sup>13<\/sup>, CO<sub>2<\/sub> sinh ra s\u1ebd \u0111\u01b0\u1ee3c \u0111o b\u1edfi m\u00e1y nh\u1ea5p nh\u00e1y l\u1ecfng beta. K\u1ebft qu\u1ea3 ph\u00e1t hi\u1ec7n nhi\u1ec5m <em>H. pylori<\/em> \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 theo s\u1ed1 \u0111\u1ebfm nh\u1ea5p nh\u00e1y trong m\u1ed9t ph\u00fat (cpm: counts per minute) nh\u01b0 sau:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gi\u00e1 tr\u1ecb t\u1eeb 0 &#8211; &lt;25 cpm l\u00e0 (-) t\u00ednh: b\u1ec7nh nh\u00e2n hi\u1ec7n kh\u00f4ng b\u1ecb nhi\u1ec5m <em>H. pylori<\/em>.<\/li>\n\n\n\n<li>Gi\u00e1 tr\u1ecb t\u1eeb 25 &#8211; &lt;50 cpm l\u00e0 kh\u00f4ng x\u00e1c \u0111\u1ecbnh.<\/li>\n\n\n\n<li>Gi\u00e1 tr\u1ecb &gt; 50 cpm l\u00e0 (+) t\u00ednh: b\u1ec7nh nh\u00e2n \u0111ang b\u1ecb nhi\u1ec5m <em>H. pylori<\/em>.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Ba th\u00e1ng sau \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb <em>H. pylori<\/em> b\u1eb1ng kh\u00e1ng sinh, c\u1ea7n x\u00e9t nghi\u1ec7m h\u01a1i th\u1edf ure C<sup>13<\/sup>: n\u1ebfu x\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh: b\u1ec7nh nh\u00e2n v\u1eabn \u0111ang b\u1ecb nhi\u1ec5m <em>H. pylori<\/em>, \u0111i\u1ec1u tr\u1ecb kh\u00f4ng th\u00e0nh c\u00f4ng; n\u1ebfu \u00e2m t\u00ednh, b\u1ec7nh nh\u00e2n hi\u1ec7n kh\u00f4ng c\u00f2n b\u1ecb nhi\u1ec5m <em>H. pylori<\/em>, \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u00e0nh c\u00f4ng.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Test th\u1edf C<sup>13<\/sup> \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng ph\u1ed5 bi\u1ebfn v\u00ec m\u1ed9t s\u1ed1 \u01b0u \u0111i\u1ec3m sau:<\/li>\n\n\n\n<li>Ph\u00e1t hi\u1ec7n nhanh vi khu\u1ea9n <em>H. pylori<\/em><\/li>\n\n\n\n<li>Kh\u00f4ng c\u1ea7n d\u00f9ng k\u0129 thu\u1eadt n\u1ed9i soi, \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao<\/li>\n\n\n\n<li>D\u1ec5 ki\u1ec3m tra sau khi \u0111i\u1ec1u tr\u1ecb<\/li>\n\n\n\n<li>Gi\u1ea3m thi\u1ec3u r\u1ee7i ro sai s\u1ed1 khi l\u1ea5y m\u1eabu<\/li>\n\n\n\n<li>Kh\u00f4ng c\u00f3 tia ph\u00f3ng x\u1ea1<\/li>\n\n\n\n<li>\u0110\u01a1n gi\u1ea3n v\u00e0 ti\u1ebft ki\u1ec7m<\/li>\n\n\n\n<li>C\u00f3 th\u1ec3 d\u00f9ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 tr\u1ebb em<\/li>\n\n\n\n<li>Ti\u1ebft ki\u1ec7m th\u1eddi gian: 30 ph\u00fat \u0111\u1ec3 l\u1ea5y 2 m\u1eabu h\u01a1i th\u1edf v\u00e0 3 ph\u00fat \u0111\u1ec3 ph\u00e2n t\u00edch ra k\u1ebft qu\u1ea3.<\/li>\n\n\n\n<li>M\u1ee9c an to\u00e0n cao cho ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nh\u00e2n vi\u00ean Y t\u1ebf<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disadvantage:<\/strong> V\u00ec ph\u01b0\u01a1ng ph\u00e1p test h\u01a1i th\u1edf kh\u00f4ng c\u1ea7n n\u1ed9i soi d\u1ea1 d\u00e0y n\u00ean ch\u1ec9 ki\u1ec3m tra \u0111\u01b0\u1ee3c ng\u01b0\u1eddi th\u1eed c\u00f3 nhi\u1ec5m <em>H. pylori<\/em> hay kh\u00f4ng; kh\u00f4ng quan s\u00e1t \u0111\u01b0\u1ee3c ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y v\u00e0 t\u00e1 trang \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng vi\u00eam, lo\u00e9t; do \u0111\u00f3 m\u00e0 c\u00f3 th\u1ec3 b\u1ecf s\u00f3t c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a tr\u00ean nh\u01b0 vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng v\u00e0 c\u00e1c lo\u1ea1i u th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y&#8230; V\u00ec v\u1eady m\u00e0 ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u nguy hi\u1ec3m nh\u01b0: n\u00f4n hay \u0111\u1ea1i ti\u1ec7n ra m\u00e1u, \u0111au d\u1ea1 d\u00e0y dai d\u1eb3ng, s\u1ee5t c\u00e2n b\u1ea5t th\u01b0\u1eddng, ng\u01b0\u1eddi l\u1edbn tu\u1ed5i&#8230;<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>c. Test huy\u1ebft thanh \u2013 x\u00e9t nghi\u1ec7m m\u00e1u<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">D\u1ef1a tr\u00ean c\u01a1 s\u1edf t\u00ecm th\u1ea5y kh\u00e1ng th\u1ec3 <em>H. pylori<\/em> trong huy\u1ebft thanh. Ng\u01b0\u1eddi ta s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p s\u1eafc k\u00fd mi\u1ec5n d\u1ecbch \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c kh\u00e1ng th\u1ec3 IgG \u0111\u1eb7c hi\u1ec7u trong huy\u1ebft thanh b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ebfm <em>H. pylori<\/em>, ph\u01b0\u01a1ng ph\u00e1p cho k\u1ebft qu\u1ea3 nhanh, kh\u00f4ng ph\u1ee9c t\u1ea1p. D\u00f9ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u1ed9t b\u1ec7nh nh\u00e2n m\u1edbi, hay nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc. Kh\u00f4ng d\u00f9ng \u0111\u1ec3 theo d\u00f5i \u0111i\u1ec1u tr\u1ecb v\u00ec t\u1ec9 l\u1ec7 IgG gi\u1ea3m r\u1ea5t ch\u1eadm. Ph\u01b0\u01a1ng ph\u00e1p cho \u0111\u1ed9 nh\u1ea1y (95-98%). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tuy nhi\u00ean, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u01b0\u1eddng cho k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh gi\u1ea3 v\u00ec cho d\u00f9 vi khu\u1ea9n <em>H. pylori<\/em> kh\u00f4ng c\u00f3 trong d\u1ea1 d\u00e0y, kh\u00e1ng th\u1ec3 kh\u00e1ng <em>H. pylori<\/em> v\u1eabn c\u00f3 th\u1ec3 l\u01b0u h\u00e0nh trong m\u00e1u m\u1ed9t v\u00e0i n\u0103m, th\u1eadm ch\u00ed l\u00e0 nhi\u1ec1u n\u0103m sau \u0111\u00f3. Ch\u00ednh v\u00ec v\u1eady, \u0111\u00e2y kh\u00f4ng ph\u1ea3i l\u00e0 lo\u1ea1i x\u00e9t nghi\u00eam tin c\u1eady, \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng tr\u01b0\u1edbc v\u00e0 sau khi \u0111i\u1ec1u tr\u1ecb. L\u01b0u \u00fd, ch\u1ec9 s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y khi kh\u00f4ng c\u00f3 s\u1eb5n ph\u01b0\u01a1ng ph\u00e1p n\u00e0o c\u00f3 \u0111\u1ed9 tin c\u1eady cao h\u01a1n.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>d. Test nhanh kh\u00e1ng th\u1ec3 H. Pylori<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">X\u00e9t nghi\u1ec7m t\u00ecm kh\u00e1ng th\u1ec3 Hp trong ph\u00e2n (Hp stool antigen test). Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y ph\u00e1t hi\u1ec7n kh\u00e1ng nguy\u00ean Hp trong ph\u00e2n, c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m Hp \u1edf tr\u1ebb em, ng\u01b0\u1eddi l\u1edbn, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng trong \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb. Ph\u01b0\u01a1ng ph\u00e1p cho \u0111\u1ed9 nh\u1ea1y (91 \u2013 98%), \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u (94-99%).<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>e. Test nhanh t\u00ecm kh\u00e1ng nguy\u00ean H. Pylori trong ph\u00e2n<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">X\u00e9t nghi\u1ec7m n\u00e0y c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u t\u01b0\u01a1ng t\u1ef1 test h\u01a1i th\u1edf, nh\u01b0ng \u00edt \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00ec quy tr\u00ecnh l\u1ea5y m\u1eabu b\u1ec7nh ph\u1ea9m c\u00f3 ph\u1ea7n b\u1ea5t ti\u1ec7n.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" style=\"font-size:25px\"><strong>3.2 X\u00e9t nghi\u1ec7m <em>H. Pylori<\/em> x\u00e2m l\u1ea5n: <\/strong><\/h3>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>a. Test Urease (CLO test)<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">L\u00e0 ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m vi khu\u1ea9n H. pylori hi\u1ec7n \u0111\u1ea1i. Tuy nhi\u00ean \u0111\u00e2y l\u00e0 x\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n, c\u1ea7n l\u1ea5y m\u1eabu m\u00f4 sinh thi\u1ebft qua n\u1ed9i soi d\u1ea1 d\u00e0y. Nguy\u00ean l\u00fd c\u1ee7a x\u00e9t nghi\u1ec7m n\u00e0y d\u1ef1a tr\u00ean s\u1ef1 s\u1ea3n xu\u1ea5t men urease c\u1ee7a vi khu\u1ea9n. Men urease n\u00e0y s\u1ebd ph\u00e2n h\u1ee7y ure trong m\u00e1u th\u00e0nh Amoniac v\u00e0 carbon dioxit l\u00e0m cho m\u00f4i tr\u01b0\u1eddng trong kit th\u1eed tr\u1edf n\u00ean ki\u1ec1m t\u00ednh h\u01a1n. M\u1eabu m\u00f4 sinh thi\u1ebft s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1eb7t trong kit th\u1eed m\u00e0u v\u00e0ng c\u00f3 ch\u1ee9a ure v\u00e0 ch\u1ea5t ch\u1ec9 th\u1ecb pH. Ho\u1ea1t t\u00ednh c\u1ee7a men urease do vi khu\u1ea9n ti\u1ebft ra s\u1ebd l\u00e0m kit th\u1eed chuy\u1ec3n t\u1eeb m\u00e0u v\u00e0ng sang m\u00e0u h\u1ed3ng c\u00e1nh sen.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>b. Nu\u00f4i c\u1ea5y H. Pylori<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">M\u1ea3nh sinh thi\u1ebft \u0111\u01b0\u1ee3c nghi\u1ec1n trong 0.5 mL n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd trong v\u00e0i gi\u00e2y, sau \u0111\u00f3 \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o m\u00f4i tr\u01b0\u1eddng nu\u00f4i c\u1ea5y. <em>H. pylori<\/em> l\u00e0 m\u1ed9t lo\u00e0i vi khu\u1ea9n y\u1ebfu v\u00e0 kh\u00f3 nu\u00f4i c\u1ea5y. Nhi\u1ec7t \u0111\u1ed9 m\u00f4i tr\u01b0\u1eddng lu\u00f4n \u1edf 37<sup>o<\/sup>C. Quan s\u00e1t h\u00e0ng ng\u00e0y s\u1ebd th\u1ea5y c\u00e1c khu\u1ea9n l\u1ea1c tr\u00f2n, s\u00e1ng sau 3 ng\u00e0y. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u v\u00e0 \u0111\u1ed9 nh\u1ea1y cao v\u00e0 \u0111\u1eb7c bi\u1ec7t c\u1ea7n thi\u1ebft trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1ea7n ph\u1ea3i th\u1eed \u0111\u1ed9 nh\u1ea1y c\u1ee7a kh\u00e1ng sinh trong \u0111i\u1ec1u tr\u1ecb <em>H. pylori<\/em>. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y cho \u0111\u1ed9 nh\u1ea1y 79 -80% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 100%.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-medium-font-size\"><strong><em>c. M\u00f4 b\u1ec7nh h\u1ecdc<\/em><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">B\u1ec7nh ph\u1ea9m \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh b\u1eb1ng Formol 10% \u0111\u01b0\u1ee3c x\u1eed l\u00fd theo ph\u01b0\u01a1ng ph\u00e1p th\u00f4ng th\u01b0\u1eddng, c\u1eaft m\u1ea3nh 4-6 mm. Nhu\u1ed9m m\u00e0u b\u1eb1ng nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p nh\u01b0: Hematixyline \u2013 eosine (H.E), Warthin \u2013 Starry, Giemsa, nhu\u1ed9m Peroxydase \u2013 Antiperoxydase. Trong c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tr\u00ean, nhu\u1ed9m Giemsa th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng h\u01a1n c\u1ea3 v\u00ec \u0111\u01a1n gi\u1ea3n, r\u1ebb ti\u1ec1n, cho k\u1ebft qu\u1ea3 nhanh. Quan s\u00e1t d\u01b0\u1edbi k\u00ednh hi\u1ec3n vi th\u1ea5y H. pylori th\u01b0\u1eddng n\u1eb1m trong c\u00e1c khe v\u00e0 tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ni\u00eam m\u1ea1c. \u01afu \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y l\u00e0 c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c \u1edf h\u1ea7u h\u1ebft c\u00e1c c\u01a1 s\u1edf y t\u1ebf. Ph\u01b0\u01a1ng ph\u00e1p cho \u0111\u1ed9 nh\u1ea1y >95% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 94 \u2013 98%.<\/p>\n\n\n\n<figure class=\"wp-block-table aligncenter\"><table><tbody><tr><td><strong>Method<\/strong><\/td><td><strong>Ch\u1ec9 \u0111\u1ecbnh x\u00e9t nghi\u1ec7m<\/strong><\/td><td><strong><strong>Highlights<\/strong><\/strong><\/td><td><strong>Nh\u01b0\u1ee3c \u0111i\u1ec3m<\/strong><\/td><\/tr><tr><td>Real-time PCR<\/td><td>C\u00f3 nhu c\u1ea7u ki\u1ec3m tra H. pylori trong d\u1ea1 d\u00e0y khi &nbsp;c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng b\u1ec7nh.<\/td><td>Ch\u00ednh x\u00e1c \u0110\u1ed9 \u0111\u1eb7c hi\u1ec7u caoX\u00e9t nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n H\u1ea1n ch\u1ebf nhi\u1ec5m ch\u00e9oLo\u1ea1i b\u1ecf nguy c\u01a1 l\u00e2y nhi\u1ec5m do thao t\u00e1c sau PCR<\/td><td>Chi ph\u00ed \u0111\u1ea7u t\u01b0 thi\u1ebft b\u1ecbY\u00eau c\u1ea7u nh\u00e2n s\u1ef1 c\u00f3 chuy\u00ean m\u00f4n v\u00e0 thao t\u00e1c t\u1ed1t<\/td><\/tr><tr><td>Test Urease<\/td><td>Khi th\u1ef1c hi\u1ec7n n\u1ed9i soi nh\u1eb1m kh\u1ea3o s\u00e1t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng th\u00ec s\u1ebd k\u1ebft h\u1ee3p vi\u1ec7c l\u1ea5y m\u1eabu x\u00e9t nghi\u1ec7m.<\/td><td>K\u1ebft h\u1ee3p quan s\u00e1t t\u00ecnh tr\u1ea1ng d\u1ea1 d\u00e0y- t\u00e1 tr\u1ea1ng.<\/td><td>\u00c2m t\u00ednh gi\u1ea3 sau \u0111i\u1ec1u tr\u1ecb.<\/td><\/tr><tr><td>Nu\u00f4i c\u1ea5y<\/td><td>Sau khi \u0111i\u1ec1u tr\u1ecb 2 ph\u00e1c \u0111\u1ed3 th\u1ea5t b\u1ea1i, ti\u1ebfn h\u00e0nh nu\u00f4i c\u1ea5y kh\u00e1ng sinh \u0111\u1ed3 \u0111\u1ec3 \u0111\u01b0a ra ph\u00e1c \u0111\u1ed3 \u0111i\u1ec7u tr\u1ecb hi\u1ec7u qu\u1ea3 h\u01a1n.<\/td><td>\u0110\u1ed9 \u0111\u1eb7c hi\u1ec7u r\u1ea5t cao, cho bi\u1ebft m\u1ee9c nh\u1ea1y c\u1ea3m v\u1edbi kh\u00e1ng sinh.Ti\u00eau chu\u1ea9n v\u00e0ng.<\/td><td>M\u1eafc ti\u1ec1n, kh\u00f3 th\u1ef1c hi\u1ec7n, \u0111\u1ed9 nh\u1ea1y th\u1ea5p.C\u00f3 th\u1ec3 nu\u00f4i c\u1ea5y \u1edf r\u1ea5t \u00edt c\u00e1c ph\u00f2ng th\u00ed nghi\u1ec7m l\u00e2m s\u00e0ng.<\/td><\/tr><tr><td>M\u00f4 b\u1ec7nh h\u1ecdc<\/td><td>Khi b\u1ec7nh nh\u00e2n c\u00f3 nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng nh\u01b0 U MALT, U lymphoma.<\/td><td>Theo d\u00f5i \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng d\u1ea1 d\u00e0y- t\u00e1 tr\u1ea1ng.<\/td><td>T\u00ednh ch\u00ednh x\u00e1c gi\u1ea3m khi b\u1ec7nh nh\u00e2n lo\u00e9t d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng ch\u1ea3y m\u00e1u c\u1ea5p t\u00ednh, PPI.Gi\u00e1 th\u00e0nh c\u0169ng nh\u01b0 th\u1eddi gian th\u1ef1c hi\u1ec7n ch\u01b0a ph\u00f9 h\u1ee3p \u0111\u1ec3 s\u1eed d\u1ee5ng cho m\u1ee5c \u0111\u00edch ch\u1ea9n \u0111o\u00e1n b\u1ec7nh t\u1ea1i Vi\u1ec7t Nam.<\/td><\/tr><tr><td>Test nhanh kh\u00e1ng th\u1ec3<\/td><td>Ch\u1ec9 d\u00f9ng \u0111\u1ec3 chu\u1ea9n \u0111o\u00e1n th\u00f4ng qua n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3, kh\u00f4ng d\u00f9ng \u0111\u1ec3 x\u00e1c nh\u1eadn t\u00ecnh tr\u1ea1ng \u0111i\u1ec1u tr\u1ecb di\u1ec7t tr\u1eeb th\u00e0nh c\u00f4ng <em>H.<\/em><em> p<\/em><em>ylori<\/em>. Kh\u00f4ng dung cho ng\u01b0\u1eddi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb <em>H.<\/em><em> <\/em><em>pylori<\/em> tr\u01b0\u1edbc \u0111\u00e2y.<\/td><td>Gi\u00e1 r\u1ebb, l\u1ea5y m\u1eabu thu\u1eadn ti\u1ec7n.<\/td><td>K\u1ebft qu\u1ea3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, b\u1ec7nh nh\u00e2n x\u01a1 gan.C\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c th\u1ea5p h\u01a1n sau khi \u0111i\u1ec1u tr\u1ecb.<\/td><\/tr><tr><td>Test nhanh t\u00ecm kh\u00e1ng nguy\u00ean trong ph\u00e2n<\/td><td>\u0110\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 x\u00e9t nghi\u1ec7m.<\/td><td>Ph\u00f9 h\u1ee3p cho ph\u1ee5 n\u1eef c\u00f3 thai.Ph\u1ea3n \u1ea3nh \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/td><td>B\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i l\u1ea5y m\u1eabu \u0111\u00fang quy tr\u00ecnh v\u00e0 x\u00e9t nghi\u1ec7m t\u1ed1i \u0111a 30 ph\u00fat sau khi l\u1ea5y m\u1eabu.K\u1ebft qu\u1ea3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi vi\u1ec7c s\u1eed d\u1ee5ng Bismuth, PPI, KS.<\/td><\/tr><tr><td>Test h\u01a1i th\u1edf CO<sub>2<\/sub> ph\u00f3ng x\u1ea1<\/td><td>Khi b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb 3 th\u00e1ng.<\/td><td>Ph\u00e1t hi\u1ec7n nhanh vi khu\u1ea9n <em>H. pylori<\/em>Kh\u00f4ng c\u1ea7n d\u00f9ng k\u1ef9 thu\u1eadt n\u1ed9i soi, \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u caoD\u1ec5 ki\u1ec3m tra sau khi \u0111i\u1ec1u tr\u1ecb<\/td><td>\u00c2m t\u00ednh gi\u1ea3 n\u1ebfu b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng sinh, bismuth, PPI, &#8230;Kh\u00f4ng \u00e1p d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai, kh\u00f3 \u00e1p d\u1ee5ng cho tr\u1ebb em.<\/td><\/tr><\/tbody><\/table><figcaption class=\"wp-element-caption\"><strong>B\u1ea3ng 1:<\/strong> \u01afu v\u00e0 nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m <em>H. pylori<\/em><\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading has-large-font-size\"><strong>4. C\u00e1c c\u00e1ch ph\u00f2ng ng\u1eeba b\u1ec7nh<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u1ec3 ph\u00f2ng ng\u1eeba nhi\u1ec5m khu\u1ea9n <em>H. pylori<\/em> g\u00e2y vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y c\u1ea7n ch\u00fa \u00fd th\u1ef1c hi\u1ec7n nghi\u00eam t\u00fac nh\u1eefng h\u01b0\u1edbng d\u1eabn sau:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>H\u1ea1n ch\u1ebf d\u00f9ng chung d\u1ee5ng c\u1ee5 \u0103n u\u1ed1ng trong gia \u0111\u00ecnh nh\u01b0 chung b\u00e1t n\u01b0\u1edbc ch\u1ea5m, h\u1ea1n ch\u1ebf g\u1eafp th\u1ee9c \u0103n cho nhau.<\/li>\n\n\n\n<li>L\u01b0u \u00fd khi \u0103n u\u1ed1ng t\u1ea1i c\u00e1c h\u00e0ng qu\u00e1n ven \u0111\u01b0\u1eddng v\u00ec th\u1ee9c \u0103n v\u00e0 d\u1ee5ng c\u1ee5 \u0103n u\u1ed1ng c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec7 sinh.<\/li>\n\n\n\n<li>N\u00ean di\u1ec7t tr\u1eeb ru\u1ed3i, mu\u1ed7i, gi\u00e1n, chu\u1ed9t; gi\u1eef g\u00ecn v\u1ec7 sinh ch\u00e9n \u0111\u0169a s\u1ea1ch s\u1ebd, ng\u00e2m c\u00e1c d\u1ee5ng c\u1ee5 \u0103n u\u1ed1ng trong gia \u0111\u00ecnh trong n\u01b0\u1edbc s\u00f4i.<\/li>\n\n\n\n<li>\u0110\u1ed1i v\u1edbi tr\u1ebb em, h\u1ea1n ch\u1ebf h\u00f4n, m\u1edbm \u0111\u1ed3 \u0103n cho tr\u1ebb.<\/li>\n\n\n\n<li>C\u00e1c v\u1eadt nu\u00f4i nh\u01b0 ch\u00f3, m\u00e8o c\u0169ng l\u00e0 ngu\u1ed3n l\u00e2y nhi\u1ec5m vi khu\u1ea9n <em>H<\/em><em>.<\/em><em> <\/em><em>p<\/em><em>ylori<\/em><em> <\/em>c\u1ea7n v\u1ec7 sinh s\u1ea1ch s\u1ebd cho th\u00fa c\u01b0ng.<\/li>\n\n\n\n<li>H\u1ea1n ch\u1ebf \u0103n \u0111\u1ed3 s\u1ed1ng nh\u01b0 rau s\u1ed1ng, g\u1ecfi hay th\u1ee9c \u0103n l\u00ean men nh\u01b0 m\u1eafm t\u00f4m, m\u1eafm ru\u1ed1c v\u00ec c\u00e1c lo\u1ea1i th\u1ef1c ph\u1ea9m n\u00e0y th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c v\u1ec7 sinh s\u1ea1ch s\u1ebd, d\u1ec5 g\u00e2y c\u00e1c b\u1ec7nh \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, trong \u0111\u00f3 c\u00f3 nhi\u1ec5m khu\u1ea9n <em>H. pylori<\/em>.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-large-font-size wp-block-paragraph\"><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[1]PARSONNET, Julie. Clinician-discoverers\u2014Marshall, Warren, and H. pylori.&nbsp;<em>New England Journal of Medicine<\/em>, 2005, 353.23: 2421-2423.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[2] S\u0102S\u0102RAN, Maria Oana; MELI\u021a, Lorena Elena; DOBRU, Ecaterina Daniela. MicroRNA modulation of host immune response and inflammation triggered by Helicobacter pylori.&nbsp;<em>International Journal of Molecular Sciences<\/em>, 2021, 22.3: 1406.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[3] Alaboudy A., Elbahrawy A., Matsumoto S., Yoshizawa A. (2011), &#8220;Conventional narrow-band imaging has good correlation with histopathological severity of Helicobacter pylori gastritis&#8221;, Dig Dis Sci, 56, pp.1127-1130<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[4] H\u00d9NG, BSCL\u00c2MV. PH\u01af\u01a0NG PH\u00c1P CH\u1ea8N \u0110O\u00c1N NHI\u1ec4M HELICOBACTER PYLORI.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[5] Hoang trong Thang. (2007). Helicobacter pylori va benh ly lien quan den da day ta trang. TAP CHI KHOA HOC TIEU HOA VIET NAM, II(6), 362 &#8211; 369.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[6] Haggerty T. D., Perry S., Sanchez L., Perez-Perez G., Parsonnet J. (2005), &#8220;Significance of transiently positive enzyme-linked immunosorbent assay results in detection of Helicobacter pylori in stool samples from children&#8221;, J Clin Microbiol 43(5), pp.2220-2223.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[7] HOOI, James KY, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis.&nbsp;<em>Gastroenterology<\/em>, 2017, 153.2: 420-429.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[8] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Schabereiter-Gurtner%20C%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Claudia Schabereiter-Gurtner<\/a>,1&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Hirschl%20AM%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Alexander M. Hirschl<\/a>,1&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Dragosics%20B%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Brigitte Dragosics<\/a>,2&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Hufnagl%20P%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Peter Hufnagl<\/a>,3&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Puz%20S%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Sonja Puz<\/a>,1<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Kov%C3%A1ch%20Z%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Zsuzsanna Kov\u00e1ch<\/a>,1&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Rotter%20M%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Manfred Rotter<\/a>,1&nbsp;and&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Makristathis%20A%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Athanasios Makristathis<\/a>1,* (2004), \u201cNovel Real-Time PCR Assay for Detection of&nbsp;Helicobacter pylori&nbsp;Infection and Simultaneous Clarithromycin Susceptibility Testing of Stool and Biopsy Specimens\u201d <a href=\"https:\/\/doi.org\/10.1128%2FJCM.42.10.4512-4518.2004\" target=\"_blank\" rel=\"noreferrer noopener\">10.1128\/JCM.42.10.4512-4518.2004<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">[9] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Saez%20J%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Jes\u00fas Saez<\/a>,a&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Belda%20S%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Sof\u00eda Belda<\/a>,b&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Santib%C3%A1%C3%B1ez%20M%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Miguel Santib\u00e1\u00f1ez<\/a>,c&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Rodr%C3%ADguez%20JC%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Juan Carlos Rodr\u00edguez<\/a>, b&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Sola-Vera%20J%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Javier Sola-Vera<\/a>,a&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Galiana%20A%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Antonio Galiana<\/a>,b<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Ruiz-Garc%C3%ADa%20M%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Montserrat Ruiz-Garc\u00eda<\/a>,b&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Brotons%20A%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Alicia Brotons<\/a>,a&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=L%C3%B3pez-Girona%20E%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Elena L\u00f3pez-Girona<\/a>,b&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Girona%20E%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Eva Girona<\/a>,a&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Sillero%20C%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Carlos Sillero<\/a>,a&nbsp;and&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?term=Royo%20G%5BAuthor%5D\" target=\"_blank\" rel=\"noopener\">Gloria Royo<\/a>b,d (2012), \u201cReal-Time PCR for Diagnosing&nbsp;Helicobacter pylori&nbsp;Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods\u201d <a href=\"https:\/\/doi.org\/10.1128%2FJCM.01205-12\" target=\"_blank\" rel=\"noreferrer noopener\">10.1128\/JCM.01205-12<\/a><\/p>","protected":false},"excerpt":{"rendered":"<p>Hi\u1ec7n nay, r\u1ea5t nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng \u0111\u1ec3 x\u00e9t nghi\u1ec7m Helicobacter Pylori . D\u1ef1a v\u00e0o nguy\u00ean l\u00ed x\u00e9t nghi\u1ec7m, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c chia th\u00e0nh hai d\u1ea1ng ch\u00ednh v\u1edbi m\u1ee5c \u0111\u00edch v\u00e0 ch\u1ec9 \u0111\u1ecbnh kh\u00e1c nhau: X\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n v\u00e0 x\u00e9t nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n.\u00a0B\u00e0i vi\u1ebft n\u00e0y s\u1ebd cung c\u1ea5p ki\u1ebfn th\u1ee9c t\u1ed5ng quan v\u1ec1 H. Pylori v\u00e0 c\u00e1c ki\u1ebfn th\u1ee9c quan tr\u1ecdng tr\u01b0\u1edbc khi l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m ph\u00f9 h\u1ee3p. <\/p>","protected":false},"author":1,"featured_media":7713,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","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":"set","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":"Hi\u1ec7n nay, r\u1ea5t nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng \u0111\u1ec3 x\u00e9t nghi\u1ec7m Helicobacter Pylori . D\u1ef1a v\u00e0o nguy\u00ean l\u00ed x\u00e9t nghi\u1ec7m, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c chia th\u00e0nh hai d\u1ea1ng ch\u00ednh v\u1edbi m\u1ee5c \u0111\u00edch v\u00e0 ch\u1ec9 \u0111\u1ecbnh kh\u00e1c nhau: X\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n v\u00e0 x\u00e9t nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n.\u00a0B\u00e0i vi\u1ebft n\u00e0y s\u1ebd cung c\u1ea5p ki\u1ebfn th\u1ee9c&hellip;","_links":{"self":[{"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts\/7709","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=7709"}],"version-history":[{"count":11,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts\/7709\/revisions"}],"predecessor-version":[{"id":9804,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/posts\/7709\/revisions\/9804"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/media\/7713"}],"wp:attachment":[{"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/media?parent=7709"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/categories?post=7709"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/abtvn.com\/en\/wp-json\/wp\/v2\/tags?post=7709"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}