{"id":2085,"date":"2023-09-02T11:30:00","date_gmt":"2023-09-02T04:30:00","guid":{"rendered":"https:\/\/khoatritruong.com\/?p=2085"},"modified":"2024-07-23T22:07:43","modified_gmt":"2024-07-23T15:07:43","slug":"tu-hai-trinh-cua-columbus-den-khoi-nguon-viem-khop-dang-thap","status":"publish","type":"post","link":"https:\/\/khoatritruong.com\/index.php\/2023\/09\/02\/tu-hai-trinh-cua-columbus-den-khoi-nguon-viem-khop-dang-thap\/","title":{"rendered":"3 Gi\u1ea3 thuy\u1ebft Kh\u1edfi ngu\u1ed3n c\u1ee7a Vi\u00eam Kh\u1edbp D\u1ea1ng Th\u1ea5p"},"content":{"rendered":"<span class=\"rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">\u23f3Th\u1eddi gian \u0111\u1ecdc: <\/span> <span class=\"rt-time\">7<\/span> <span class=\"rt-label rt-postfix\">ph\u00fat<\/span><\/span><style>\/*! elementor - v3.15.0 - 20-08-2023 *\/<br \/>\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style>\n<h2>Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p l\u00e0 g\u00ec?<\/h2>\n<p>Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p (VKDT, ti\u1ebfng Anh: <em>rheumatoid arthritis<\/em>) l\u00e0 b\u1ec7nh t\u1ef1 mi\u1ec5n h\u1ec7 th\u1ed1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t bi\u1ec3u hi\u1ec7n vi\u00eam nhi\u1ec1u kh\u1edbp \u0111\u1ed1i x\u1ee9ng, th\u01b0\u1eddng \u1edf c\u00e1c kh\u1edbp nh\u1ecf b\u00e0n tay, v\u00e0 c\u00f3 th\u1ec3 g\u00e2y c\u01a1 quan kh\u00e1c ngo\u00e0i kh\u1edbp. <em>\u201cD\u1ea1ng th\u1ea5p\u201d (rheumatoid)<\/em> ngh\u0129a l\u00e0 gi\u1ed1ng s\u1ed1t th\u1ea5p kh\u1edbp, trong \u0111\u00f3 <em>\u201cth\u1ea5p\u201d<\/em> ngh\u0129a l\u00e0 \u0111au nh\u1ee9c, s\u01b0ng kh\u1edbp.<\/p>\n<p>Y h\u1ecdc hi\u1ec7n \u0111\u1ea1i \u0111\u00e3 ti\u1ebfn b\u1ed9 r\u1ea5t xa trong gi\u1ea3m tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111i\u1ec1u tr\u1ecb VKDT. Nh\u01b0ng ngu\u1ed3n g\u1ed1c c\u1ee7a b\u1ec7nh v\u1eabn c\u00f2n nhi\u1ec1u \u1ea9n khu\u1ea5t v\u00e0 c\u00f3 th\u1ec3 li\u00ean quan y\u1ebfu t\u1ed1 di truy\u1ec1n, m\u00f4i tr\u01b0\u1eddng v\u00e0 y\u1ebfu t\u1ed1 ng\u1eabu nhi\u00ean kh\u00e1c. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd t\u00ecm hi\u1ec3u ba manh m\u1ed1i v\u1ec1 <i>Kh\u1edfi ngu\u1ed3n c\u1ee7a VKDT<\/i>.<\/p>\n<h2>Gi\u1ea3 thuy\u1ebft Ngu\u1ed3n g\u1ed1c C\u1ed5 \u0111\u1ea1i<\/h2>\n<p>Ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean \u0111\u1ec1 c\u1eadp VKDT trong y v\u0103n hi\u1ec7n \u0111\u1ea1i l\u00e0 Augustin Jacob Landr\u00e9-Beauvais v\u00e0o n\u0103m 1800. Khi l\u00e0m vi\u1ec7c t\u1ea1i nh\u00e0 th\u01b0\u01a1ng Saltp\u00eatri\u00e8re, \u00f4ng \u0111i\u1ec1u tr\u1ecb nhi\u1ec1u ng\u01b0\u1eddi b\u1ec7nh b\u1ecb \u0111au kh\u1edbp n\u1eb7ng m\u00e0 kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c b\u1eb1ng nh\u1eefng b\u1ec7nh \u0111\u00e3 bi\u1ebft l\u00fac \u0111\u00f3 (nh\u01b0 tho\u00e1i h\u00f3a kh\u1edbp, s\u1ed1t th\u1ea5p kh\u1edbp). \u00d4ng m\u00f4 t\u1ea3 b\u1ec7nh l\u00fd n\u00e0y kh\u00f4ng gi\u1ed1ng v\u1edbi g\u00fat; b\u1ec7nh \u1ea3nh h\u01b0\u1edfng ng\u01b0\u1eddi ngh\u00e8o v\u00e0 suy nh\u01b0\u1ee3c h\u01a1n l\u00e0 ng\u01b0\u1eddi gi\u00e0u v\u00e0 kh\u1ecfe m\u1ea1nh, n\u1eef nhi\u1ec1u h\u01a1n nam, \u0111au nhi\u1ec1u kh\u1edbp h\u01a1n l\u00e0 m\u1ed9t kh\u1edbp trong c\u01a1n \u0111\u1ea7u, \u0111au kh\u00f4ng n\u1eb7ng nh\u01b0 g\u00fat nh\u01b0ng k\u00e9o d\u00e0i h\u01a1n. \u00d4ng \u0111\u1eb7t gi\u1ea3 thuy\u1ebft \u0111\u00e2y l\u00e0 m\u1ed9t b\u1ec7nh ch\u01b0a \u0111\u01b0\u1ee3c nh\u1eadn bi\u1ebft v\u00e0 \u0111\u1eb7t t\u00ean l\u00e0 <em>Goutte Asth\u00e9nique Primitive (G\u00fat suy nh\u01b0\u1ee3c nguy\u00ean ph\u00e1t)<\/em>.<\/p>\n<p>H\u01a1n n\u1eeda th\u1ebf k\u1ec9 sau (1859), Alfred Garrod \u0111\u00e3 ph\u00e1t hi\u1ec7n t\u0103ng acid uric m\u00e1u trong g\u00fat m\u00e0 kh\u00f4ng ghi nh\u1eadn trong b\u1ec7nh vi\u00eam kh\u1edbp kh\u00e1c, c\u0169ng nh\u01b0 ph\u00e2n lo\u1ea1i VKDT l\u00e0 m\u1ed9t b\u1ec7nh ri\u00eang bi\u1ec7t (g\u1ecdi l\u00e0\u00a0<em>G\u00fat th\u1ea5p kh\u1edbp [Rheumatic Gout]<\/em>).<\/p>\n<p>Archibald Garrod\u2014con trai th\u1ee9 t\u01b0 c\u1ee7a Alfred Garrod\u2014n\u0103m 1890 m\u1ed9t l\u1ea7n n\u1eefa \u0111\u1ec1 c\u1eadp \u0111\u1ebfn VKDT. D\u1ef1a tr\u00ean ph\u00e1t hi\u1ec7n kh\u1ea3o c\u1ed5 b\u1ec7nh h\u1ecdc cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng g\u1ee3i \u00fd VKDT t\u1ea1i Pompeii, Ai C\u1eadp, B\u1eafc \u00c2u, \u00f4ng cho r\u1eb1ng VKDT kh\u00f4ng ph\u1ea3i m\u1edbi xu\u1ea5t\u00a0 m\u00e0 \u0111\u00e3 hi\u1ec7n di\u1ec7n t\u1eeb th\u1eddi t\u1ed5 ti\u00ean ch\u00fang ta. Lu\u1eadn thuy\u1ebft c\u1ee7a Archibald Garrod l\u00e0 c\u01a1 s\u1edf \u1ee7ng h\u1ed9\u00a0<em>Ngu\u1ed3n g\u1ed1c C\u1ed5 \u0111\u1ea1i<\/em>\u00a0c\u1ee7a VKDT.<\/p>\n<p>Tuy nhi\u00ean, c\u00e1c t\u00e1c gi\u1ea3 n\u00e0y \u0111\u1ec1 c\u1eadp ngu\u1ed3n g\u1ed1c c\u00f3 th\u1ec3 t\u00ecm th\u1ea5y tr\u00ean y v\u0103n \u1ea2-r\u1eadp, Hebrew hay Trung Qu\u1ed1c. Truy t\u00ecm l\u1ea1i y v\u0103n c\u1ed5 c\u1ee7a Trung Qu\u1ed1c, m\u00ecnh ngh\u0129 quy\u1ec3n\u00a0<i>Ho\u00e0ng \u0110\u1ebf n\u1ed9i kinh t\u1ed1 v\u1ea5n <\/i>h\u01a1n 5000 n\u0103m tr\u01b0\u1edbc \u0111\u01b0\u1ee3c xem l\u00e0 t\u00e0i li\u1ec7u x\u01b0a nh\u1ea5t v\u1ec1 y h\u1ecdc. \u1ede \u0111\u00e2y m\u00ecnh tham kh\u1ea3o b\u1ea3n d\u1ecbch c\u1ee7a Nguy\u1ec5n T\u1eed Si\u00eau (2009), s\u00e1ch c\u00f3 \u0111\u1ec1 c\u1eadp <i>Ch\u1ee9ng T\u00fd<\/i> c\u00f3 bi\u1ec3u hi\u1ec7n g\u1ea7n gi\u1ed1ng v\u1edbi vi\u00eam kh\u1edbp. Tuy nhi\u00ean, m\u00f4 t\u1ea3 n\u00e0y kh\u00e1 m\u01a1 h\u1ed3, kh\u00f3 x\u00e1c \u0111\u1ecbnh l\u00e0 VKDT c\u0169ng nh\u01b0 kh\u00f4ng th\u1ec3 ph\u00e2n bi\u1ec7t nguy\u00ean nh\u00e2n \u0111au kh\u1edbp kh\u00e1c. \u0110\u00e2y l\u00e0 v\u1ea5n \u0111\u1ec1 nhi\u1ec1u t\u01b0 li\u1ec7u c\u1ed5 \u0111\u1ea1i \u0111\u1ec1u g\u1eb7p ph\u1ea3i khi t\u00ecm hi\u1ec3u l\u1ecbch s\u1eed c\u1ee7a VKDT.<\/p>\n<h2>Gi\u1ea3 thuy\u1ebft Ngu\u1ed3n g\u1ed1c G\u1ea7n \u0111\u00e2y<\/h2>\n<p>V\u00e0o th\u1ebf k\u1ef7 XX, Charles Short \u0111\u00e3 th\u00e1ch th\u1ee9c gi\u1ea3 thuy\u1ebft <em>Ngu\u1ed3n g\u1ed1c C\u1ed5 \u0111\u1ea1i<\/em> khi \u0111\u00e0o b\u1edbi l\u1ea1i b\u1eb1ng ch\u1ee9ng kh\u1ea3o c\u1ed5 c\u1ee7a Archibald Garrod. Short t\u00ecm l\u1ea1i c\u00e1c b\u00e1o c\u00e1o kh\u1ea3o c\u1ed5 \u0111\u01b0\u1ee3c Archibald Garrod tr\u00edch d\u1eabn v\u00e0 nh\u1eadn ra c\u00e1c h\u00e0i c\u1ed1t \u0111\u00f3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u1edbi vi\u00eam kh\u1edbp c\u1ed9t s\u1ed1ng (bi\u1ec3u hi\u1ec7n th\u1ec3 tr\u1ee5c k\u00e8m th\u1ec3 ngo\u1ea1i bi\u00ean), tho\u00e1i h\u00f3a kh\u1edbp v\u00e0 g\u00fat m\u00e0 kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng x\u00e1c \u0111\u1ecbnh ch\u1eafc ch\u1eafn VKDT.<\/p>\n<p>Short c\u0169ng tra l\u1ee5c c\u00e1c v\u0103n b\u1ea3n c\u1ee7a Hippocrates, Aretaeus (b\u00e1c s\u0129 th\u1eddi Hy L\u1ea1p C\u1ed5 \u0111\u1ea1i), Scribonius (b\u00e1c s\u0129 c\u1ee7a ho\u00e0ng \u0111\u1ebf Caesar), Soranus (b\u00e1c s\u0129 th\u1eddi Byzantine) c\u00f3 m\u00f4 t\u1ea3 tri\u1ec7u ch\u1ee9ng gi\u1ed1ng v\u1edbi VKDT. C\u00e1c chuy\u00ean gia kh\u00e1c \u1ee7ng h\u1ed9 \u0111\u00e2y l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ee7a VKDT trong th\u1eddi k\u00ec c\u1ed5 \u0111\u1ea1i nh\u01b0ng Short cho r\u1eb1ng nh\u1eefng m\u00f4 t\u1ea3 n\u00e0y qu\u00e1 m\u01a1 h\u1ed3\u2014\u0111\u00f4i khi nh\u1ea7m l\u1eabn v\u1edbi g\u00fat\u2014kh\u00f4ng \u0111\u1ea1t \u0111\u1ee7 ti\u00eau chu\u1ea9n khoa h\u1ecdc v\u1eefng ch\u1eafc \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh VKDT.<\/p>\n<p>V\u00ec lu\u1eadn \u0111i\u1ec3m c\u1ee7a Archibald Garrod kh\u00f4ng thuy\u1ebft ph\u1ee5c n\u00ean Short gi\u1ea3 thuy\u1ebft VKDT c\u00f3 ngu\u1ed3n g\u1ed1c hi\u1ec7n \u0111\u1ea1i v\u00e0 c\u00f4ng tr\u00ecnh n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn nh\u1ea5t cho gi\u1ea3 thuy\u1ebft\u00a0<em>Ngu\u1ed3n g\u1ed1c G\u1ea7n \u0111\u00e2y<\/em>. Con \u0111\u01b0\u1eddng t\u00ecm manh m\u1ed1i t\u1eeb y v\u0103n c\u1ed5 \u0111\u1ea1i c\u00f3 v\u1ebb \u0111\u00e3 \u0111i v\u00e0o ng\u00f5 c\u1ee5t v\u00e0 khi \u0111\u00f3, ng\u01b0\u1eddi ta s\u1ebd t\u00ecm t\u1edbi nh\u1eefng b\u1eb1ng ch\u1ee9ng l\u1ecbch s\u1eed kh\u00e1c nh\u01b0 t\u00e1c ph\u1ea9m ngh\u1ec7 thu\u1eadt.<\/p>\n<h2>Cu\u1ed9c t\u00ecm ki\u1ebfm tr\u00ean t\u00e1c ph\u1ea9m ngh\u1ec7 thu\u1eadt<\/h2>\n<p>Tranh v\u1ebd c\u00f3 th\u1ec3 l\u00e0 ngu\u1ed3n t\u01b0 li\u1ec7u gi\u00fap ph\u00e1t hi\u1ec7n VKDT tr\u01b0\u1edbc th\u1eddi \u0111i\u1ec3m b\u00e1o c\u00e1o Beauvais. V\u00ed d\u1ee5, b\u1ee9c\u00a0<a style=\"background-color: #f8f5f4;\" href=\"https:\/\/www.museodelprado.es\/en\/the-collection\/art-work\/the-three-graces\/145eadd9-0b54-4b2d-affe-09af370b6932\"><em>The Three Graces\u00a0<\/em>(1638) c\u1ee7a Peter Paul Rubens<\/a> (<a href=\"https:\/\/www.museodelprado.es\/en\/the-collection\/art-work\/the-three-graces\/145eadd9-0b54-4b2d-affe-09af370b6932\" target=\"_blank\" rel=\"noopener\"><u>xem tranh t\u1ea1i \u0111\u00e2y<\/u><\/a>) l\u00e0 m\u1ed9t trong nh\u1eefng t\u00e1c ph\u1ea9m n\u1ed5i ti\u1ebfng nh\u1ea5t v\u1ec1 b\u1eb1ng ch\u1ee9ng VKDT hi\u1ec7n di\u1ec7n tr\u01b0\u1edbc th\u1eddi lu\u1eadn v\u0103n c\u1ee7a Beauvais (b\u00e0n tay ph\u1ea3i c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef ngo\u00e0i c\u00f9ng b\u00ean tr\u00e1i, b\u1ea1n c\u00f3 th\u1ec3 so s\u00e1nh v\u1edbi h\u00ecnh b\u00ean d\u01b0\u1edbi).<\/p>\n<p>L\u1ecbch s\u1eed c\u1ee7a ho\u1ea1 s\u0129 Rubens cho th\u1ea5y \u00f4ng th\u01b0\u1eddng g\u1eafn li\u1ec1n v\u1edbi hi\u1ec7n th\u1ef1c v\u00e0 v\u1ebd l\u1ea1i ng\u01b0\u1eddi m\u1eabu theo c\u00e1ch hi\u1ec7n th\u1ef1c. V\u00ec v\u1eady, nhi\u1ec1u ng\u01b0\u1eddi xem r\u1eb1ng \u0111\u00e2y l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ee7a VKDT trong h\u1ed9i h\u1ecda, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 tr\u01b0\u1eddng h\u1ee3p b\u1ee9c tranh tr\u00ean tr\u1ea7n nh\u00e0 nguy\u1ec7n Sistina (Vatican) c\u1ee7a Michelangelo minh ch\u1ee9ng cho b\u01b0\u1edbu c\u1ed5.<\/p>\n<style>\/*! elementor - v3.15.0 - 20-08-2023 *\/<br \/>\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"940\" height=\"659\" src=\"http:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/The-Three-Graces-in-RA-e1693069441465.png\" alt=\"The Three Graces&#039;s Hand and rheumatoid arthritis&#039;s deformity\" loading=\"lazy\" \/><\/p>\n<p>Tuy nhi\u00ean, k\u1ebft lu\u1eadn t\u1eeb tranh v\u1ebd ph\u1ea3i th\u1eadt c\u1ea9n tr\u1ecdng v\u00ec t\u00e1c ph\u1ea9m ngh\u1ec7 thu\u1eadt kh\u00f4ng ph\u1ea3i l\u00e0 b\u1eb1ng ch\u1ee9ng khoa h\u1ecdc. H\u00ecnh v\u1ebd c\u1ee7a h\u1ecda s\u0129 ph\u1ea3n \u00e1nh phong c\u00e1ch ngh\u1ec7 thu\u1eadt c\u00e1 nh\u00e2n v\u00e0 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m th\u1ef1c th\u1ec3 trong tranh \u0111\u01a1n thu\u1ea7n l\u00e0 quy \u01b0\u1edbc ngh\u1ec7 thu\u1eadt m\u00e0 kh\u00f4ng c\u00f3 gi\u00e1 tr\u1ecb y h\u1ecdc. Ngo\u00e0i ra, nh\u1eefng mi\u00eau t\u1ea3 trong tranh c\u00f3 th\u1ec3 do b\u1ec7nh th\u1ea5p kh\u1edbp kh\u00e1c nh\u01b0 s\u1ed1t th\u1ea5p kh\u1edbp, g\u00fat. V\u00e0 m\u1ed9t l\u1ea7n n\u1eefa, ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh VKDT t\u1eeb tranh v\u1ebd \u0111i v\u00e0o ng\u00f5 c\u1ee5t.<\/p>\n<h2>B\u1eb1ng ch\u1ee9ng kh\u1ea3o c\u1ed5 h\u1ecdc<\/h2>\n<p>Nh\u00e0 khoa h\u1ecdc ngh\u0129 r\u1eb1ng b\u1ec7nh x\u01b0\u01a1ng v\u00e0 kh\u1edbp (bao g\u1ed3m VKDT) th\u01b0\u1eddng d\u1ec5 nghi\u00ean c\u1ee9u tr\u00ean m\u1eabu h\u00e0i c\u1ed1t v\u00ec kh\u00f4ng c\u00f3 m\u00f4 m\u1ec1m v\u00e0 c\u00f3 th\u1ec3 kh\u1ea3o s\u00e1t b\u1eb1ng X quang. Tuy nhi\u00ean, Charles Short ghi nh\u1eadn nh\u1eefng b\u00e1o c\u00e1o kh\u1ea3o c\u1ed5 tr\u01b0\u1edbc \u0111\u00e2y d\u00f9 c\u00f3 t\u1ed5n th\u01b0\u01a1ng kh\u1edbp ngo\u1ea1i bi\u00ean, nh\u01b0ng th\u1ef1c ch\u1ea5t n\u1eb1m trong b\u1ec7nh c\u1ea3nh vi\u00eam kh\u1edbp ngo\u1ea1i bi\u00ean c\u1ee7a vi\u00eam kh\u1edbp c\u1ed9t s\u1ed1ng. \u00d4ng gi\u1ea3 \u0111\u1ecbnh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp (<em>thu\u1eadt ng\u1eef c\u0169<\/em>) c\u00f3 th\u1ec3 \u0111\u00e3 ti\u1ebfn h\u00f3a t\u1eeb th\u1eddi k\u00ec c\u1ed5 \u0111\u1ea1i \u0111\u1ec3 tr\u1edf th\u00e0nh VKDT \u1edf th\u1eddi k\u1ef3 hi\u1ec7n \u0111\u1ea1i. Nh\u01b0ng nghi\u00ean c\u1ee9u di truy\u1ec1n nh\u1eefng n\u0103m 1970 \u0111\u00e3 b\u00e1c b\u1ecf \u0111i\u1ec1u n\u00e0y.<\/p>\n<p style=\"font-size: 20px; font-style: normal; font-weight: 400;\">Th\u1eadt ra, nh\u1eefng d\u1ea5u hi\u1ec7u \u0111\u01b0\u1ee3c cho r\u1eb1ng do VKDT g\u00e2y ra c\u00f3 th\u1ec3 do b\u00e0o m\u00f2n x\u01b0\u01a1ng sau khi ch\u1ebft. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n VKDT tr\u00ean m\u1eabu x\u01b0\u01a1ng c\u0169ng c\u00f3 c\u00e1c ti\u00eau ch\u00ed do nhi\u1ec1u b\u1ec7nh g\u00e2y n\u00ean nh\u01b0 nang d\u01b0\u1edbi s\u1ee5n, d\u00ednh kh\u1edbp, gai x\u01b0\u01a1ng. M\u1ed9t v\u1ea5n \u0111\u1ec1 c\u1ee7a kh\u00e1m nghi\u1ec7m h\u00e0i c\u1ed1t t\u01b0\u01a1ng t\u1ef1 nh\u01b0 t\u00e1c ph\u1ea9m ngh\u1ec7 thu\u1eadt l\u00e0 kh\u00f3 ph\u00e2n bi\u1ec7t VKDT v\u1edbi c\u00e1c b\u1ec7nh l\u00fd h\u1ee7y kh\u1edbp kh\u00e1c.<\/p>\n<p>Ti\u1ebfn b\u1ed9 m\u1edbi trong m\u1ea3ng nh\u00e2n ch\u1ee7ng h\u1ecdc y khoa sau n\u00e0y \u0111\u00e3 s\u1eed d\u1ee5ng k\u0129 thu\u1eadt x\u00e1c \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng tr\u00ean m\u1eabu h\u00e0i c\u1ed1t c\u00f3 th\u1ec3 g\u1ee3i \u00fd VKDT. Tuy nhi\u00ean, k\u1ebft qu\u1ea3 c\u00e1c nghi\u00ean c\u1ee9u n\u00e0y cho th\u1ea5y b\u1eb1ng ch\u1ee9ng t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng tr\u00ean h\u00e0i c\u1ed1t t\u1ea1i ch\u00e2u M\u1ef9, \u0111\u01b0a \u0111\u1ebfn gi\u1ea3 thuy\u1ebft kh\u00e1c c\u1ee7a VKDT\u2014<em>Ngu\u1ed3n g\u1ed1c Th\u1ebf gi\u1edbi M\u1edbi (ch\u00e2u M\u1ef9) sang Th\u1ebf gi\u1edbi C\u0169 (ch\u00e2u \u00c2u-\u00c1-Phi)<\/em>.<\/p>\n<h2>T\u1eeb H\u1ea3i tr\u00ecnh c\u1ee7a Columbus \u0111\u1ebfn S\u1ef1 xu\u1ea5t hi\u1ec7n VKDT<\/h2>\n<p>Nh\u1eefng nghi\u00ean c\u1ee9u hi\u1ec7n \u0111\u1ea1i tr\u00ean c\u01a1 s\u1edf ph\u00e2n t\u1eed cho th\u1ea5y m\u1ed1i li\u00ean quan gi\u1eefa VKDT v\u1edbi m\u1ed9t nh\u00f3m ph\u1ee9c h\u1ee3p kh\u00e1ng nguy\u00ean h\u00f2a h\u1ee3p m\u00f4 (MHC\u2014major histocompatibility complex\u2014nh\u00f3m II) m\u00e3 h\u00f3a tr\u00ean allele HLA-DR4. Nh\u01b0ng kh\u00f4ng ph\u1ea3i ai mang gen n\u00e0y c\u0169ng b\u1ecb b\u1ec7nh.<\/p>\n<p>T\u00e1c nh\u00e2n vi khu\u1ea9n nh\u01b0 vi khu\u1ea9n, virus (retrovirus, parvovirus B19, rubella, EBV\u2026) c\u00f3 th\u1ec3 \u0111\u00f3ng vai tr\u00f2 nh\u01b0 y\u1ebfu t\u1ed1 k\u00edch ho\u1ea1t g\u00e2y VKDT. Ngo\u00e0i ra, h\u00fat thu\u1ed1c l\u00e1 c\u0169ng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 k\u00edch ho\u1ea1t kh\u00e1c do c\u00f3 th\u1ec3 t\u0103ng t\u1ec9 l\u1ec7 m\u1edbi m\u1eafc VKDT tr\u00ean ng\u01b0\u1eddi c\u00f3 allele HLA nh\u1ea1y c\u1ea3m.\u00a0X\u00e9t v\u1ec1 gi\u1ea3 thuy\u1ebft\u00a0<em style=\"background-color: var(--ast-global-color-4); color: var(--ast-global-color-3); font-size: 1rem;\">Ngu\u1ed3n g\u1ed1c Th\u1ebf gi\u1edbi M\u1edbi sang Th\u1ebf gi\u1edbi C\u0169<\/em>, h\u00fat thu\u1ed1c \u0111\u00e3 xu\u1ea5t hi\u1ec7n t\u1ea1i ch\u00e2u \u00c2u ch\u1ec9 sau khi Columbus ph\u00e1t hi\u1ec7n ra ch\u00e2u M\u1ef9 (t\u1eadp t\u1ee5c h\u00fat thu\u1ed1c l\u00e1 \u0111\u00e3 c\u00f3 t\u1eeb th\u1eddi th\u1ed5 d\u00e2n b\u1ea3n \u0111\u1ecba tr\u01b0\u1edbc \u0111\u00e2y)<\/p>\n<p>Tuy nhi\u00ean, m\u1ed1i li\u00ean quan n\u00e0y kh\u00f4ng ho\u00e0n to\u00e0n ch\u1eafc ch\u1eafn v\u00ec m\u1ed9t ph\u1ea7n ba ng\u01b0\u1eddi VKDT kh\u00f4ng c\u00f3 gen HLA-DR t\u01b0\u01a1ng \u1ee9ng c\u0169ng nh\u01b0 kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 ng\u01b0\u1eddi VKDT \u0111\u1ec1u h\u00fat thu\u1ed1c l\u00e1 (m\u1eb7c d\u00f9 c\u00f3 th\u1ec3 ch\u1ecbu \u1ea3nh h\u01b0\u1edfng t\u1eeb h\u00fat thu\u1ed1c th\u1ee5 \u0111\u1ed9ng ho\u1eb7c \u0111\u1ed9c ch\u1ea5t m\u00f4i tr\u01b0\u1eddng kh\u00e1c).<\/p>\n<p>Nh\u1eefng y\u1ebfu t\u1ed1 tr\u00ean (h\u00fat thu\u1ed1c, nhi\u1ec5m tr\u00f9ng, gen) th\u1ef1c ch\u1ea5t ch\u1ec9 l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1. Entezami v\u00e0 c\u1ed9ng s\u1ef1 cho r\u1eb1ng VKDT c\u00f3 th\u1ec3 \u0111\u00e3 xu\u1ea5t hi\u1ec7n tr\u00ean c\u1ea3\u00a0<em>Th\u1ebf gi\u1edbi M\u1edbi l\u1eabn C\u0169<\/em>\u00a0nh\u01b0ng r\u1ea5t hi\u1ebfm \u1edf\u00a0<em>Th\u1ebf gi\u1edbi C\u0169<\/em>\u00a0v\u00ec kh\u00f4ng c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 m\u00f4i tr\u01b0\u1eddng. Sau khi m\u1edf c\u1eeda giao th\u01b0\u01a1ng v\u1edbi ch\u00e2u M\u1ef9, m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 nguy c\u01a1 (\u0111\u1eb7c bi\u1ec7t thu\u1ed1c l\u00e1, h\u00e0ng h\u00f3a nhi\u1ec5m b\u1ea9n, ng\u01b0\u1eddi di c\u01b0 b\u1ecb nhi\u1ec5m vi khu\u1ea9n, virus li\u00ean quan VKDT) c\u00f3 th\u1ec3 \u0111\u00e3 chuy\u1ec3n d\u1ecbch sang ch\u00e2u \u00c2u-\u00c1-Phi, bi\u1ebfn VKDT th\u00e0nh m\u1ed9t b\u1ec7nh th\u01b0\u1eddng g\u1eb7p h\u01a1n t\u1ea1i\u00a0<em>Th\u1ebf gi\u1edbi C\u0169<\/em>.<\/p>\n<p>VKDT th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n v\u00e0o \u0111\u1ed9 tu\u1ed5i 30-65, trong khi tu\u1ed5i th\u1ecd trung b\u00ecnh v\u00e0o n\u0103m 1800 l\u00e0 d\u01b0\u1edbi 30 (th\u1eddi \u0111i\u1ec3m m\u00f4 t\u1ea3 l\u1ea7n \u0111\u1ea7u VKDT). K\u1ebft h\u1ee3p c\u00e1c b\u1eb1ng ch\u1ee9ng kh\u1ea3o c\u1ed5 b\u1ec7nh h\u1ecdc, VKDT c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n t\u1eeb th\u1eddi c\u1ed5 \u0111\u1ea1i nh\u01b0ng r\u1ea5t hi\u1ebfm. Enzetami v\u00e0 c\u1ed9ng s\u1ef1 ngh\u0129 r\u1eb1ng nh\u1eefng c\u00e1 nh\u00e2n c\u00f3 nguy c\u01a1 b\u1ecb VKDT c\u00f3 l\u1ebd \u0111\u00e3 ch\u1ebft tr\u01b0\u1edbc khi k\u1ecbp ph\u00e1t b\u1ec7nh.<\/p>\n<p style=\"font-size: 20px; font-style: normal; font-weight: 400;\">V\u00ec v\u1eady, gi\u1ea3 thuy\u1ebft hi\u1ec7n t\u1ea1i l\u00e0:<\/p>\n<ul style=\"font-size: 20px; font-style: normal; font-weight: 400;\">\n<li style=\"font-size: 20px;\">VKDT kh\u00f4ng ph\u1ea3i b\u1ec7nh c\u00f3 ngu\u1ed3n g\u1ed1c g\u1ea7n \u0111\u00e2y, c\u00f3 th\u1ec3 \u0111\u00e3 hi\u1ec7n di\u1ec7n t\u1eeb h\u00e0ng ng\u00e0n n\u0103m tr\u01b0\u1edbc v\u00e0 ph\u00e2n b\u1ed1 \u0111\u1ecba l\u00fd khi\u1ebfn n\u00f3 \u00edt g\u1eb7p \u1edf ch\u00e2u \u00c2u.<\/li>\n<li style=\"font-size: 20px;\">VKDT l\u00e0 \u0111\u00e1p \u1ee9ng v\u1edbi k\u00edch th\u00edch m\u00f4i tr\u01b0\u1eddng \u1edf nh\u1eefng c\u00e1 nh\u00e2n nh\u1ea1y c\u1ea3m di truy\u1ec1n. B\u1ea3n ch\u1ea5t v\u00e0 ngu\u1ed3n g\u1ed1c c\u1ee7a y\u1ebfu t\u1ed1 k\u00edch ho\u1ea1t n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5.<\/li>\n<li style=\"font-size: 20px;\">Nh\u1eefng y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng k\u00edch ho\u1ea1t c\u00f3 th\u1ec3 quan tr\u1ecdng trong ph\u00e2n nh\u00f3m b\u1ec7nh VKDT. V\u00ed d\u1ee5, h\u00fat thu\u1ed1c l\u00e1 c\u00f3 th\u1ec3 l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng cho ng\u01b0\u1eddi VKDT c\u00f3 mang gen HLA nh\u1ea1y c\u1ea3m v\u00e0 c\u00f3 t\u1ef1 kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i protein ch\u1ee9a citrulline. V\u00ec v\u1eady, ph\u00e2n t\u00edch l\u1ecbch s\u1eed c\u1ee7a VKDT c\u1ea7n \u0111\u01b0a v\u00e0o kh\u1ea3 n\u0103ng: b\u1ec7nh m\u00e0 hi\u1ec7n t\u1ea1i g\u1ecdi l\u00e0 VKDT c\u00f3 th\u1ec3 th\u1eadt ch\u1ea5t g\u1ed3m nhi\u1ec1u b\u1ec7nh b\u00ean trong.<\/li>\n<\/ul>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ol>\n<li>Entezami P, Fox DA, Clapham PJ, Chung KC. Historical perspective on the etiology of rheumatoid arthritis. Hand Clin. 2011;27(1):1-10. <u><a href=\"https:\/\/doi.org\/10.1016\/j.hcl.2010.09.006\">doi:10.1016\/j.hcl.2010.09.006<\/a><\/u><\/li>\n<li>Short CL. The antiquity of rheumatoid arthritis. Arthritis Rheum. 1974;17(3):193-205. <u><a href=\"https:\/\/doi.org\/10.1002\/art.1780170302\">doi:10.1002\/art.1780170302<\/a><\/u><\/li>\n<li>Tsoucalas G, Sgantzos M. Primary Asthenic Gout by Augustin-Jacob Landre-Beauvais in 1800: Is this the first description of Rheumatoid Arthritis?. Mediterr J Rheumatol. 2017;28(4):223-226. <u><a href=\"https:\/\/doi.org\/10.31138\/mjr.28.4.223\">doi:10.31138\/mjr.28.4.223<\/a><\/u><\/li>\n<li>Bellamy N. Colour Atlas of Clinical Rheumatology. Springer Netherlands; 1985. <u><a href=\"doi:10.1007\/978-94-009-4882-2\">doi:10.1007\/978-94-009-4882-2<\/a><\/u><\/li>\n<li><u><a href=\"https:\/\/www.museodelprado.es\/en\/the-collection\/art-work\/the-three-graces\/145eadd9-0b54-4b2d-affe-09af370b6932\">The Three Graces (1638) by Peter Paul Rubens<\/a><\/u><\/li>\n<li>Nguy\u1ec5n T\u1eed Si\u00eau (bi\u00ean d\u1ecbch). Ho\u00e0ng \u0110\u1ebf n\u1ed9i kinh t\u1ed1 v\u1ea5n. Nh\u00e0 xu\u1ea5t b\u1ea3n Lao \u0111\u1ed9ng; 2009.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p><span class=\"rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">\u23f3Th\u1eddi gian \u0111\u1ecdc: <\/span> <span class=\"rt-time\">7<\/span> <span class=\"rt-label rt-postfix\">ph\u00fat<\/span><\/span> Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p l\u00e0 g\u00ec? Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p (VKDT, ti\u1ebfng Anh: rheumatoid arthritis) l\u00e0 b\u1ec7nh t\u1ef1 mi\u1ec5n h\u1ec7 th\u1ed1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t bi\u1ec3u hi\u1ec7n vi\u00eam nhi\u1ec1u kh\u1edbp \u0111\u1ed1i x\u1ee9ng, th\u01b0\u1eddng \u1edf c\u00e1c kh\u1edbp nh\u1ecf b\u00e0n tay, v\u00e0 c\u00f3 th\u1ec3 g\u00e2y c\u01a1 quan kh\u00e1c ngo\u00e0i kh\u1edbp. \u201cD\u1ea1ng th\u1ea5p\u201d (rheumatoid) ngh\u0129a l\u00e0 gi\u1ed1ng s\u1ed1t th\u1ea5p &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/khoatritruong.com\/index.php\/2023\/09\/02\/tu-hai-trinh-cua-columbus-den-khoi-nguon-viem-khop-dang-thap\/\"> <span class=\"screen-reader-text\">3 Gi\u1ea3 thuy\u1ebft Kh\u1edfi ngu\u1ed3n c\u1ee7a Vi\u00eam Kh\u1edbp D\u1ea1ng Th\u1ea5p<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":2111,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"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":"","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","footnotes":""},"categories":[13],"tags":[26,14,15],"class_list":["post-2085","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lich-su-benh-ly","tag-danh-cho-nhan-vien-y-te","tag-lich-su-benh-ly","tag-viem-khop-dang-thap"],"aioseo_notices":[],"rttpg_featured_image_url":{"full":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases.png",1920,1080,false],"landscape":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases.png",1920,1080,false],"portraits":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases.png",1920,1080,false],"thumbnail":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases-150x150.png",150,150,true],"medium":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases-300x169.png",300,169,true],"large":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases-1024x576.png",1024,576,true],"1536x1536":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases-1536x864.png",1536,864,true],"2048x2048":["https:\/\/khoatritruong.com\/wp-content\/uploads\/2023\/08\/History-of-diseases.png",1920,1080,false]},"rttpg_author":{"display_name":"Tr\u01b0\u01a1ng Tr\u00ed Khoa","author_link":"https:\/\/khoatritruong.com\/index.php\/author\/khoatritruong-com\/"},"rttpg_comment":26,"rttpg_category":"<a href=\"https:\/\/khoatritruong.com\/index.php\/category\/lich-su-benh-ly\/\" rel=\"category tag\">L\u1ecbch s\u1eed b\u1ec7nh l\u00fd<\/a>","rttpg_excerpt":"\u23f3Th\u1eddi gian \u0111\u1ecdc: 7 ph\u00fat Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p l\u00e0 g\u00ec? Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p (VKDT, ti\u1ebfng Anh: rheumatoid arthritis) l\u00e0 b\u1ec7nh t\u1ef1 mi\u1ec5n h\u1ec7 th\u1ed1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t bi\u1ec3u hi\u1ec7n vi\u00eam nhi\u1ec1u kh\u1edbp \u0111\u1ed1i x\u1ee9ng, th\u01b0\u1eddng \u1edf c\u00e1c kh\u1edbp nh\u1ecf b\u00e0n tay, v\u00e0 c\u00f3 th\u1ec3 g\u00e2y c\u01a1 quan kh\u00e1c ngo\u00e0i kh\u1edbp. \u201cD\u1ea1ng th\u1ea5p\u201d (rheumatoid)&hellip;","_links":{"self":[{"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/posts\/2085"}],"collection":[{"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/comments?post=2085"}],"version-history":[{"count":57,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/posts\/2085\/revisions"}],"predecessor-version":[{"id":2271,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/posts\/2085\/revisions\/2271"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/media\/2111"}],"wp:attachment":[{"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/media?parent=2085"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/categories?post=2085"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/khoatritruong.com\/index.php\/wp-json\/wp\/v2\/tags?post=2085"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}