{"id":2245,"date":"2018-11-19T13:40:07","date_gmt":"2018-11-19T13:40:07","guid":{"rendered":"https:\/\/robot.yeupet.vn\/dai-cuong-ve-doc-chat-hoc-thu-y\/"},"modified":"2018-11-19T13:40:07","modified_gmt":"2018-11-19T13:40:07","slug":"dai-cuong-ve-doc-chat-hoc-thu-y","status":"publish","type":"post","link":"https:\/\/robot.yeupet.vn\/index.php\/2018\/11\/19\/dai-cuong-ve-doc-chat-hoc-thu-y\/","title":{"rendered":"\u0110\u1ea1i C\u01b0\u01a1ng V\u1ec1 \u0110\u1ed9c Ch\u1ea5t H\u1ecdc Th\u00fa Y"},"content":{"rendered":"<p><strong>1. Gi\u1edbi thi\u1ec7u \u0110\u1ed9c ch\u1ea5t trong th\u00fa y<\/strong><\/p>\n<p>S\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t \u0111\u1ed9c \u0111\u00e3 t\u1ed3n t\u1ea1i t\u1eeb khi c\u00f3 con ng\u01b0\u1eddi. Trong c\u00e1c cu\u1ed9c \u0111i s\u0103n v\u00e0 tranh gi\u00e0nh gi\u1eefa c\u00e1c b\u1ed9 t\u1ed9c, con ng\u01b0\u1eddi \u0111\u00e3 bi\u1ebft s\u1eed d\u1ee5ng m\u0169i t\u00ean \u0111\u1ed9c \u0111\u1ec3 gi\u00e0nh chi\u1ebfn th\u1eafng v\u00e0 ta c\u00f3 th\u1ec3 cho r\u1eb1ng s\u1eed d\u1ee5ng \u0111\u1ed9c ch\u1ea5t ra \u0111\u1eddi sau khi con ng\u01b0\u1eddi bi\u1ebft s\u1eed d\u1ee5ng m\u0169i t\u00ean. C\u0169ng nh\u01b0 v\u1eady, \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe c\u1ee7a lo\u00e0i ng\u01b0\u1eddi, \u0111\u1ed9c ch\u1ea5t c\u0169ng \u0111\u00e3 nhi\u1ec1u tu\u1ed5i nh\u01b0 vi sinh v\u1eadt g\u00e2y b\u1ec7nh.<\/p>\n<p>Nh\u1eefng lo\u00e0i c\u00e2y c\u00f3 m\u1ea1ch c\u00f3 th\u1ec3 ch\u00faa nhi\u1ec1u lo\u1ea1i ch\u1ea5t \u0111\u1ed9c \u0111\u1ed1i v\u1edbi c\u00f4n tr\u00f9ng v\u00e0 c\u00e1c \u0111\u1ed9ng v\u1eadt kh\u00e1c. C\u00e2y c\u1ed1i c\u0169ng \u0111\u00e3 bi\u1ebft s\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed9c nh\u01b0 m\u1ed9t v\u0169 kh\u00ed t\u1ef1 v\u1ec7! Ng\u00e0y nay h\u00e0ng ch\u1ee5c ngh\u00ecn lo\u1ea1i ch\u1ea5t \u0111\u1ed9c \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi v\u00e0 \u0111\u1ed9ng v\u1eadt trong khi s\u1ed1 l\u01b0\u1ee3ng c\u00e1c ch\u00e1t c\u00f3 th\u1ec3 gi\u1ea3i \u0111\u1ed9c m\u00e0 ch\u00fang ta bi\u1ebft l\u1ea1i ch\u1eb3ng \u0111\u00e1ng l\u00e0 bao. H\u00e3y t\u01b0\u1edfng t\u01b0\u1ee3ng l\u00e0 ta ch\u1ec9 c\u00f3 h\u01a1n 20 lo\u1ea1i kh\u00e1ng sinh \u0111\u1ec3 ch\u1ed1ng l\u1ea1i c\u00e1c b\u1ec7nh truy\u1ec1n nhi\u1ec5m!<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dai-cuong-ve-doc-chat-hoc-thu-y.jpg\" class=\"aligncenter wp-image-7943\" alt=\"dai-cuong-ve-doc-chat-hoc-thu-y\" width=\"402\" height=\"643\">\u0110\u1ed9c ch\u1ea5t trong th\u00fa y<\/p>\n<p>Trong y h\u1ecdc, ch\u1ea9n \u0111o\u00e1n v\u00e0 qu\u1ea3n l\u00fd nhi\u1ec5m \u0111\u1ed9c bao g\u1ed3m nh\u1eefng nguy\u00ean t\u1eafc c\u01a1 b\u1ea3n sau:<\/p>\n<ul>\n<li>Xem x\u00e9t c\u00e1c bi\u1ec3u hi\u1ec7n c\u1ee7a nhi\u1ec5m \u0111\u1ed9c: toxidromes<\/li>\n<li>S\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n: diagnostic tools<\/li>\n<li>\u00cdt t\u1ed1n k\u00e9m: financial restraints<\/li>\n<\/ul>\n<p>Trong th\u00fa y, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 qu\u1ea3n l\u00fd nhi\u1ec5m \u0111\u1ed9c c\u00f3 nh\u1eefng tr\u1edf ng\u1ea1i sau:<\/p>\n<ul>\n<li>\u0110a d\u1ea1ng v\u1ec1 \u0111\u1ed1i t\u01b0\u1ee3ng (nhi\u1ec1u lo\u1ea1i \u0111\u1ed9ng v\u1eadt) v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n kh\u00e1c nhau<\/li>\n<li>C\u00f3 tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ecb nhi\u1ec5m \u0111\u1ed9c do b\u1ecb c\u1ed1 t\u00ecnh g\u00e2y h\u1ea1i (v\u00ed d\u1ee5 do m\u00e2u thu\u1eabn hay hi\u1ec1m th\u00f9 gi\u1eefa c\u00e1c ch\u1ee7 gia s\u00fac). Tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u0169ng g\u1eb7p \u1edf ng\u01b0\u1eddi nh\u01b0ng \u00edt h\u01a1n.<\/li>\n<li>S\u1ed1 l\u01b0\u1ee3ng \u0111\u1ed1i t\u01b0\u1ee3ng ph\u1ea3i ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb cao (nhi\u1ec1u khi c\u1ea3 m\u1ed9t \u0111\u00e0n l\u1edbn, m\u1ed9t trang tr\u1ea1i, m\u1ed9t khu v\u1ef1c\u2026)<\/li>\n<li>Ph\u1ea3i \u0111\u1ea3m b\u1ea3o y\u00eau c\u1ea7u duy tr\u00ec ngu\u1ed3n th\u1ef1c ph\u1ea9m an to\u00e0n \u0111\u1ec3 cung c\u1ea5p cho ng\u01b0\u1eddi.<\/li>\n<li>C\u00e1c kh\u00f3 kh\u0103n tr\u00ean \u0111\u1ed3i h\u1ecfi c\u00e1c b\u00e1c s\u0129 th\u00fa y ph\u1ea3i n\u1eafm v\u1eefng nh\u1eefng ki\u1ebfn th\u1ee9c v\u1ec1 \u0111\u1ed9c ch\u1ea5t h\u1ecdc v\u00e0 c\u00e1c m\u00f4n h\u1ecdc li\u00ean quan v\u00e0 lu\u00f4n lu\u00f4n tu\u00e2n th\u1ee7 nguy\u00ean t\u1eafc: \u0110i\u1ec1u tr\u1ecb con b\u1ec7nh ch\u1ee9 kh\u00f4ng ph\u1ea3i ch\u1ea5t \u0111\u1ed9c (treat the patient, not the poison).<\/li>\n<\/ul>\n<p><strong>2. M\u1ed9t s\u1ed1 kh\u00e1i ni\u1ec7m trong nghi\u00ean c\u1ee9u \u0111\u1ed9c ch\u1ea5t<\/strong><\/p>\n<ul>\n<li>\u0110\u1ed9c ch\u1ea5t h\u1ecdc l\u00e0 khoa h\u1ecdc nghi\u00ean c\u1ee9u v\u1ec1 nh\u1eefng ch\u1ea5t \u0111\u1ed9c v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a ch\u00fang \u0111\u1ebfn c\u00e1c ch\u1ee9c n\u0103ng sinh l\u00fd b\u00ecnh th\u01b0\u1eddng c\u1ee7a c\u01a1 th\u1ec3.C\u00e1c ki\u1ebfn th\u1ee9c li\u00ean quan ch\u1eb7t ch\u1ebd nh\u1ea5t \u0111\u1ebfn \u0111\u1ed9c ch\u1ea5t h\u1ecdc n\u1eb1m trong c\u00e1c l\u0129nh v\u1ef1c nghi\u00ean c\u1ee9u v\u1ec1: d\u01b0\u1ee3c h\u1ecdc, to\u00e1n h\u1ecdc, h\u00f3a h\u1ecdc, sinh th\u00e1i h\u1ecdc, \u0111\u1ed9ng v\u1eadt h\u1ecdc, th\u1ef1c v\u1eadt h\u1ecdc.<\/li>\n<li>LD50 (lethal dose 50): L\u00e0 li\u1ec1u ch\u1ea5t \u0111\u1ed9c g\u00e2y ch\u1ebft m\u1ed9t n\u1eeda s\u1ed1 \u0111\u1ed9ng v\u1eadt quan s\u00e1t v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 c\u00e2n nh\u1eafc v\u1ec1 m\u1ee9c \u0111\u1ed9 g\u00e2y \u0111\u1ed9c t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a m\u1ed9t ch\u1ea5t \u0111\u1ed9c. Nhi\u1ec1u LD50 \u0111\u01b0\u1ee3c ghi nh\u1eadn khi quan s\u00e1t tr\u00ean chu\u1ed9t th\u00ed nghi\u1ec7m.<\/li>\n<li>LC50 (lethal concentration 50): N\u1ed3ng \u0111\u1ed9 c\u1ee7a ch\u1ea5t \u0111\u1ed9c g\u00e2y ch\u1ebft m\u1ed9t n\u1ee9a s\u1ed1 \u0111\u1ed9ng v\u1eadt quan s\u00e1t. LC50 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 \u0111\u1ed9c c\u1ee7a c\u00e1c ch\u1ea5t trong kh\u00f4ng kh\u00ed v\u00e0 n\u01b0\u1edbc.<\/li>\n<li>T\u00ednh \u0111\u1ed9c (toxicity) l\u00e0 kh\u00e1i ni\u1ec7m ph\u1ea3n \u00e1nh \u0111\u1eb7c t\u00ednh g\u00e2y \u0111\u1ed9c. Trong th\u1ef1c t\u1ebf ta th\u01b0\u1eddng d\u00f9ng c\u00e1c \u0111\u01a1n v\u1ecb nh\u01b0 mg\/kg (s\u1ed1 mg ch\u1ea5t \u0111\u1ed9c c\u00f3 th\u1ec3 g\u00e2y tri\u1ec7u ch\u1ee9ng \u0111\u1ed1i v\u1edbi 1kg kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 th\u1ec3). Kh\u00f4ng n\u00ean nh\u1ea7m l\u1eabn gi\u1eefa t\u00ednh g\u00e2y \u0111\u1ed9c v\u1edbi c\u01a1 ch\u1ebf g\u00e2y \u0111\u1ed9c (toxicosis).<\/li>\n<li>C\u01a1 ch\u1ebf g\u00e2y \u0111\u1ed9c hay c\u01a1 ch\u1ebf \u1ea3nh h\u01b0\u1edfng (toxicosis): c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng khi b\u1ecb nhi\u1ec5m \u0111\u1ed9c, c\u00e1c ph\u1ea3n \u1ee9ng sinh l\u00fd c\u1ee7a c\u01a1 th\u1ec3 khi nhi\u1ec5m ch\u1ea5t.<\/li>\n<\/ul>\n<p><strong>3. C\u00e1c lo\u1ea1i ch\u1ea5t \u0111\u1ed9c trong th\u00fa y<\/strong><\/p>\n<p>\u0110\u1ed9c ch\u1ea5t h\u1ecdc th\u00fa y Ch\u1ea5t \u0111\u1ed9c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1edbi v\u00e0 v\u1eadt nu\u00f4i r\u1ea5t phong ph\u00fa v\u1ec1 ch\u1ee7ng lo\u1ea1i nh\u01b0: c\u00e1c kim lo\u1ea1i (\u0111\u1eb7c bi\u1ec7t l\u00e0 kim lo\u1ea1i n\u1eb7ng), n\u1ea5m \u0111\u1ed9c, c\u00e1c ch\u1ea5t \u0111\u1ed9c c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb th\u1ee9c \u0103n, thu\u1ed1c, thu\u1ed1c tr\u1eeb s\u00e2u, thu\u1ed1c tr\u1eeb c\u1ecf, ch\u1ea5t \u0111\u1ed9c sinh h\u1ecdc (ch\u1ea5t \u0111\u1ed9c c\u00f3 ngu\u1ed3n g\u1ed1c th\u1ef1c v\u1eadt, ch\u1ea5t \u0111\u1ed9c c\u00f3 ngu\u1ed3n g\u1ed1c \u0111\u1ed9ng v\u1eadt nh\u01b0 c\u00f4n tr\u00f9ng g\u00e2y \u0111\u1ed9c hay n\u1ecdc r\u1eafn), ch\u1ea5t \u0111\u1ed9c c\u1ee7a vi khu\u1ea9n.<br \/>\nC\u00e1c y\u1ebfu t\u1ed1 c\u1ea7n xem x\u00e9t<\/p>\n<ul>\n<li>Li\u1ec1u l\u01b0\u1ee3ng: li\u1ec1u qu\u00e1 cao c\u1ee7a b\u1ea5t c\u1ee9 th\u1ee9 g\u00ec \u0111\u1ec1u tr\u1edf th\u00e0nh \u0111\u1ed9c. S\u1ef1 \u0111\u00e1nh gi\u00e1 li\u1ec1u l\u01b0\u1ee3ng c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c d\u1ef1a tr\u00ean m\u1ed1i quan h\u1ec7 gi\u1eef li\u1ec1u l\u01b0\u1ee3ng v\u00e0 m\u1ee9c \u0111\u1ed9 ph\u1ea3n \u1ee9ng (th\u01b0\u1eddng \u0111\u01b0\u1ee3c bi\u1ec3u di\u1ec5n b\u1eb1ng \u0111\u1ed3 th\u1ecb). C\u0103n c\u1ee9 v\u00e0o h\u00ecnh d\u1ea1ng c\u1ee7a \u0111\u1ed3 th\u1ecb c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 \u0111\u1ed9c c\u1ee7a m\u1ed9t ch\u1ea5t.<\/li>\n<li>S\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a ch\u1ea5t \u0111\u1ed9c ch\u01b0a ch\u1eafc \u0111\u00e3 \u0111\u1ee7 \u0111\u1ec3 k\u1ebft lu\u1eadn l\u00e0 c\u00f3 g\u00e2y \u0111\u1ed9c. V\u00ed d\u1ee5 ta ph\u00e1t hi\u1ec7n th\u1ea5y m\u1ed9t lo\u00e0i c\u00e2y \u0111\u1ed9c tr\u00ean \u0111\u1ed3ng c\u1ecf nh\u01b0ng ph\u1ea3i c\u00f3 b\u1eb1ng ch\u1ee9ng ch\u1ee9ng t\u1ecf r\u1eb1ng \u0111\u00e0n gia s\u00fac c\u1ee7a ta \u0103n lo\u1ea1i c\u00e2y \u0111\u1ed9c \u0111\u00f3.<\/li>\n<li>Nh\u1eefng con v\u1eadt kh\u00e1c nhau trong c\u00f9ng m\u1ed9t \u0111\u00e0n c\u00f3 th\u1ec3 \u0103n nh\u1eefng lo\u1ea1i th\u1ee9c \u0103n kh\u00e1c nhau.<\/li>\n<li>\u0110\u1eb7c t\u00ednh g\u00e2y \u0111\u1ed9c ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1 th\u1ec3 v\u00e0 lo\u00e0i.<\/li>\n<li>Nh\u1eefng d\u1ea5u hi\u1ec7u nhi\u1ec5m \u0111\u1ed9c ph\u1ea3i c\u00f3 li\u00ean quan \u0111\u1ebfn ch\u1ea5t \u0111\u1ed9c nghi v\u1ea5n.<\/li>\n<\/ul>\n<p><strong>3.1. Nghi\u00ean c\u1ee9u c\u01a1 ch\u1ebf nhi\u1ec5m \u0111\u1ed9c<\/strong><\/p>\n<ul>\n<li>Bi\u1ec5n \u0111\u1ed5i qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i ch\u1ea5t c\u1ee7a c\u01a1 th\u1ec3 sau khi b\u1ecb ch\u1ea5t \u0111\u1ed9c th\u00e2m nh\u1eadp.<\/li>\n<li>M\u00f4 t\u1ea3 con \u0111\u01b0\u1eddng x\u00e2m nh\u1eadp v\u00e0 lan truy\u1ec1n ch\u1ea5t \u0111\u1ed9c trong c\u00e1c c\u01a1 quan c\u0169ng nh\u01b0 qu\u00e1 tr\u00ecnh lo\u1ea1i th\u1ea3i ch\u1ea5t \u0111\u1ed9c kh\u1ecfi c\u01a1 th\u1ec3.<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 c\u1ee7a ch\u1ea5t \u0111\u1ed9c t\u1ea1i m\u1ed9t c\u01a1 quan n\u00e0o \u0111\u00f3 ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1c y\u1ebfu t\u1ed1: li\u1ec1u l\u01b0\u1ee3ng, \u0111\u1eb7c t\u00ednh l\u00fd h\u00f3a c\u1ee7a ch\u1ea5t \u0111\u1ed9c, qu\u00e1 tr\u00ecnh h\u1ea5p thu c\u1ee7a c\u01a1 th\u1ec3, ph\u00e2n b\u1ed1 c\u1ee7a \u0111\u1ecdc ch\u1ea5t, \u00e1i l\u1ef1c \u0111\u1ed1i v\u1edbi c\u01a1 quan \u0111\u00f3, t\u1ed1c \u0111\u1ed9 trao \u0111\u1ed5i, t\u1ed1c \u0111\u1ed9 th\u1ea3i tr\u1eeb.<\/li>\n<li>Nh\u1eefng \u1ea3nh h\u01b0\u1edfng sau khi nhi\u1ec5m \u0111\u1ed9c ph\u1ee5 thu\u1ed9c v\u00e0o: lo\u1ea1i ch\u1ea5t \u0111\u1ed9c v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 c\u0169ng nh\u01b0 \u0111\u1eb7c \u0111i\u1ec3m sinh l\u00fd c\u1ee7a c\u01a1 th\u1ec3. C\u00e1c y\u1ebfu t\u1ed1 v\u1ec1 thu\u1ed9c v\u1ec1 c\u01a1 th\u1ec3 bao g\u1ed3m: tu\u1ed5i, lo\u1ea1i c\u01a1 quan b\u1ecb nhi\u1ec5m \u0111\u1ed9c, c\u00e1c c\u01a1 quan ch\u1ee9c n\u0103ng (gan v\u00e0 th\u1eadn), tinh sthaams c\u1ee7a m\u00e0ng, \u0111\u1ed9 pH c\u1ee7a m\u00f4, lo\u00e0i, gi\u1ea3i ph\u1eabu \u2013 sinh l\u00fd h\u1ec7 ti\u00eau h\u00f3a.<\/li>\n<li>Quan s\u00e1t m\u1ed1i quan h\u1ec7 gi\u1eefa th\u1eddi gian v\u00e0 m\u1ee9c \u0111\u1ed9 g\u00e2y \u0111\u1ed9c:<\/li>\n<\/ul>\n<p><strong>3.2. Nhi\u1ec5m \u0111\u1ed9c b\u1eadc 0 (zero-order)<\/strong><br \/>\nTh\u01b0\u1eddng th\u1ea5y v\u1edbi c\u00e1c lo\u1ea1i ch\u1ea5t nh\u01b0 ethanol, methanol, ethylen glycol, aspirin v\u01a1i c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m: Ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng v\u00e0 c\u00f3 tr\u1ea1ng th\u00e1i b\u00e3o h\u00e0o, t\u1ef7 l\u1ec7 th\u1ea3i tr\u1eeb kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o n\u1ed3ng \u0111\u1ed9 c\u1ee7a h\u00f3a ch\u1ea5t g\u00e2y \u0111\u1ed9c trong huy\u1ebft thanh, t\u1ed1c \u0111\u1ed9 th\u1ea3i tr\u1eeb l\u00e0 h\u1eb1ng s\u1ed1, \u0111\u1ed3 th\u1ecb bi\u1ec3u di\u1ec5n c\u00f3 d\u1ea1ng tuy\u1ebfn t\u00ednh.<\/p>\n<p><strong>3.3. Nhi\u1ec5m \u0111\u1ed9c b\u1eadc nh\u1ea5t (First-order)<\/strong><br \/>\nV\u1edbi h\u1ea7u h\u1ebft c\u00e1c lo\u1ea1i thu\u1ed1c, t\u1ef7 l\u1ec7 th\u1ea3i tr\u1eeb ph\u1ee5 thu\u1ed9c v\u00e0o n\u1ed3ng \u0111\u1ed9 c\u1ee7a ch\u1ea5t \u0111\u1ed9c trong c\u01a1 th\u1ec3, t\u1ef7 l\u1ec7 th\u1ea3i tr\u1eeb t\u00ednh theo ph\u1ea7n tr\u0103m l\u00e0 h\u1eb1ng s\u1ed1, th\u1eddi gian b\u00e1n th\u1ea3i tr\u1eeb ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng c\u1ee7a thu\u1ed1c. \u0110\u01b0\u1eddng bi\u1ec3u di\u1ec5n logarith n\u1ed3ng \u0111\u1ed9 c\u00f3 d\u1ea1ng tuy\u1ebfn t\u00ednh.<\/p>\n<p><strong>4. C\u00e1c con \u0111\u01b0\u1eddng x\u00e2m nh\u1eadp c\u1ee7a \u0111\u1ed9c ch\u1ea5t<\/strong><\/p>\n<p>Ph\u1ea7n l\u1edbn c\u00e1c ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp qua \u0111\u01b0\u01a1ng ti\u00eau h\u00f3a hay qua da<br \/>\nT\u1ed1c \u0111\u1ed9 x\u00e2m nh\u1eadp c\u1ee7a ch\u1ea5t \u0111\u1ed9c v\u00e0o c\u01a1 th\u1ec3 ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u01b0\u1eddng x\u00e2m nh\u1eadp theo th\u1ee9 t\u1ef1 : \u0111\u01b0\u1eddng m\u00e1u &gt; \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p &gt; m\u00e0ng ph\u00fac m\u1ea1c &gt; trong c\u01a1 &gt; \u0111\u01b0\u1eddng mi\u1ec7ng &gt; bi\u1ec3u b\u00ec da.<\/p>\n<p>S\u1ef1 kh\u00e1c nhau v\u1ec1 t\u1ed1c \u0111\u1ed9 x\u00e2m nh\u1eadp \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 \u0111\u1eb7c t\u00ednh l\u00fd h\u00f3a v\u00e0 s\u1ef1 ph\u1ee9c t\u1ea1p c\u1ee7a c\u00e1c l\u1edbp c\u1ea5u t\u1ea1o c\u1ee7a c\u01a1 quan.<\/p>\n<p>Ph\u00f2ng tr\u00e1nh kh\u00f4ng cho ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp \u0111\u01b0\u1ee3c coi l\u00e0 bi\u1ec7n ph\u00e1p t\u1ed1i \u01b0u nh\u1ea5t. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p h\u1ea1n ch\u1ebf bao g\u1ed3m r\u1eeda d\u1ea1 d\u00e0y-ru\u1ed9t, d\u00f9ng than ho\u1ea1t t\u00ednh, g\u00e2y n\u00f4n, r\u1eeda da v\u00f9ng ti\u1ebfp x\u00fac v\u1edbi ch\u1ea5t \u0111\u1ed9c\u2026<\/p>\n<p><strong>4.1. C\u01a1 ch\u1ebf h\u1ea5p thu nh\u1edd khuy\u1ebfch t\u00e1n th\u1ee5 \u0111\u1ed9ng<\/strong><br \/>\nKhuy\u1ebfch t\u00e1n b\u1ecb \u0111\u1ed9ng ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1c y\u1ebfu t\u1ed1:<\/p>\n<ul>\n<li>Kh\u1ea3 n\u0103ng th\u1ea5m qua m\u00e0ng t\u1ebf b\u00e0o c\u1ee7a ch\u1ea5t \u0111\u1ed9c<\/li>\n<li>M\u00e0ng t\u1ebf b\u00e0o c\u00f3 c\u1ea5u tr\u00fac ng\u0103n c\u1ea3n kh\u00f4ng cho h\u1ea7u h\u1ebft c\u00e1c c\u1ea5u tr\u00fac c\u00f3 k\u00edch th\u01b0\u1edbc l\u1edbn \u0111i qua.<\/li>\n<li>M\u00e0ng t\u1ebf b\u00e0o ch\u1ee9a l\u1edbp lipid k\u00e9p v\u1edbi nhi\u1ec1u khe v\u00e0 c\u00e1c protein n\u1eb1m b\u00ean ngo\u00e0i v\u00e0 xuy\u00ean qua m\u00e0ng.<\/li>\n<\/ul>\n<p><strong>\u0110\u1eb7c \u0111i\u1ec3m:<\/strong><\/p>\n<ul>\n<li>L\u00e0 ph\u01b0\u01a1ng th\u1ee9c x\u00e2m nh\u1eadp c\u1ee7a nhi\u1ec1u d\u01b0\u1ee3c ph\u1ea9m v\u00e0 ch\u1ea5t \u0111\u1ed9c<\/li>\n<li>Kh\u00f4ng c\u1ea7n n\u0103ng l\u01b0\u1ee3ng<\/li>\n<li>Kh\u00f4ng c\u00f3 tr\u1ea1ng th\u00e1i b\u00e3o h\u00f2a<\/li>\n<li>C\u00e1c ch\u1ea5t h\u00f2a tan trong lipid c\u00f3 t\u1ed1c \u0111\u1ed9 x\u00e2m nh\u1eadp nhanh.<\/li>\n<li>C\u00e1c ch\u1ea5t kh\u00f4ng b\u1ecb ion h\u00f3a, kh\u00f4ng ph\u00e2n c\u1ef1c trong d\u1ecbch c\u01a1 th\u1ec3 c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng x\u00e2m nh\u1eadp nhanh. T\u1ef7 l\u1ec7 t\u01b0\u01a1ng \u0111\u1ed1i gi\u1eefa ph\u1ea7n b\u1ecb ion h\u00f3a v\u00e0 kh\u00f4ng b\u1ecb ion h\u00f3a c\u1ee7a ch\u1ea5t \u0111\u1ed9c ph\u1ee5 thu\u1ed9c v\u00e0o pH c\u1ee7a d\u1ecbch th\u1ec3 v\u00e0 pKa c\u1ee7a ch\u1ea5t \u0111\u1ed9c.<\/li>\n<li>C\u00f3 th\u1ec3 d\u00f9ng c\u00e2n b\u1eb1ng Henderson-Hasselbalch m\u00f4 t\u1ea3 m\u1ed1i t\u01b0\u01a1ng quan c\u1ee7a pH v\u00e0 \u0111\u1eb7c t\u00ednh h\u00f3a l\u00fd c\u1ee7a m\u1ed9t ch\u1ea5t v\u1edbi t\u00f4c \u0111\u1ed9 ion h\u00f3a c\u1ee7a ch\u1ea5t \u0111\u00f3.<\/li>\n<\/ul>\n<p><strong>4.2. C\u01a1 ch\u1ebf h\u1ea5p thu nh\u1edd v\u1eadn chuy\u1ec3n ch\u1ee7 \u0111\u1ed9ng<\/strong><\/p>\n<ul>\n<li>Y\u00eau c\u1ea7u n\u0103ng l\u01b0\u1ee3ng (\u0111\u00f2i h\u1ecfi ph\u1ea3i c\u00f3 ATP \u2013 adenosine triphosphate) \u0111\u1ec3 v\u1eadn chuy\u1ec3n c\u00e1c ch\u1ea5t ng\u01b0\u1ee3c v\u1edbi gradient n\u1ed3ng \u0111\u1ed9 hay m\u00e0ng \u0111i\u1ec7n h\u00f3a.<\/li>\n<li>C\u1ea7n c\u00e1c protein v\u1eadn chuy\u1ec3n (protein mang)<\/li>\n<li>C\u00f3 tr\u1ea1ng th\u00e1i b\u00e3o h\u00f2a<\/li>\n<li>V\u1eadn chuy\u1ec3n c\u00f3 ch\u1ecdn l\u1ecdc<\/li>\n<\/ul>\n<p><strong>X\u00e2m nh\u1eadp qua \u0111\u01b0\u1eddng d\u1ea1 d\u00e0y \u2013 ru\u1ed9t<\/strong><\/p>\n<ul>\n<li>T\u1eeb d\u1ea1 d\u00e0y v\u00e0 ru\u1ed9t, ch\u1ea5t \u0111\u1ed9c ph\u1ea3i qua \u0111\u01b0\u1ee3c nhi\u1ec1u h\u1ec7 th\u1ed1ng c\u1ea5u t\u1ea1o c\u1ee7a c\u01a1 th\u1ec3 tr\u01b0\u1edbc khi c\u00f3 m\u1eb7t trong h\u1ec7 tu\u1ea7n ho\u00e0n.<\/li>\n<li>Ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y ru\u1ed9t li\u00ean ti\u1ebfp v\u1edbi l\u1edbp ngo\u00e0i c\u01a1 th\u1ec3.<\/li>\n<li>C\u00e1c ch\u1ea5t kh\u00f4ng ph\u00e2n c\u1ef1c h\u00f2a tan trong lipid d\u1ec5 x\u00e2m nh\u1eadp qua \u0111\u01b0\u1eddng n\u00e0y.<\/li>\n<li>\u0110\u1ed1i v\u1edbi c\u00e1c ch\u1ea5t ph\u00e2n c\u1ef1c: C\u00e1c ch\u1ea5t c\u00f3 t\u00ednh acid y\u1ebfu th\u01b0\u1eddng \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 t\u1eeb d\u1ea1 d\u00e0y; nh\u1eefng ch\u1ea5t c\u00f3 t\u00ednh baz\u01a1 y\u1ebfu th\u01b0\u1eddng \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 \u1edf ru\u1ed9t non.<\/li>\n<li>C\u00e1c ch\u1ea5t \u0111\u01b0\u1ee3c h\u1ea5p thu \u1edf d\u1ea1 d\u00e0y \u2013 ru\u1ed9t tr\u01b0\u1edbc h\u1ebft \u0111\u1ebfn gan (g\u00e2y \u1ea3nh h\u01b0\u1edfng b\u01b0\u1edbc \u0111\u1ea7u). \u1ede gan c\u00f3 qu\u00e1 tr\u00ednh gi\u1ea3i \u0111\u1ed9c v\u00e0 s\u1ea3n sinh c\u00e1c d\u1eabn ch\u1ea5t.<\/li>\n<li>Khuy\u1ebfch t\u00e1n th\u1ee5 \u0111\u1ed9ng l\u00e0 c\u01a1 ch\u1ebf \u0111\u1ea7u ti\u00ean c\u1ee7a qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp qua bi\u1ec3u m\u00f4 th\u00e0nh d\u1ea1 d\u00e0y-ru\u1ed9t.<\/li>\n<li>M\u1ed9t v\u00e0i ch\u1ea5t (nh\u01b0 s\u1eaft, thallium, cholecalciferol, ch\u00ec) \u0111\u01b0\u1ee3c h\u1ea5p thu nh\u1edd h\u1ec7 th\u1ed1ng v\u1eadn chuy\u1ec3n c\u1ee7a ch\u00ednh \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/li>\n<li>H\u1ea5p thu ch\u1ea5t \u0111\u1ed9c c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o tu\u1ed5i c\u1ee7a \u0111\u1ed9ng v\u1eadt. \u0110\u1ed9ng v\u1eadt s\u01a1 sinh c\u00f3 h\u00e0ng r\u00e0o ng\u0103n c\u1ea3n k\u00e9m h\u01a1n n\u00ean ch\u1ea5t \u0111\u1ed9c d\u1ec5 x\u00e2m nh\u1eadp h\u01a1n theo \u0111\u01b0\u1eddng n\u00e0y.<\/li>\n<li>C\u00e1c lo\u00e0i kh\u00e1c nhau c\u00f3 m\u1ee9c \u0111\u1ed9 nhi\u1ec5m ch\u1ea5t \u0111\u1ed9c kh\u00e1c nhau do \u0111\u1ed9 pH kh\u00e1c nhau (\u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u1ee7a c\u00e1c lo\u00e0i nhai l\u1ea1i c\u00f3 t\u00ednh ki\u1ec1m cao h\u01a1n \u1edf d\u1ea1 d\u00e0y \u0111\u01a1n); th\u1ec3 t\u00edch v\u00e0 t\u00ednh ch\u1ea5t n\u01b0\u1edbc b\u1ecdt kh\u00e1c nhau; \u0111\u1eb7c \u0111i\u1ec3m gi\u1ea3i ph\u1ea9u kh\u00e1c nhau\u2026 D\u1ea1 d\u00e0y k\u00e9p \u0111\u1ed3ng th\u1eddi l\u00e0 m\u1ed9t kho ch\u1ee9a \u1edf \u0111\u00f3 c\u0169ng s\u1ea3y ra qu\u00e1 tr\u00ecnh h\u00f2a tan ch\u1ea5t \u0111\u1ed9c, k\u1ebft h\u1ee3p v\u1edbi protein \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1eddi gian v\u1eadn chuy\u1ec3n ch\u1ea5t \u0111\u1ed9c.<\/li>\n<\/ul>\n<p><strong>X\u00e2m nh\u1eadp qua da<\/strong><\/p>\n<ul>\n<li>L\u00e0 con \u0111\u01b0\u1eddng x\u00e2m nh\u1eadp ph\u1ed5 bi\u1ebfn trong th\u00fa y.<\/li>\n<li>Da c\u0169ng l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac ph\u00f2ng v\u1ec7 cho c\u01a1 th\u1ec3 nh\u1edd l\u1edbp t\u1ebf b\u00e0o bi\u1ec3u b\u00ec v\u1edbi v\u00f4 s\u1ed1 t\u1ebf b\u00e0o v\u00e0 kh\u00f4ng c\u00f3 c\u1ea5u tr\u00fac m\u1ea1ch.<\/li>\n<li>Kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 c\u1ee7a da s\u1ebd gi\u1ea3m n\u1ebfu da b\u1ecb tr\u1ea7y s\u01b0\u1edbc, t\u1ed5n th\u01b0\u01a1ng, vi\u00eam hay ti\u1ebfp x\u00fac v\u1edbi c\u00e1c dung m\u00f4i h\u1eefu c\u01a1 (dung m\u00f4i h\u1eefu c\u01a1 l\u00e0 ch\u1ea5t mang cho m\u1ed9t s\u00f4 thu\u1ed1c tr\u1eeb s\u00e2u).<\/li>\n<li>Khuy\u00each t\u00e1n b\u1ecb \u0111\u1ed9ng l\u00e0 c\u01a1 ch\u1ebf ban \u0111\u1ea7u c\u1ee7a qu\u00e1 tr\u00ecnh x\u00e2m nhi\u1ec5m qua da.<\/li>\n<li>Ch\u1ea5t \u0111\u1ed9c c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp nhanh h\u01a1n qua c\u00e1c l\u1ed7 ch\u00e2n l\u00f4ng.<\/li>\n<\/ul>\n<p><strong>X\u00e2m nh\u1eadp qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p<\/strong><\/p>\n<ul>\n<li>Khuy\u1ebfch t\u00e1n b\u1ecb \u0111\u1ed9ng l\u00e0 c\u01a1 ch\u1ebf c\u00f3 kh\u1edfi \u0111\u1ea7u c\u1ee7a \u0111\u01b0\u1eddng x\u00e2m nh\u1eadp n\u00e0y.<\/li>\n<li>L\u00e0 c\u00e1ch x\u00e2m nh\u1eadp quan tr\u1ecdng c\u1ee7a c\u00e1c kh\u00ed \u0111\u1ed9c: carbon monoxide (CO), hydrogen sulfide (H2S), nitrogen dioxide (NO2), carbon dioxide (CO2), kh\u00ed cyanide.<\/li>\n<li>Ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp t\u1ea1i c\u00e1c nh\u00e1nh ph\u1ebf qu\u1ea3n nh\u1ecf v\u00e0 c\u00e1c ph\u1ebf nang.<\/li>\n<li>C\u00e1c ph\u1ebf nang c\u00f3 di\u1ec7n t\u00edch ti\u1ebfp x\u00fac l\u1edbn v\u1edbi kh\u00f4ng kh\u00ed \u0111\u1ed3ng th\u1eddi ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi th\u00e0nh c\u1ee7a c\u00e1c mao m\u1ea1ch , \u00edt c\u1ea5u tr\u00fac ph\u00f2ng v\u1ec7 n\u00ean kh\u00ed \u0111\u1ed9c d\u1ec5 x\u00e2m nh\u1eadp v\u00e0o h\u1ec7 tu\u1ea7n ho\u00e0n.<\/li>\n<li>C\u00e1c y\u1ebfu t\u1ed1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn x\u00e2m nh\u1eadp c\u1ee7a ch\u1ea5t \u0111\u1ed9c bao g\u1ed3m:<\/li>\n<\/ul>\n<p>+ Kh\u1ea3 n\u0103ng h\u00f2a tan c\u1ee7a kh\u00ed \u0111\u1ed9c; d\u1ea1ng kh\u00ed (d\u1ea1ng h\u01a1i hay c\u00f3 c\u00e1c ph\u1ea7n t\u1eed, k\u00edch th\u01b0\u1edbc c\u00e1c ph\u1ea7n t\u1eed kh\u00ed (n\u1ebfu k\u00edch th\u01b0\u1edbc &gt;5 micron s\u1ebd t\u00e1c \u0111\u1ed9ng m\u1ea1nh v\u00e0o c\u00e1c m\u00e0ng nh\u1ea7y m\u0169i \u2013 thanh qu\u1ea3n; k\u00edch th\u01b0\u1edbc t\u1eeb 2-5 micron c\u00f3 th\u1ec3 xu\u1ed1ng \u0111\u1ebfn c\u00e1c nh\u00e1nh c\u1ee7a c\u00e2y ph\u1ebf qu\u1ea3n; c\u00e1c h\u1ea1t c\u00f3 k\u00edch th\u01b0\u1edbc &lt; 1micron c\u00f3 th\u1ec3 xu\u1ed1ng \u0111\u1ebfn ph\u1ebf nang v\u00e0 x\u00e2m nh\u1eadp qua th\u00e0nh ph\u1ebf nang. Ph\u1ea7n n\u00e0y tr\u00ecnh b\u00e0y v\u1ec1 s\u1ef1 ph\u00e2n b\u1ed1 ch\u1ea5t \u0111\u1ed9c trong c\u01a1 th\u1ec3 Sau khi x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3, c\u00e1c ch\u1ea5t \u0111\u1ed9c ph\u1ea3i \u0111\u1ebfn \u0111\u01b0\u1ee3c c\u00e1c c\u01a1 quan m\u1edbi g\u00e2y \u0111\u01b0\u1ee3c \u1ea3nh h\u01b0\u1edfng c\u00f3 h\u1ea1i.<\/p>\n<p><strong>S\u1ef1 ph\u00e2n b\u1ed1 ch\u1ea5t \u0111\u1ed9c ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1c y\u1ebfu t\u1ed1:<\/strong><\/p>\n<ul>\n<li>L\u01b0\u1ee3ng d\u1ecbch th\u1ec3 v\u00e0 m\u00e1u tu\u1ea7n ho\u00e0n t\u1ea1i m\u00f4, kh\u1ea3 n\u0103ng h\u00f2a tan trong lipid, protein k\u1ebft h\u1ee3p (c\u1ea3 protein trong c\u00e1c m\u00f4 v\u00e0 trong huy\u1ebft t\u01b0\u01a1ng),<\/li>\n<li>\u00c1i l\u1ef1c c\u1ee7a m\u00f4 v\u1edbi ch\u1ea5t \u0111\u1ed9c, c\u00e1c h\u00e0ng r\u00e0o c\u00f3 ch\u1ee9c n\u0103ng ng\u0103n c\u1ea3n ch\u1ea5t \u0111\u1ed9c\u2026\u00c1i l\u1ef1c c\u1ee7a c\u01a1 quan v\u1edbi ch\u1ea5t \u0111\u1ed9c \u2013 M\u1ed9t s\u1ed1 ch\u1ea5t \u0111\u1ed9c c\u00f3 \u00e1i l\u1ef1c v\u1edbi m\u1ed9t hay v\u00e0i lo\u1ea1i m\u00f4 nh\u1ea5t \u0111\u1ecbnh. \u2013 Ch\u1ea5t \u0111\u1ed9c c\u00f3 th\u1ec3 t\u00edch t\u1ee5 l\u1ea1i trong c\u00e1c m\u00f4. \u2013 Ch\u00ec c\u00f3 th\u1ec3 t\u1eadp trung trong x\u01b0\u01a1ng (t\u01b0\u01a1ng t\u1ef1 nh\u01b0 canxi). \u2013 Thu\u1ed1c tr\u1eeb s\u00e2u c\u00f3 xu h\u01b0\u1edbng t\u00edch t\u1ee5 t\u1ea1i m\u00f4 m\u1ee1 nhi\u1ec1u h\u01a1n \u1edf c\u00e1c m\u00f4 kh\u00e1c.<\/li>\n<li>\u1ea2nh h\u01b0\u1edfng c\u1ee7a d\u1ecbch th\u1ec3 \u2013 C\u01a1 quan c\u00e0ng c\u00f3 l\u01b0\u1ee3ng d\u1ecbch th\u1ec3 tu\u1ea7n ho\u00e0n l\u1edbn (nh\u01b0 d\u00f2ng m\u00e1u) c\u00e0ng c\u00f3 nguy c\u01a1 ti\u1ebfp x\u00fac v\u1edbi ch\u1ea5t \u0111\u1ed9c. C\u01a1 x\u01b0\u01a1ng (skeletal muscles) c\u00f3 d\u00f2ng m\u00e1u tu\u1ea7n ho\u00e0n m\u1ee9c trung b\u00ecnh. M\u00f4 m\u1ee1, x\u01b0\u01a1ng c\u00f3 l\u01b0\u1ee3ng m\u00e1u tu\u1ea7n ho\u00e0n th\u1ea5p. Protein k\u1ebft h\u1ee3p \u2013 L\u01b0\u1ee3ng protein k\u1ebft h\u1ee3p t\u1ef7 l\u1ec7 ngh\u1ecbch v\u1edbi l\u01b0\u1ee3ng ch\u1ea5t \u0111\u1ed9c \u1edf d\u1ea1ng t\u1ef1 do. \u2013 Ch\u1ea5t \u0111\u1ed9c th\u01b0\u1eddng \u1edf d\u1ea1ng tr\u01a1 khi k\u1ebft h\u1ee3p v\u1edbi protein c\u1ee7a huy\u1ebft t\u01b0\u01a1ng. \u2013 Ch\u1ea5t \u0111\u1ed9c \u1edf d\u1ea1ng k\u1ebft h\u1ee3p kh\u00f4ng l\u1ecdc \u0111\u01b0\u1ee3c t\u1ea1i th\u1eadn. \u2013 Ch\u1ea5t \u0111\u1ed9c \u1edf d\u1ea1ng k\u1ebft h\u1ee3p v\u1edbi protein c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c thay th\u1ebf (b\u1ecb chi\u1ebfm ch\u1ed7) b\u1edfi m\u1ed9t ch\u1ea5t kh\u00e1c.<\/li>\n<\/ul>\n<p><strong>C\u00e1c c\u01a1 quan c\u00f3 nguy c\u01a1 nhi\u1ec5m \u0111\u1ed9c cao:<\/strong> Th\u1eadn, gan, n\u00e3o, tim.<\/p>\n<p><strong>4.3. C\u00e1c \u201ch\u00e0ng r\u00e0o\u201d ng\u0103n ch\u1ea5t \u0111\u1ed9c<\/strong><\/p>\n<ul>\n<li>H\u00e0ng r\u00e0o m\u00e1u-n\u00e3o b\u1ed9: \u2013 C\u00f3 t\u00e1c d\u1ee5ng ng\u0103n c\u1ea3n v\u1edbi c\u00e1c ch\u1ea5t ph\u00e2n c\u1ef1c; \u2013 Ng\u0103n c\u1ea3n ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp v\u00e0o h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng; \u2013 C\u00e1c t\u1ebf b\u00e0o n\u1eb1m gi\u1eefa t\u1ebf b\u00e0o th\u1ea7n kinh v\u00e0 mao m\u1ea1ch (c\u00e1c astrocyte) n\u1eb1m xung quanh v\u00e0 li\u00ean k\u1ebft ch\u1eb7t ch\u1ebd v\u1edbi mao m\u1ea1ch. V\u00ed d\u1ee5: Ivermectin th\u01b0\u1eddng an to\u00e0n v\u1edbi c\u00e1c \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa v\u00ec n\u00f3 kh\u00f4ng th\u1ec3 x\u00e2m nh\u1eadp t\u1eeb m\u00e1u v\u00e0o n\u00e3o b\u1ed9 \u0111\u1ec3 t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn c\u00e1c c\u01a1 quan th\u1ee5 c\u1ea3m acid gama-aminobutyric (\u03b3-aminobutyric acid (GABA) receptors). \u1ede gi\u1ed1ng ch\u00f3 collie, t\u00e1c d\u1ee5ng ng\u0103n c\u1ea3n n\u00e0y c\u00f3 hi\u1ec7u qu\u1ea3 th\u1ea5p h\u01a1n n\u00ean ivermectin c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c \u0111\u1ed1i v\u1edbi th\u1ea7n kinh trung \u01b0\u01a1ng.<\/li>\n<li>Nhau thai: \u2013 Nhau thai c\u00f3 m\u1ed9t s\u1ed1 l\u1edbp t\u1ebf b\u00e0o n\u1eb1m gi\u1eefa h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n c\u1ee7a c\u01a1 th\u1ec3 m\u1eb9 v\u00e0 c\u1ee7a b\u00e0o thai. \u2013 C\u00f3 s\u1ef1 kh\u00e1c nhau v\u1ec1 kh\u1ea3 n\u0103ng ng\u0103n ch\u1eb7n ch\u1ea5t \u0111\u1ed9c c\u1ee7a nhau thai gi\u1eefa c\u00e1c lo\u00e0i do ki\u1ec3u b\u00e1m d\u00ednh c\u1ee7a nhau con v\u00e0o t\u1eed cung m\u1eb9 \u1edf c\u00e1c lo\u00e0i c\u00f3 kh\u00e1c nhau. L\u01b0\u1ee3ng ch\u1ea5t \u0111\u1ed9c ph\u00e2n b\u1ed1 \u2013 Th\u1ec3 t\u00edch d\u1ecbch th\u1ec3 trong m\u1ed9t c\u01a1 th\u1ec3 (m\u00f4i tr\u01b0\u1eddng h\u00f2a tan ch\u1ea5t \u0111\u1ed9c) t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi n\u1ed3ng \u0111\u1ed9 ch\u1ea5t \u0111\u1ed9c trong huy\u1ebft t\u01b0\u01a1ng. \u2013 L\u01b0\u1ee3ng ch\u1ea5t \u0111\u1ed9c ph\u00e2n b\u1ed1 th\u1ef1c t\u1ebf (volume of distribution, Vd) bi\u1ec3u th\u1ecb ch\u00ednh x\u00e1c h\u01a1n v\u00e0 \u0111\u01b0\u1ee3c t\u00ednh b\u1eb1ng b\u1eb1ng l\u01b0\u1ee3ng ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 chia cho n\u1ed3ng \u0111\u1ed9 c\u1ee7a ch\u1ea5t \u0111\u1ed9c trong huy\u1ebft t\u01b0\u01a1ng (Vd=Amount of toxin in the body\/concentration in plasma). \u2013 Vd th\u01b0\u1eddng l\u1edbn h\u01a1n th\u1ec3 t\u00edch n\u01b0\u1edbc c\u1ee7a c\u01a1 th\u1ec3. \u2013 Vd kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t th\u00f4ng s\u1ed1 sinh l\u00fd \u2013 Vd c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u01b0\u1edbc t\u00ednh lo\u1ea1i th\u1ea3i ch\u1ea5t \u0111\u1ed9c. \u2013 N\u1ebfu Vd l\u1edbn (&gt;5L\/kg) ch\u1ee9ng t\u1ecf n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng th\u1ea5p, ch\u1ea5t \u0111\u1ed9c \u1edf d\u1ea1ng k\u1ebft h\u1ee3p hay t\u1eadp trung t\u1ea1i c\u00e1c m\u00f4, kh\u1ea3 n\u0103ng t\u00e1ch ch\u1ea5t \u0111\u1ed9c ra kh\u1ecfi c\u00e1c protein k\u1ebft h\u1ee3p th\u1ea5p (nh\u01b0 ch\u1ea5t t\u1eeb c\u00e2y mao \u0111\u1ecba ho\u00e0ng, ch\u1ea5t h\u1eefu c\u01a1 ch\u1ee9a clo, thu\u1ed1c phi\u1ec7n).<\/li>\n<\/ul>\n<p><strong>4.3. B\u00e0i ti\u1ebft (th\u1ea3i) ch\u1ea5t \u0111\u1ed9c:<\/strong><br \/>\nCh\u1ea5t \u0111\u1ed9c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ea3i ra ngo\u00e0i c\u01a1 th\u1ec3 theo c\u00e1c con \u0111\u01b0\u1eddng: N\u01b0\u1edbc ti\u1ec3u, ph\u00e2n, m\u1eadt, kh\u00f4ng kh\u00ed th\u1edf ra, s\u1eefa, n\u01b0\u1edbc b\u1ecdt.<\/p>\n<ul>\n<li>B\u00e0i ti\u1ebft ch\u1ea5t \u0111\u1ed9c bao g\u1ed3m qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i v\u00e0 th\u1ea3i ch\u1ea5t \u0111\u1ed9c.<\/li>\n<li>T\u1ed1c \u0111\u1ed9 th\u1ea3i tr\u1eeb: th\u1ec3 t\u00edch m\u00e1u hay huy\u1ebft t\u01b0\u01a1ng kh\u00f4ng c\u00f2n ch\u1ea5t \u0111\u1ed9c t\u00ednh tr\u00ean m\u1ed9t \u0111\u01a1n v\u1ecb th\u1eddi gian.<\/li>\n<li>Th\u1ea3i tr\u1eeb ch\u1ea5t \u0111\u1ed9c to\u00e0n th\u00e2n: Th\u1ec3 t\u00edch m\u00e1u hay huy\u1ebft t\u01b0\u01a1ng kh\u00f4ng c\u00f2n ch\u1ee9a ch\u1ea5t \u0111\u1ed9c trong m\u1ed9t \u0111\u01a1n v\u1ecb th\u1eddi gian v\u00e0 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi t\u1ea5t c\u1ea3 c\u00e1c qu\u00e1 tr\u00ecnh \u0111\u00e0o th\u1ea3i ch\u1ea5t \u0111\u1ed9c c\u1ee7a c\u01a1 th\u1ec3.<\/li>\n<li>Con \u0111\u01b0\u1eddng th\u1ea3i tr\u1eeb quan tr\u1ecdng nh\u1ea5t l\u00e0 n\u01b0\u1edbc ti\u1ec3u v\u00e0 ph\u00e2n.<\/li>\n<li>pH v\u00e0 l\u01b0u l\u01b0\u1ee3ng m\u00e1u tu\u1ea7n ho\u00e0n c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i th\u1eddi gian t\u1ed3n t\u1ea1i c\u1ee7a ch\u1ea5t \u0111\u1ed9c.<\/li>\n<li>C\u00e1c bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3 v\u00e0 d\u00f9ng thu\u1ed1c gi\u1ea3i \u0111\u1ed9c c\u00f3 th\u1ec3 gi\u00fap l\u00e0m t\u0103ng qu\u00e1 tr\u00ecnh \u0111\u00e0o th\u1ea3i ch\u1ea5t \u0111\u1ed9c.<\/li>\n<\/ul>\n<p><strong>\u0110\u00e0o th\u1ea3i theo n\u01b0\u1edbc ti\u1ec3u<\/strong><\/p>\n<ul>\n<li>Qu\u00e1 tr\u00ecnh l\u1ecdc: C\u00e1c ph\u00e2n t\u1eed ch\u1ea5t \u0111\u1ed9c kh\u00f4ng k\u1ebft h\u1ee3p v\u1edbi protein v\u00e0 c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf h\u01a1n 60.000 \u0111\u01b0\u1ee3c l\u1ecdc t\u1ea1i th\u1eadn.<\/li>\n<li>Th\u1ea9m th\u1ea5u t\u1ea1i c\u00e1c \u1ed1ng th\u1eadn<\/li>\n<li>\u0110\u1ed9 pH n\u01b0\u1edbc ti\u1ec3u: c\u00e1c ch\u1ea5t axit y\u1ebfu s\u1ebd c\u00f3 m\u1eb7t trong n\u01b0\u1edbc ti\u1ec3u c\u00f3 t\u00ednh ki\u1ec1m v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/li>\n<li>T\u1ea1i c\u00e1c \u1ed1ng th\u1eadn c\u0169ng c\u00f3 c\u00e1c axit v\u00e0 baz\u01a1 h\u1eefu c\u01a1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a ch\u1ea5t \u0111\u1ed9c trong n\u01b0\u1edbc ti\u1ec3u.<\/li>\n<\/ul>\n<p><strong>\u0110\u00e0o th\u1ea3i theo ph\u00e2n<\/strong><\/p>\n<ul>\n<li>\u0110\u00f3ng vai tr\u00f2 quan tr\u1ecdng v\u1edbi c\u00e1c ch\u1ea5t x\u00e2m nh\u1eadp theo \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/li>\n<li>Qu\u00e1 tr\u00ecnh \u0111\u00e0o th\u1ea3i theo ph\u00e2n c\u00f3 t\u00e1c d\u1ee5ng c\u00e0ng l\u1edbn trong tr\u01b0\u1eddng h\u1ee3p ch\u1ea5t \u0111\u1ed9c kh\u00f4ng b\u1ecb h\u1ea5p thu nhi\u1ec1u \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/li>\n<li>C\u01a1 th\u1ec3 kh\u00f4ng th\u1ec3 h\u1ea5p thu 100% l\u01b0\u1ee3ng ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp \u0111\u1ed3ng th\u1eddi d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c lo\u1ea1i d\u1ecbch nh\u01b0 d\u1ecbch m\u1eadt, n\u01b0\u1edbc b\u1ecdt, d\u1ecbch d\u1ea1 d\u00e0y, d\u1ecbch ru\u1ed9t, d\u1ecbch t\u1ee5y n\u00ean t\u1ef7 l\u1ec7 ch\u1ea5t \u0111\u1ed9c x\u00e2m nh\u1eadp s\u1ebd gi\u1ea3m.<\/li>\n<li>S\u1ef1 th\u1ea3i \u0111\u1ed9c n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u0103ng c\u01b0\u1eddng n\u1ebfu c\u00f3 m\u1eb7t c\u1ee7a c\u00e1c ch\u1ea5t gi\u1ea3i \u0111\u1ed9c, than ho\u1ea1t t\u00ednh\u2026<\/li>\n<\/ul>\n<p><strong>D\u1ecbch m\u1eadt<\/strong><\/p>\n<ul>\n<li>Th\u1ea9m th\u1ea5u l\u00e0 c\u01a1 ch\u1ebf \u0111\u1ea7u ti\u00ean<\/li>\n<li>Con \u0111\u01b0\u1eddng th\u1ea3i tr\u1eeb \u0111\u1ed1i v\u1edbi c\u00e1c ch\u1ea5t \u0111\u1ed9c c\u00f3 ph\u00e2n t\u1eed l\u01b0\u1ee3ng l\u1edbn nh\u01b0 ivermectin.<\/li>\n<li>V\u00f2ng tu\u1ea7n ho\u00e0n ru\u1ed9t-gan: M\u1ed9t s\u1ed1 ch\u1ea5t \u0111i v\u00e0o d\u1ecbch m\u1eadt v\u00e0 quay l\u1ea1i \u0111\u01b0\u1eddng ti\u00eau h\u00f3a; c\u00e1c vi khu\u1ea9n trong d\u1ea1 d\u00e0y-ru\u1ed9t t\u00e1c d\u1ee5ng \u0111\u1ebfn ch\u1ea5t \u0111\u1ed9c, ch\u1ea5t \u0111\u1ed9c \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu t\u1ea1i ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y-ru\u1ed9t\u2026<\/li>\n<\/ul>\n<p><strong>Th\u1ea3i theo s\u1eefa<\/strong><\/p>\n<ul>\n<li>Ch\u1ea5t \u0111\u1ed9c theo s\u1eefa c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i cho tr\u1ebb v\u00e0 gia s\u00fac non.<\/li>\n<li>L\u00e0 v\u1ea5n \u0111\u1ec1 c\u1ea7n \u0111\u01b0\u1ee3c quan t\u00e2m \u0111\u1ec3 b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng.<\/li>\n<\/ul>\n<p>+ V\u00ed d\u1ee5: n\u1ed3ng \u0111\u1ed9 cho ph\u00e9p c\u1ee7a aflatoxin trong s\u1eefa = 0<br \/>\n+ S\u1eefa \u0111\u01b0\u1ee3c v\u1eaft v\u00e0 ch\u1ebf bi\u1ebfn t\u1ea1i c\u00f9ng trang tr\u1ea1i \u0111\u01b0\u1ee3c ki\u1ec3m tra th\u00fa y ch\u1eb7t ch\u1ebd s\u1ebd h\u1ea1n ch\u1ebf nhi\u1ec5m \u0111\u1ed9c cho ng\u01b0\u1eddi.<br \/>\n+ Ki\u1ec3m tra v\u1ec7 sinh \u0111\u1ed3ng c\u1ecf r\u1ea5t quan tr\u1ecdng trong ch\u0103n nu\u00f4i \u0111\u1ed9ng v\u1eadt cho s\u1eefa ph\u00f2ng nhi\u1ec5m \u0111\u1ed9c s\u1eefa.<\/p>\n<ul>\n<li>pH c\u1ee7a s\u1eefa th\u1ea5p h\u01a1n c\u1ee7a huy\u1ebft t\u01b0\u01a1ng n\u00ean s\u1eefa c\u00f3 th\u1ec3 gi\u1eef c\u00e1c ion.<\/li>\n<li>Lipid trong s\u1eefa s\u1ebd t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u00f2a tan trong n\u00f3 c\u00f3 m\u1eb7t trong s\u1eefa (v\u00ed d\u1ee5 DDT, PCB \u2013 polychlorinated biphenyl, PBB \u2013 polybrominated biphenyl).<\/li>\n<\/ul>\n<p><strong>Th\u1ea3i tr\u1eeb theo \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p<\/strong><\/p>\n<ul>\n<li>Ph\u1ed5 bi\u1ebfn v\u1edbi c\u00e1c ch\u1ea5t kh\u00ed<\/li>\n<li>T\u1ed1c \u0111\u1ed9 v\u00e0 m\u1ee9c \u0111\u1ed9 th\u1ea3i tr\u1eeb t\u1ef7 l\u1ec7 ngh\u1ecbch v\u1edbi kh\u1ea3 n\u0103ng h\u00f2a tan c\u1ee7a ch\u1ea5t kh\u00ed trong m\u00e1u.<\/li>\n<\/ul>\n<p><strong>\u0110\u1ed9ng h\u1ecdc c\u1ee7a qu\u00e1 tr\u00ecnh th\u1ea3i tr\u1eeb<\/strong><\/p>\n<ul>\n<li>C\u00f3 th\u1ec3 d\u00f9ng c\u00e1c c\u00f4ng th\u1ee9c to\u00e1n h\u1ecdc \u0111\u1ec3 m\u00f4 t\u1ea3 c\u00e1c qu\u00e1 tr\u00ecnh th\u1ea3i ch\u1ea5t \u0111\u1ed9c.<\/li>\n<li>\u00cdt c\u00f3 \u00fd ngh\u0129a \u0111\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m \u0111\u1ed9c c\u1ea5p.<\/li>\n<li>Hay \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong nhi\u1ec5m \u0111\u1ed9c m\u00e3n t\u00ednh.<\/li>\n<\/ul>\n<p><strong>4. Trao \u0111\u1ed3i \u0111\u1ed9c ch\u1ea5t (bi\u1ebfn \u0111\u1ed5i sinh h\u1ecdc ch\u1ea5t \u0111\u1ed9c trong c\u01a1 th\u1ec3)<\/strong><\/p>\n<p>M\u1ee5c \u0111\u00edch c\u1ee7a qu\u00e1 tr\u00ecnh n\u00e0y l\u00e0 l\u00e0m t\u0103ng t\u00ednh h\u00f2a tan c\u1ee7a ch\u1ea5t \u0111\u1ed9c trong n\u01b0\u1edbc \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng qu\u00e1 tr\u00ecnh th\u1ea3i \u0111\u1ed9c.<\/p>\n<p>Gan l\u00e0 c\u01a1 quan \u0111\u1ea7u ti\u00ean tham gia v\u00e0o qu\u00e1 tr\u00ecnh n\u00e0y v\u00ec h\u1ea5u h\u1ebft c\u00e1c t\u1ebf b\u00e0o c\u1ee7a gan c\u00f3 kh\u1ea3 n\u0103ng trao \u0111\u1ed5i ch\u1ea5t cao. T\u00e1c \u0111\u1ed9ng gi\u1ea3i \u0111\u1ed9c c\u1ee7a gan ph\u1ee5 thu\u1ed9c v\u00e0o t\u1eebng c\u00e1 th\u1ec3, lo\u00e0i, tr\u1ea1ng th\u00e1i sinh l\u00fd c\u1ee7a c\u01a1 th\u1ec3.<\/p>\n<p>K\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn: Gi\u1ea3m \u0111\u1ed9c t\u00ednh (nh\u01b0 \u0111\u1ed1i v\u1edbi ivermectin) ho\u1eb7c l\u00e0m t\u0103ng t\u00ednh \u0111\u1ed9c do t\u1ea1o ra d\u1eabn ch\u1ea5t g\u00e2y \u0111\u1ed9c m\u1ea1nh h\u01a1n (nh\u01b0 paraoxon \u0111\u01b0\u1ee3c t\u1ea1o ra khi nhi\u1ec5m \u0111\u1ed9c parathion; aflatoxin B1 apoxit t\u1eeb aflatoxin B1).<\/p>\n<p>Qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i bao g\u1ed3m hai giai \u0111o\u1ea1n (hai pha): Giai \u0111o\u1ea1n I l\u00e0m ph\u00e1 v\u1ee1 c\u00e1c li\u00ean k\u1ebft h\u00f3a h\u1ecdc hay t\u00e1ch c\u00e1c nh\u00f3m ho\u1ea1t t\u00ednh \u0111\u1ec3 t\u1ea1o v\u00ed tr\u00ed th\u00edch h\u1ee3p trong ph\u00e2n t\u1eed ch\u1ea5t \u0111\u1ed9c. Giai \u0111o\u1ea1n II di\u1ec5n ra qu\u00e1 tr\u00ecnh k\u1ebft h\u1ee3p, t\u0103ng t\u00ednh h\u00f2a tan v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng th\u1ea3i tr\u1eeb.<\/p>\n<p><strong>Giai \u0111o\u1ea1n I<\/strong><\/p>\n<ul>\n<li>Qu\u00e1 tr\u00ecnh t\u00e1c \u0111\u1ed9ng th\u00f4ng qua P450<\/li>\n<\/ul>\n<p>P450 l\u00e0 nh\u00f3m c\u00e1c enzyme tr\u00ean m\u00e0ng ty th\u1ec3<br \/>\nP450 \u0111\u01b0\u1ee3c ch\u1ee9a trong c\u00e1c microsome (c\u00e1c t\u00fai c\u00f3 ngu\u1ed3n g\u1ed1c ribosome hay c\u00e1c t\u1eeb m\u00e0ng t\u1ebf b\u00e0o\u2026 sau khi ly t\u00e2m)<\/p>\n<p>Nh\u1eefng qu\u00e1 tr\u00ecnh sau sau th\u01b0\u1eddng di\u1ec5n ra th\u00f4ng qua P450: oxidation, reduction, hydroxylation, dealkylation, epoxidation, d\u00e9ulfuration, sulfoxidation.<\/p>\n<ul>\n<li>T\u00e1c \u0111\u1ed9ng kh\u00f4ng th\u00f4ng qua P450<\/li>\n<\/ul>\n<p><strong>Giai \u0111o\u1ea1n II<\/strong><\/p>\n<ul>\n<li>Di\u1ec5n ra c\u00e1c ph\u1ea3n \u1ee9ng t\u1ed5ng h\u1ee3p<\/li>\n<li>C\u1ea7n cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng<\/li>\n<li>C\u00e1c qu\u00e1 tr\u00ecnh h\u00f3a h\u1ecdc: glucoronidation, sulfation, glutathione conjugation, acetylation, amino acid conjugation, methylation.<\/li>\n<\/ul>\n<p><strong>\u201cB\u1eaft\u201d ion<\/strong><\/p>\n<ul>\n<li>Sau khi ch\u1ea5t \u0111\u1ed9c \u0111\u01b0\u1ee3c h\u1ea5p thu \u0111\u1ebfn tr\u1ea1ng th\u00e1i b\u00e3o h\u00f2a trong huy\u1ebft t\u01b0\u01a1ng s\u1ebd di\u1ec5n s\u1ef1 can b\u1eb1ng ch\u1ea5t \u0111\u1ed9c t\u1ea1i c\u00e1c m\u00f4 c\u00f3 \u00e1i l\u1ef1c v\u1edbi n\u00f3.<\/li>\n<li>Trong c\u01a1 th\u1ec3 c\u00f3 nhi\u1ec1u la\u1ecdi m\u00e0ng ng\u0103n c\u00e1ch gi\u1eefa c\u00e1c xoang ch\u1ee9a d\u1ecbch.<\/li>\n<li>C\u00e1c d\u1ecbch th\u1ec3 trong c\u00e1c xoang kh\u00e1c nhau c\u00f3 pH kh\u00e1c nhau.<\/li>\n<li>C\u00e1c v\u1ecb tr\u00ed c\u00f3 th\u1ec3 s\u1ea3y ra qu\u00e1 tr\u00ecnh thi\u1ebft l\u1eadp c\u00e2n b\u1eb1ng t\u1ea1i m\u00e0ng: Tuy\u1ebfn s\u1eefa, ph\u1ed5i, \u1ed1ng th\u1eadn.<\/li>\n<li>Bi\u1ec3u m\u00f4 tuy\u1ebfn s\u1eefa c\u00f3 h\u00e0ng r\u00e0o lipid ng\u0103n c\u00e1ch huy\u1ebft t\u01b0\u01a1ng (pH=7,4) v\u1edbi s\u1eefa (pH=6,5-6,8)<\/li>\n<li>S\u1ef1 ch\u00eanh l\u1ec7ch n\u00e0y t\u1ea1o \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 kh\u00e1ng sinh \u0111\u1ebfn tuy\u1ebfn v\u00fa \u0111\u1ec3 ph\u00e1t huy t\u00e1c d\u1ee5ng.<\/li>\n<li>M\u1ee9c ion h\u00f3a s\u1ebd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a c\u00e1c ch\u1ea5t trong s\u1eefa.<\/li>\n<\/ul>\n<p><strong>\u0110\u01a1n v\u1ecb ppm v\u00e0 ppb<\/strong><br \/>\nHai \u0111\u01a1n v\u1ecb th\u01b0\u01a1ng d\u00f9ng khi t\u00ednh to\u00e1n n\u1ed3ng \u0111\u1ed9c ch\u1ea5t \u0111\u1ed9c l\u00e0 \u0111\u01a1n v\u1ecb ppm (parts per million) v\u00e0 ppb (parts per billion).<\/p>\n<p>ppm v\u00e0 ppb \u0111\u01b0\u1ee3c d\u00f9ng trong c\u00e1c b\u00e1o c\u00e1o, t\u00e0i li\u1ec7u ph\u00e2n t\u00edch \u0111\u1ed9c ch\u1ea5t. C\u00e1c nh\u00e2n vi\u00ean ph\u00e2n t\u00edch v\u00e0 t\u00ednh to\u00e1n c\u00f3 th\u1ec3 quy \u0111\u1ed5i (hay suy lu\u1eadn) t\u1eeb n\u1ed3ng \u0111\u1ed9 ppm v\u00e0 ppb ra c\u00e1c s\u1ed1 li\u1ec7u c\u00f3 \u00fd ngh\u0129a trong ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng.<\/p>\n<p>M\u1ed9t ppm \u0111\u01b0\u1ee3c hi\u1ec3u l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a ch\u1ea5t c\u1ea7n ph\u00e2n t\u00edch tr\u00ean m\u1ed9t tri\u1ec7u ph\u1ea7n c\u1ee7a m\u1eabu ph\u00e2n t\u00edch (m\u1eabu ph\u00e2n t\u00edch c\u00f3 th\u1ec3 l\u00e0 th\u1ee9c \u0103n, n\u01b0\u1edbc u\u1ed1ng, m\u1eabu \u0111\u1ea5t).<br \/>\nC\u00f3 th\u1ec3 quy \u0111\u1ed5i 1ppm = 1mg\/kg = 1\u03bcg\/g<br \/>\nT\u1eeb \u0111\u00f3 ta c\u00f3 th\u1ec3 ghi nh\u1edb 1mg\/kg = 1ppm<br \/>\nNh\u01b0 v\u1eady, c\u00f3 m\u1edbi li\u00ean h\u1ec7 tr\u1ef1c ti\u1ebfp gi\u1eefa \u0111\u01a1n v\u1ecb ppm v\u00e0 n\u1ed3ng \u0111\u1ed9 ph\u1ea7n tr\u0103m.<br \/>\n1 ppm = 1 mg\/kg<br \/>\n1 ppm = 0.000001<br \/>\n1 ppm = 0.0001%<br \/>\nT\u1eeb n\u1ed3ng \u0111\u1ed9 ph\u1ea7n tr\u0103m chuy\u1ec3n sang ppm ta ch\u1ec9 c\u1ea7n d\u1ecbch d\u1ea5u ph\u1ea9n v\u1ec1 ph\u00eda PH\u1ea2I 4 ch\u1eef s\u1ed1.<br \/>\nT\u1eeb ppm chuy\u1ec3n v\u1ec1 n\u1ed3ng \u0111\u1ed9 ph\u1ea7n tr\u0103m ch\u1ec9 c\u1ea7n d\u1ecbch d\u1ea5u ph\u1ea9y v\u1ec1 ph\u00eda TR\u00c1I 4 ch\u1eef s\u1ed1.<br \/>\n(ppm lu\u00f4n lu\u00f4n l\u1edbn h\u01a1n n\u1ed3ng \u0111\u1ed9 %)<\/p>\n<p>N\u1ed3ng \u0111\u1ed9 ppb c\u00f3 m\u1ed1i li\u00ean h\u1ec7 v\u1edbi n\u1ed3ng \u0111\u1ed9 % t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ppm.<br \/>\n1 ppb l\u00e0 m\u1ed9t ph\u1ea7n ch\u1ea5t c\u1ea7n ph\u00e2n t\u00edch tr\u00ean m\u1ed9t t\u1ef7 ph\u1ea7n m\u1eabu ph\u00e2n t\u00edch.<br \/>\n1 ppb = 1\u03bcg\/kg<br \/>\nQuy \u0111\u1ed5i %. T\u1ef7 l\u1ec7 ph\u1ea7n tr\u0103m c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ednh theo kh\u1ed1i l\u01b0\u1ee3ng %(weight\/weight) hay %(w\/w) : s\u1ed1 gam ch\u1ea5t c\u1ea7n ph\u00e2n t\u00edch trong 100 gam m\u1eabu ph\u00e2n t\u00edch:<\/p>\n<ul>\n<li>%(w\/w) = (s\u1ed1 gam ch\u1ea5t ph\u00e2n t\u00edch \/ s\u1ed1 gam m\u1eabu) X 100<\/li>\n<li>Ph\u1ea7n tr\u0103m kh\u1ed1i l\u01b0\u1ee3ng\/th\u1ec3 t\u00edch %(weight\/volume) hay %(w\/v).<\/li>\n<li>%(w\/v) = (s\u1ed1 gam ch\u1ea5t c\u1ea7n ph\u00e2n t\u00edch \/ 100 ml m\u1eabu ph\u00e2n t\u00edch) X 100<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>1. Gi\u1edbi thi\u1ec7u \u0110\u1ed9c ch\u1ea5t trong th\u00fa y S\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t \u0111\u1ed9c \u0111\u00e3 t\u1ed3n t\u1ea1i t\u1eeb khi c\u00f3 con ng\u01b0\u1eddi. Trong c\u00e1c cu\u1ed9c \u0111i s\u0103n v\u00e0 tranh gi\u00e0nh gi\u1eefa c\u00e1c b\u1ed9 t\u1ed9c, con ng\u01b0\u1eddi \u0111\u00e3 bi\u1ebft s\u1eed d\u1ee5ng m\u0169i t\u00ean \u0111\u1ed9c \u0111\u1ec3 gi\u00e0nh chi\u1ebfn th\u1eafng v\u00e0 ta c\u00f3 th\u1ec3 cho r\u1eb1ng s\u1eed d\u1ee5ng \u0111\u1ed9c [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2245","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2245","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/comments?post=2245"}],"version-history":[{"count":0,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2245\/revisions"}],"wp:attachment":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/media?parent=2245"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/categories?post=2245"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/tags?post=2245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}