DOI 10 312 76 VJST 64( 12) 19 23 Khoa hoc Y DUdc I Y hoc lam sang m Hieu qua cua mot $6 bien phap can thiep che do an va loi song den hoi Chung chuyen hoa o’ ngiroi 25 64 tuoi tai tinh Thai Binh Pham[.]
DOI: 10.312 76 VJST.64( 12) 19-23 Khoa hoc Y - DUdc I Y hoc lam sang m Hieu qua cua mot $6 bien phap can thiep che an va loi song den hoi Chung chuyen hoa o’ ngiroi 25-64 tuoi tai tinh Thai Binh Pham Thj Van Anh1*, Le Dire Curing2, Ninh Thi Nhung2 1Trung tam K iem so a t Berth tat Thai B inh :Truang D a i hoc Y D u o c Thai B inh N g a y n h a n b a i /1 /2 2 ; n g a y c h u y e n p h a n b ie n /1 /2 2 ; n g a y n h an p h an b ie n /1 /2 2 ; n g a y c h i p n h an d a n g /1 /2 2 Tom tat: Nghien cun nham danh gia hieu qua cua mot s6 bien phap can thiep den hoi chung chuyen hoa (HCCH) tren 184 ngiroi tu* 25 den 64 tuoi tai xa cua tinh Thai Binh tir thang 8/2020-1/2021 Ket qua sau can thiep bang truyen thong, che an, tap luyen the due cho thay, ty le mac HCCH o’ nhom can thiep giant tir 100 xuong 63,7%, hieu qua can thiep dat 13,7%, trung binh so yeu to cua HCCH giam 0,63±0,10 Gia tri trung binh cac chi so mau sau can thiep cho thay, trung binh glucose mau giam 0,36±0,17 mmol/1, HDL-C mau tang 0,126±0,047 mmol/1, triglycerid mau giam 0,25±0,12 mmol/1 Can thiep co hieu qua giam ty le m lc HCCH va giam cac yeu t6 phan HCCH Tir khoa: hieu qua can thiep, hoi chirng chuyen hria, Thai Binh, 25-64 tuoi Chi so nhan loai: 3.2 H tv & n a e H C C H la m o t tr o n g n h u n g v a n d e s u e k h o e c o n g d o n g d u g c q u a n ta m n h a t h ie n n a y H o i c h u n g n a y la m o t t o h o p c a c y e u to g rim t a n g g l u c o s e m a u , t a n g h u y e t a p , rrii lo a n m o m a u (t a n g t r ig ly c e r id , g ia m H D L - C ) v a b e o p h i tr u n g ta m ( b e o b u n g ) N g h i e n c u u d u g c t h u c h ie n tir t h a n g / 2 d e n th a n g / 2 ; th u c h ie n c a c b ie n p h a p c a n t h ie p tr o n g t h a n g c o d a n h g i a ta i c a c th rii d ie m : M la thrii d ie m b a t d a u c a n t h ie p (t h a n g /2 ) ; M la thrii d ie m k e t t h u c th a n g c a n t b ie p (t h a n g / 2 ) Thiet ke nghien ciru H C C H k h r in g c h i g ia t a n g a c a c th a n h phri ld n , m a c a c tin h k h u v u c D o n g b a n g s o n g H o n g n h u T h a i B in h c u n g c o t y le m a c N g h i e n ciru c a n t h ie p c r in g d o n g c o d d i c h u n g t r o n g t h o i H C C H n g a y c a n g g ia ta n g N g h i e n c u u tr e n d rii tuqm g v u n g n rin g thrin h u y e n V u T h u d o tu o i - n a m c h o th a y , t y l e m a c H C C H c h u n g la ,6 % [1 ] , N a m t y le m a c H C C H c u a n g u d i b e n h d ie u tri nrii tru ta i K h o a N o i , B e n h v ie n D a k h o a Q u y n h P h u la ,4 % [2 ] , g ia n th a n g c o d a n h g ia t iu o c , sa u c a n th ie p c h o n h u n g n g u d i - tu o i d u g c c h ia la m n h o m : c a n t h i e p v a d i c h ii n g T a i th rii d ie m tru ric c a n t b ie p , d o i t u o n g n g h ie n c u u o c a nhom d u g c k ie m tra c a n n a n g , c h ie u c a o , d o v r in g e o , v r in g m o n g h u y e t a p , p h o n g v a n t im c a c y e u t o n g u y c a c u a H C C H t h e o C a c n g h ie n c u u v e c a n th ie p b a n g c h e d o a n , l o i s o n g d e c a i b o c a u h o i S T E P S c u a T o c h u c Y t e T h e g ir ii v a la m c a c x e t th ie n tin h tr a n g H C C H d a d u g c t ie n h a n h a n h ie u n u a c tr e n th e n g h ie m m a u n h u trig ly cerid h u y e t th a n h , H D L -C , g lu c o s e m a u lu c g id i , tr o n g d o ta p tr u n g t a n g c u r in g u q u a , n g u cric t o a n p h l n , d o i S a u d o ap d u n g c a c b ie n p h a p c a n th ie p tro n g han c h e ch a t b e o b a o h o a , ta n g ch a t b e o k h o n g b a o h o a , h a n ch e N h o m ca n th iep : m u o i v a d a t c a n b a n g n a n g l u g n g a m tin h c h o th a y r o s u c a i th ie n c a c y e u t o c a u th a n h H C C H v a g ia m t y le m l c H C C H T u d o la m g ia m v i e c t ie n tr ie n tir H C C H s a n g c a c b e n h m a n tin h k h o n g li e n q u a n trii d in h d u r in g n h u t im m a c h , d a i t h a o d u r in g , u n g th u [ ] , D o d o , v i e c n g h ie n c u u h ie u q u a c u a c a c b ie n p h a p c a n th ie p c h e d o a n , l o i s o n g n h a m c a i t h ie n H C C H ri n g u r ii Doi turrng N g h i e n c u u d u g c t h u c h ie n ri n h u n g n g u r ii - t u o i m l c H C C H ta i x a th u ric tin h T h a i B in h : x a c a n th ie p la M in h L ang, h u yen V u T h u va P h on g C hau, h u yen D o n g H ung; xa H u n g , tin h T h a i B in h d a p u n g c a c t ie u c h u a n c h g n m a u , d u g c t u v a n , t h e o d o i, g ia m sa t t h u c h ie n d ie u c h in h c h e d o a n t h e o t h u c d o n d u g c x a y d u n g b rii c a c c h u y e n g ia , tr u y e n t h o n g th a y d o i lo i s o n g , h u r in g d a n c h e d o ta p lu y e n tr o n g N hom doi chung: L a n h u n g n g u r ii - t u o i d a n g s o n g h u y e n K ie n X u o n g , tin h T h a i B in h d a p u n g c a c tie u c h u a n c h g n m a u d u g c t r u y e n t h o n g v e c h e d o d in h d u r in g v a t h a y d o i l o i s o n g t h e o c a c c h u o n g tr in h t h u c h ie n th u r in g q u y c u a x a , k h o n g d u g c a p d u n g b i e n p h a p d ie u c h in h c h e d o a n v a c h e d o lu y e n tap D a n h g i a k e t q u a q u a d ie u tra ta i c a c thrii d ie m s o s a n h tru ric s a u ri c a 'T a c g i a lie n h e: E m a il: p h a m a n h n ih e @ g m a il.c o m B S e H rtV riN am Mm h T r a n g , h u y e n Q u y n h P h u v a x a B in h N g u y e n , d o i c h u n g la Q u y n h T r a n g , h u y e n Q u y n h P h u v a B in h N g u y e n , h u y e n K ie n X u o n g L a n h u n g n g u r ii - t u o i d a n g s o n g ta i x a M in h L a n g , h u y e n V u T h u v a x a P h o n g C h a u , h u y e n D o n g - t u o i ta i tin h T h a i B in h la rat c a n th ie t ■ ii tuning va phnnng phap nghien cini th ang: 19 V i^ c o n h rim v a s o s a n h n h o m c a n rtHgp w n Khoa hoc Y - DUOc I Y hoc lam sang k h o n g c o d a n , h u y e t a p d o b a n g h u y e t ap d ie n t u d u n g Effectiveness o f som e dietary and lifestyle interventions for m etabolic syndrom e in people aged 25-64 years old in Thai Binh province M l u m a u d u p e la y v a o b u d i s a n g s a u k h i d a n h in a n t r a d e d o It n h i t g id C a c c h i s o g l u c o s e m a u , tr ig ly c e r id , H D L - C d u p e d o b a n g m a y p h a n t ic h t u d o n g d u p e k ie m c h u a n /k ie m d in h d o c a c b a c s y , k y th u a t v ie n ta i T r u n g tarn K i e m s o a t B e n h ta t T h a i B in h Thi Van Anh Pham1*, Due Cuong Le2, Thi Nhung Ninh2 ‘Thai B inh C enters f o r D isease C ontrol a n d P revention 2Thai B inh U niversity o f M edicine a n d P harm acy co b a n g q u a n c a n h t a y v a p in T r o n g n g h ie n c u u n a y , H C C H d u p e x a c d jn h t h e o tie u c h u a n c h a n d o a n x a c d in h H C C H t h o n g n h a t c u a H i e p h o i d a i th a o d u d n g q u o c t e V ie n q u o c g i a v e c a c b e n h tim , p h o i, m a u , H i e p h o i t im m a c h M y H ie p h o i t im m a c h t h e g id i , H i e p h o i x o R e c e iv e d 17 O c to b e r 2 ; a c c e p te d 14 N o v e m b e r 2 Abstract: v u a d o n g m a c h t h e g i d i H o i n g h ie n c u u b e o p h i q u o c t e (n a m 0 ) N h u n g ngu cri d u p e x a c d jn h m a c H C C H k h i c o /5 y e u The study aimed to assess the effectiveness of interventions on metabolic syndrome (MetS) in 184 people aged 25-64 years old in communes of Thai Binh province from August 2020 to January 2021 Results after the intervention by means of communication, diet, and exercise showed that after the interventions the prevalence of MetS decrease from 100 to 63.7%, and the intervention effectiveness was 13.7% The mean of MetS components decreased by 0.63±0.10 Comparing the blood indexes before and after the intervention, the mean of glucose decreased by 0J6±0.17 mmol/1, the mean of high density lipoprotein cholesterol (HDL-C) increased by 0.126±0.047 mmol/1, and the mean of triglyceride decreased by 0.25±0.12 mmol/1 Interventions have the effect of reducing the syndrome rate and its components t o ( v o n g e o > c m d n a m , > c m d n u ; n o n g d o t r ig ly c e r id m a u lu c d o i > ,7 m m o l/1 ; H A tarn th u > m m H g v a /h o a c h u y e t a p ta m tru em g > m m H g ; n o n g d o H D L - C < m m o l/1 d n a m v a < m m o l/1 d n u ; n o n g d o g l u c o s e m a u lu c d o i > ,6 m m o l / Phan tich thong ke S o li e u d u p e n h a p v a la m s a c h b a n g p h a n m e m E p iD a ta v a p h a n t ic h b a n g p h a n m e m S P S S C a c b ie n d in h lu p n g d u p e b ie u d ie n t h e o tr a n g b in h ± d o le c h c h u a n d u p e s o sa n h b a n g k ie m d in h b a n g c a c t e s t t h o n g k e P h a n t i c h s o li e u d u p e t i l n h a n h t a i th d i d ie m d ie u tra b a n d a u v a s a u th a n g a p d u n g c a c b ie n p h a p c a n t h ie p C h i s o h ie u q u a v a h ie u q u a c a n th ie p d u p e tin h n h u sau : - C h i s o h ie u q u a d u p e tin h t h e o c o n g th u c : Keywords: intervention, metabolic syndrome, Thai Binh, 25-64 years old CSHQ(%) = |Pi - P2 I x 100 Classification number: 3.2 tr o n g d o : C S H Q la c h i s o h ie u q u a ; P , la t y l e h ie n m a c H C C H ta i th d i d ie m t r a d e c a n th ie p ; P la t y le h ie n m a c H C C H ta i th d i d ie m s a u c a n th ie p n h o m d d i c h u n g ta i M v a M - H i e u q u a c a n th ie p : D o lu d n g p h a n tra m (% ) h ie u q u a c a n C o n g thutc tln h c o m a u (n ): th ie p n h d c h e n h le c h c h i s o h ie u q u a g i u a n h o m c a n th ie p v a d oi ch u n g l-q /2 V P ( l - P ) + Z \-p s l P i ~ P \ ) + P i - P i ) ] H Q C T (% ) = C S H Q nct - C S H Q ndc (.Pi - p i f tr o n g d o : H Q C T la h ie u q u a c a n th ie p ; C S H Q nct la c h i s o h ie u tr o n g d o : n: c o m a u t o i th ie u ; a la x a c s u a t c u a s a i la m lo a i I, c h o n m u c y n g h la t h o n g k e c t= ,0 (Z _d l = ,9 ) ; f c u a sa i la m lo a i II, c h o n - ^ = ,8 ( l u c m a u ) (Z la x a c su a t q u a c u a n h o m c a n th ie p ; C S H Q ndc la c h i s o h ie u q u a c u a n h o m doi ch u n g = ,9 ) ; p4 : tv le m a c H C C H tr a d e c a n th ie p ( p ^ O [4 ]); p 2: t y le m a c - C h i s d A R R ( A b s o l u t e r is k r e d u c tio n - g ia m n g u y c o tu y e t H C C H sa u c a n th ie p , k y v o n g g ia m % , p = ,3 ; n =88 d o i d d i): L a k h a c b ie t n g u y c o g i u a n h o m b ie u d ie n b a n g t y le tu p n g m oi nhom p h a n tr a m v a k h o a n g tin c a y % C I [5 ] A R R % = p0- p Thu thap so lieu C a c d a c tr a n g n h a n k h a u h o c , k in h te , x a h o i v a c a c y e u tr o n g d o : p la n g u y c o m i c b e n h tr o n g n h o m c h u n g , d u p e tin h t o lie n q u a n c u a d o i t u p n g d u p e th u th a p b a n g p h u o n g p h a p b a n g s d d d i t u p n g m d c b e n h d th d i d ie m s a u c a n th ie p c h ia c h o p h o n g v a n tr u e t ie p v d i b o c a u h o i t h ie t k e sa n C a n n a n g d u p e t d n g d o i t u p n g m d c b e n h d th d i d ie m tr a d e c a n th ie p n h a n v d i d o b a n g c a n d ie n tir S E C A v d i d o c h in h x a c ,0 k g , d o c h ie u 100 % ( d n h o m c h u n g ) ; p ] la n g u y c o m a c b e n h tr o n g n h o m c a n c a o d u n g b a n g th u d e g o m a n h , v o n g e o d o b a n g th u d e d a y th ie p , d u p e tin h b a n g s o d o i t u p n g m a c b e n h d th d i d ie m sa u 64( 12) 12.2022 20 Khoa hoc Y - DifOc I Y hoc lam sang c a n t h ie p c h ia c h o t o n g d o i tir o n g m a c b e n h a thcri d ie m t r u a c c a n t h ie p n h a n B in g Higu qua can thiep vdi trung binh huyet ap, vong eo 100 % ( d n h o m c a n th ie p ) Chi so Nhdm can thiep (n=91, X±SD) Nh6m doi chung (n=93, X4SD) P, M« 135,5418,3 131,5416,8 0,128 M 129,8411,2 134,8417,7 0,025 Chenh lech 5,624 2,10 -3,3441,60 P; 0,009 0,04 M» 88,9410,3 85,94410,35 0,076 m6 80,8412,7 82,64413,10 ,257 Chenh lech 8,0941,28 3,3141,16 Pi 0,000 0,005 81,7046,88 83,03±7,46 0,211 M6 79,8546,77 83,1746,79 0,001 Chenh lech 1,844 0,51 -0,1440,5 Pi 0,001 0,782 Thdi diem - C h i s o N N T ( N u m b e r n e e d e d to trea t - s o b e n h n h a n c a n d ir g e d ie u tri d e g ia m m o t c a b e n h ) d u o c tin h t h e o c o n g th irc [6]: Huyet ap tain thu n n t = l / ( p 0- P ]) tr o n g d o : p la n g u y c o m a c b e n h tr o n g n h o m c h u n g ; p , la n g u y co m a c b e n h tr o n g n h o m c a n th ie p ; p 0, p , d ir g e tin h n h ir tr o n g Huyet ap tam truemg ch i so A R R % Duo dire nghien cuu N g h ie n c u u d u g c th o n g q u a b b i H o i d b n g x e t d u y e t c u c m g c u a T r u o n g D a i h o c Y D u g c T h a i B in h D &k 6i t u g n g Vong eo n g h ie n c u u d a d u g c g ia i t h ic h v e m u c d ic h , n o i d u n g n g h ie n c u u , n h u n g rui ro v a q u y e n lg i d e tu n g u y e n k y g ia y d o n g y th a m g ia n g h ie n c u u Ghi chu: p,: so sanh nhom can thiep va d6i chirng cung o' cung thcri diem, si> dung kiem djnh Student T-test; p2: so sanh cung nhom b then d*6m trubc va sau can thiep, sir dung kiem djnh Paired sample T-test (Paired T-test i K6t qua Dye diem chung giam m ag xuong - = Q J E m m o l/1 ( c o y nghTa t h o n g k e ) V d i n h o m chung luoog g h m r m a u g ia m ( k h o n g c o y nghTa t h o n g ke) Luong darasr aaa tr o n g n h o m c a n t h ie p g ia m m m o l nfcriadSidaag g ia m ,3 m m o l/l ( c o y nghTa thdng ke) K e t q u a b a n g c h o th a y , s a u c a n t h ie p la m K e t q u a b a n g c h o th a y , k h o n g c o s u k h a c b ie t c o y nghTa t h o n g k e g iu a d a c d i e m c h u n g c u a d o i t u g n g n g h ie n c u u tr o n g n h o m c a n t h ie p v a d o i c h u n g Bang Oac diem doi tirowg tham gia nghien ciru can thi$p b in h l u g n g g l u c o s e m a u tir ,8 ± 5 m m o l l Bang Hieu qua can thi$p vdi mau cua doi tLrgng nghita cuu fife diem Nhom can thiep (trung binh ±SD, n=91) Nhom doi chvng (trong binh ±SD, n=93) (trung hinh 4SD, a=184) P Tuoi 51,3749,5 50,6149,4 50,99*9,45 >0,05 BMI 23,47±2,39 23,2442,51 23,3542,44 >0.05 Tiuoc c a h e p 5J*=L55 Huvet ap tam thu 135,46±18,28 131,49416,88 133,45417,65 >0,05 Glucose non S m io n fc ip 532=A E Huyet ap tam tracing 88,94412,29 85,94410,35 87,42411,42 >0,05 tnmgbioh C heafeiph Nhjp tim 81,6±11,2 80,7411,9 81,2411,5 >0,05 Vong eo 81,70±6,88 83,0347,46 82,3747,19 >0,05 Glucose 5,894=1,55 6,2842,24 6,0841,93 >0,05 HDL-C 1,074=0,28 1,0140,20 1,0440,24 >0,05 Trighcerid 2,63±1,38 2,7341,25 Chung 2,65±1,28 HDL-C trung binh >0,05 Ghi chu: p: so sanh trung binh giira nhom, Anova test Triglycerid trung binh b in h h u y e t a p tarn th u t u ,5 ± ,3 x u o n g ,8 ± 1 ,2 m m H g va h u y e t a p tarn t r u o n g g ia m t u 8 ,9 ± ,3 x u o n g ,8 ± ,7 m 0.036 0.0*5 Trade can thiep 1,074028 1.014020 0,13* Sau can thiep 1,1940,41 1,06±025 0.008 Chenh Ifch 0,1240,05 0,0540,03 Pi 0,008 0,130 Trade can thiep 2,6341,38 2,734125 0.K Sau can thiep 2,3840,71 2,5541,05 0.195 Chenh lech 0,2540,12 0,1840,15 Pi 0,041 0,254 Ghi chu: p,: so s3nh nhom can thiep va ddi chung cung a ding thcri diem, si>dung kiem djnh Student T-test; p2:so sanh cung nhom a then diem triroc va sau can thiep, sir dung kiem djnh Paired sample T-test m m H g ( c o y nghTa t h o n g k e ) V o i n h o m c h u n g , h u y e t ap ta m thu t a n g n h e , h u y e t Tning b in h v o n g e o s m u u a js P; Hieu qua can thiep den ty le mac HCCH K e t q u a b a n g c h o th a y , s a u c a n t h ie p la m g ia m tr u n g W H D L - C tr u n g b in h ta n g t u ,0 ± ,2 le n ,1 ± ,4 m m o l l a p ta m t r u o n g g ia m c o y n g h ia t h o n g k e v a c o y nghTa t h o n g k e V d i n h o m c h u n g , tr u n g b in h H D L - C g ia m t u ,7 ± ,8 c m x u b n g ,8 ± ,7 ta n g le n k h o n g c o y nghTa t h o n g k e T r u n g b in h H D L - C troog c m ( c o y nghTa t h o n g k e ) V o i n h o m d o i c h u n g , tr u n g b in h n h o m c a n th ie p ta n g , ± ,0 m m o l/1 , tr o n g n h o m d o i c h u n g vong e o t a n g ,0 ± ,0 m m o l/1 c o y nghTa t h o n g k e ta n g le n ( k h o n g c o y nghT a t h o n g k e ) SSsM GHt'vk Nam M,12) ,2M 22 21 Khoa hoc Y - DUOc I Y hoc lam sang T r ig ly c e r id tr u n g b in h g ia m t£r , ± ,3 x u o n g ,3 ± ,7 c h o t h i y , g i a tri tr a n g b in h h u y e t a p g ia m tir ,7 ± ,7 x u d n g t u i n c a n th ie p v a x u d n g ,9 ± ,2 m m o l/1 ( c o y n g h ia t h o n g k e ) V d i n h o m c h u n g , tr u n g b in h ,3 ± ,2 m m H g s a u t r ig ly c e r id g ia m m m H g s a u 12 tu a n c a n th ie p ; g i a trj tr u n g b in h h u y e t a p ta m khong co y n g h ia t h o n g k e T r u n g b in h t r ig ly c e r id d n h o m c a n th ie p v a d o i c h u n g k h o n g c o y nghTa t r a o n g g ia m t u ,7 ± ,6 x u d n g , ± 1 ,2 m m H g s a u th o n g k e v a x u d n g ,3 ± ,3 m m H g s a u 12 tu a n c a n t h ie p [7 ], S a u c a n th ie p , tr u n g b in h s o y e u td H C C H g ia m , ± ,1 c a o h o n c o y nghTa t h o n g k e s o v o i n h o m d o i c h u n g ( , ± , ) v a s o v o i t r a d e k h i c a n th ie p (b a n g ) tu a n B e o b u n g c o th e x e m la m o t c h i tie u q u a n tr o n g d e tie n lu p n g c a c v a n d e s u e k h o e lie n q u a n td i p h a n b o m o co th e c u n g n h u t h u a c a n b e o p h i C a c n g h ie n c u u t r a d e d a y d a c h u n g Bang So sanh trung binh so yeu to cua HCCH cua doi tirang nghien ciru trad e va sau can thiep m in h d u p e b e o b u n g la m o t tr o n g n h u n g co c h e b e n h s in h q u a n tr o n g c u a H C C H b d i b e o b u n g s e s a n x u a t n h ie u y e u t o n h u : T N F c u in t e r le u k in P A I -1 a d ip o n e c t in , a c id b e o t u d o la m r o i Chi s6 Nhom can thifp (n=91, X±SD) Thin diem Nh6m d6i chung (n=93, XdtSD) P, lo a n c h u y e n h o a v a li e n q u a n c h a t c h e d e n b e n h l y t im m a c h S a u c a n t h ie p tr u n g b in h v o n g e o d o i t u p n g tr o n g n h o m c a n Trung binh so yeu to Trucrc can thiep 3^9+0,54 3,46*0.69 0.054 Sau can thiep 2,66=1.04 3.14=1,15 0.003 C h eah lfch 0.63*4.10 032*4,13 P; 0,000 0,013 t h ie p g ia m ± ,5 c m , t u ,7 ± ,8 x u d n g ,8 ± ,7 c m ( c o y nghTa t h o n g k e ) G ia tri tr u n g b in h v o n g e o tr o n g n h o m d o i c h u n g t a n g , ± ,5 c m , t u ,0 ± ,4 le n ,1 ± ,7 c m ( k h o n g c o y nghTa t h o n g k e ) C a c n g h ie n c u u k h a c tr e n t h e g id i K e t q u a b a n g c h o th a y , s a u c a n t h ie p c o ,7 % d o i t u p n g c u n g c h o th a y , h ie u q u a c u a c a c c a n t h ie p la m g ia m g i a tr i tr a n g m a c H C C H d n h o m c a n t h ie p v a th a p hem s o v d i n h o m c h u n g b in h v o n g e o c u a d o i t u p n g m a c H C C H N g h i e n c u u c u a M ( 7 ,4 % ) H i e u q u a c a n th ie p la ,7 % H i e u q u a g ia m n g u y c o G u z m a n v a c s ( 2 ) [ 8] tr e n d o i t u p n g th u a c a n b e o p h i t u y e t d o i v d i h u y e t a p c a o la ,7 % v a c u d o i t u p n g d u p e m a c H C C H c h o th a y , s a u c a n th ie p 13 tu a n v o n g b u n g tr u n g c a n th ie p th i c o m o t d o i t u p n g k h o n g m ic H C C H s a u c a n th ie p b in h g ia m ,8 ± ,3 c m ( p < ,0 ) , s a u tu a n v o n g b u n g tr a n g b in h g ia m ,1 ± ,9 c m ( p < ,0 ) , s a u t u a n v o n g ( N T T * ,3 ) Bang Hieu qua can thiep thay doi ty le mac HCCH cua doi tiromg nghien cu>u trad e va sau can thiep HCCH Nh6m doi chrng (n=93) Nhom can thiep (n=91) So lujmg So lircmg % N g a y n a y , ta n g g l u c o s e m a u v a d a i t h a o d u r in g d a n g la % g l u c o s e m a u d u p e v i n h u k e g i e t n g u d i t h a m la n g K e t q u a tr o n g n g h ie n c u u c h o th a y , c a n t h ie p g ia tri tr u n g b in h g l u c o s e Tntctc can thiep 93 100 91 10( Sau can thiep 72 77,4 58 63, 22,6 Hieu qua can thiep (%) 13,7 b u n g g ia m s a u tu a n la ,5 ± ,7 c m ( p < ,0 ) [5 ] v a n d e q u a n tr o n g d u p e c o n g d o n g q u a n ta m , b d i sir ta n g Thin diem Chi so hieu qua (%) b u n g tr a n g b in h g ia m , ± ,6 c m ( p < ,0 ) , g i a tri v o n g 36,3 g ia m , ± ,1 m m o l/1 ( c o y nghTa t h o n g k e ) , tr o n g n h o m d o i c h u n g , g i a tri tr u n g b in h g l u c o s e g ia m , ± ,1 m m o l/1 ( k h o n g c o y nghTa t h o n g k e ) C a c n g h ie n c u u k h a c c u n g c h o t h a y h ie u q u a c u a c a c c h u c m g tr in h c a n t h ie p la m g ia m lu p n g ARR% 13,7 NNT 7,3 g lu c o s e m a u T r u o n g T u y e t M a i v a N g u y e n T h i L a m (2 ) [7 ] n g h ie n c u u tr e n d o i t u p n g t h u a c a n , b e o p h i c o H C C H ta i H a N o i c h o th a y , s a u c a n th ie p 12 tu a n , lu p n g g l u c o s e m a u g ia m , ± ,9 m m o l/1 , t u , ± ,9 x u d n g , ± , m m o l/1 , t y le C a c n g h ie n c u u tr o n g n u d e v a n u d e n g o a i d e u c h o th a y t a n g g l u c o s e m a u g ia m t u x u d n g ,7 % n h u n g k h o n g c o y h ie u q u a c u a c a c g ia i p h a p c a n t h ie p v e t r a y e n t h o n g , g i a o d u e n g h ia t h o n g k e N g h i e n c u u k h a c ta i M a la y s ia t ie n h a n h c a n s u e k h o e d in h d u r in g , ta p lu y e n g iu p g ia m t y l e m a c H C C H th ie p b a n g t u v a n v a g ia m s a t v e v a n d o n g tr e n d o i tu p n g T a n g h u y e t a p tr e n d o i t u p n g m a c H C C H la n g u y c o c a o v a y c a c b ie n c o t im m a c h , d o d o c a n t h ie p g ia m t y l e m a c v a o r a tri s o h u y e t a p la h e t s u e q u a n tr o n g T r o n g n g h ie n c u u a n y s a u c a n th ie p trj s o tr u n g b in h h u y e t ap tarn th u g ia m c o > a g j iia th o n g k e K e t q u a c a c n g h ie n c u u k h a c tr o n g v a n g o a i an; d h o m a c H C C H tr o n g tu a n c h o th a y , s a u c a n t h ie p lu p n g g l u c o s e m a u tr u n g b in h g ia m t u ,9 ± ,6 x u d n g ,4 ± , m m o l/1 d n h o m c a n th ie p ; d n h o m d o i c h u n g , lu p n g g l u c o s e m a u tr a n g b in h g ia m t u ,0 ± ,7 x u d n g , ± ,7 m m o l/1 , s u k h a c b ie t c o y nghTa t h o n g k e [9 ], k e t q u a t u o n g t y C a c n g h ie n c u u tr o n g v a n g o a i n u d e R o i lo a n lip id m a u c o m o i lie n q u a n c h a t c h e d e n H C C H n d h o t h i s s a u c a c c h u c m g tr in h c a n t h ie p , tri s o h u y e t a p ta m n g u d i c o H C C H t h u d n g g a y t a n g in s u lin , la m ta n g g i a i p h o n g t f e m a t a a i tr a c in g tr o n g n h o m c a n t h ie p g ia m N g h i e n c u u tren c a c a c id b e o t u d o tr o n g tu a n h o a n , la m ta n g x o v u a d o n g th a n h th iia c a n b e o p h i m a c H C C H ta i H a N o i m a c h , ta n g n g u y c o m a c b e n h t im m a c h K e t q u a tr o n g n g h ie n Meu to lien quan d nguen truong tai huvai \ u The Thai B ah ajaa 7013" Top chi Dmhduongva Thuc pkam 11(5} In 12-13 [2] Nguyen Vim Rnh dung kiem djnh Student T-test; p2:so sanh cung nhom a then diem triroc va sau can. .. tirowg tham gia nghien ciru can thi$p b in h l u g n g g l u c o s e m a u tir ,8 ± 5 m m o l l Bang Hieu qua can thi$p vdi mau cua doi tLrgng nghita cuu fife diem Nhom can thiep (trung binh ±SD,