Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân hội chứng mạch vành cấp được can thiệp động mạch vành qua da tại Bệnh viện Đa khoa Trung ương Thái Nguyên (Luận văn thạc sĩ)
TR Chuyeen ngành : NT 62.72.20.50 N THÁI NGUYÊN 2015 i L c hi n t i B nh vi n i gian h nh vi n - ih pv ib tk li u lu a c b t k m Nguy ii L IC Trong su c t nhi u s ,t c u ki n c p th ng nghi p l ic c t i: ng o b ph ih c i h c u ki n thu n l ct u ih cY yb su t th i gian h c t u ki u c bi c t i: PGS.TS Nguy n Ti ih cY i ng t ib i th u h c BSNTBV - c B nh vi ng B ng d t ng ih ng d c u TS Nguy n Tr ng Hi u khoa ng khoa Tim m ch B nh vi ng B h - r t nhi u th ct i th y tr c ti b i ng d ng d ct c t i: iii TS Ph B ng d y, t u ki n t t nh t ct u m h c ng ch m lu p th hoa N i Tim m ch B nh vi p th th n Tim m ch Vi t Nam, Vi nhi ,t ng d y, u ki c t p Cu ct ib m nh ng nghi ct Nguy iv DANH M C CH ACC VI T T T ch Hoa k (American College of cardiology) ADA : Hi p h ng Hoa k (American Diabetic Association) AHA : H i tim m ch Hoa k (American Heart Association) ASE :H ch Hoa k (American Society Echocardiography) BMI : Ch s kh (Body mass index) BN :B CABG : B c c u n i ch (Coronary Artery Bypass Grafting) CCS: : H i tim m ch Canada (Canadian Cardiology Society) CCU c pc (Coronary care unit) CVD : B nh tim m ch (Cardiovascular disease) CHD :B ng m (Coronary heart disease) ESH :H (European Society of Hypertension) ESC : H i tim m (European Society of Cardiology) v EF :P (Ejection fraction) tt Dd Ds ng m t ng nh ng HDL-C : Lipoprotein Cholesterol t tr ng cao (High density lipoprotein cholesterol) HCMVC : H i ch ng m p HATT : Huy HATTr : Huy LDL-C : Lipoprotein Cholesterol t tr ng th p (Low density lipoprotein cholesterol) LAD ng m c (Left anterior descending) LCX ng m (Left circumflex artery) LV : Th (Left ventricle) LVEF tt a th (Left ventricular ejection fraction) h th (Left ventricular end diastolic diameter) (Left ventricular end systolic diameter) MSCT :Ch p c t l (Multislice computer tomography) vi NMCT : Nh NMCTSTC : Nh NMCTKSTC : Nh PCI : Can thi ng m (Percutaneous coronary intervention) PAD :B ng m ch ngo i vi (Peripheral arterial disease) ng m i (Right coronary artery) RLNT : R i lo n nh p tim SPECT :X tl p (Single photon emission computed tomography) THA TT : Th Vd : Th Vs : Th YTNC :Y ut WHO : T ch c Y t th gi i WPW : H i ch ng Wolf- Parkinson- White vii M CL C 1.2 .8 12 1.4 26 1.5 27 : 30 30 31 31 31 33 45 46 47 47 50 50 50 59 64 viii 64 71 77 78 79 80 81 ix DANH M i Vs theo Teicho 41 41 U THAM KH O A u Ti ng Vi t Nguy ng qui s d t Anh (2012), , t b n Y H c,tr 349-440 Hu nh Qu (2013), "K t qu u ch ng m i ch ng m ch p t i B nh Vi n Tim m ch An Giang t 7-9/2013",K y u H i Ngh Khoa h c B nh vi n An Giang, S , tr 143-150 ng d n ch Nguy n Qu c Anh (2011), tr b nh n i khoa, u t b n Y h c,tr 213-216 Ph m Gia Kh i (2008), Khuy can thi ng m H i tim m ch h c Vi t Nam,tr 517-519 Ph m Gia Kh i (2012), t b n Y h c,tr.169-170 Ph m Gia Kh t Linh (2011), " m ts y ut gi can thi ng n u n t l t vong sau 48 a",Tim m ch h c Vi t Nam, 58,tr ng m 44-52 i (2008), , ch ng h c c a tim b i, Ph m Gia Kh i, Nguy "Kh s Tei tr.52-206 t, Ph (2006), b p".Tim m ch h c Vi t Nam, 43 tr.16-22 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C B U KHOA H C 1.H 2.Gi i: Nam (1) N (2 3.Tu i:65 (3); Ngh nghi (1) Ngh (2) ; (3) [BB,KD,NT] c: Kinh (1) ; Thi u s (2) a ch : (1) (2) n: n: Th n vi n: c 12h: 12-24h: > 24h: 10 Ch 1.HA: : c can thi p( p( ng: (b (1) Nh p Tim: (2) / / kg) mmHg) (kg/m2) BMI c can thi p: c N (1) (2) c sau can thi gi m (1) (2) (1) - Sau can thi Ran m 9.Ph (2) m? (1) (2) ph i: suy tim theo kilip Kilip1 Kilip2 Kilip Kilip : m hay b (1) (2) gi m (1) B (2) (3) V C : c/sau can thi p (mmol/l) c/sau can thi p (mmol/l) HDL- c /sau can thi p (mmol/l) LDL- c/sau can thi p (mmol/l) sau can thi HbA1C -c ? (1) c/sau can thi p (%) (1) (2) (2) c/sau can thi p (mmol/l) : CK, CK-MB, hs- ECG: (t n s : ck/p) R i lo n nh p c can thi p Sau can thi p K t qu ch p m u can thi ( - c can thi p: -Vd,Vs: -EF: -R i lo n v L A AO LV Dd Ds Vd Vs FS EF RV TSTT D S VLT D S - Sau can thi p: L A AO LV Dd Ds Vd Vs FS EF RV TSTT D S VLT D S VI Ti n s u tr * + Th +S Ti n s *B (1) (1) : (2) (2) ( (1) (2) c ph i: Th i gian +B cb VII Y u t c: ng: Y u t GD: Th (1) (1) (1) (1) (1) (1) K (2) (2) (2) (2) (2) (2) HV Nguy ... ng nghi ct Nguy iv DANH M C CH ACC VI T T T ch Hoa k (American College of cardiology) ADA : Hi p h ng Hoa k (American Diabetic Association) AHA : H i tim m ch Hoa k (American Heart Association)... ASE :H ch Hoa k (American Society Echocardiography) BMI : Ch s kh (Body mass index) BN :B CABG : B c c u n i ch (Coronary Artery Bypass Grafting) CCS: : H i tim m ch Canada (Canadian Cardiology... sau can thi B ng 3.26 Ch s E gi i th ab i ch 62 pc c can thi p 63 TV B , [18], [15] ( ( p N (NMCTSTC) (NMCTKSTC nh ( [30], [67] a HCMVC [60] [49], [65], [71] ( (CABG), qua da