As the older patients are, as the rate of hypertension is higher; in patients over 70 years of age, the rate of hypertension is 60%.. As the duration higher; in patients over 10 years of
Trang 1IV KET LUAN
Qua nghien cffli ve thffc trang ATVSTP tai
eac bep an tap the eua doanh nghiep d Hai
Dffdng ket qua eho thay:
- Dien tich cac bep an : Chiem 5 0 % cac phdng
che bien cd dien tich <iOOm^; chi cd 12% dien
tich >200m^; Dien tich phdng an tff 200-500m^
chiem ty le nhieu nhat ( 4 5 % )
- Chiem 4 4 % cac BATT chu'a dat yeu eau ve
nhffng qui dmh thii tuc hanh chinh
- Cd tdi 17,5% cae BATT khdng dat yeu cau ve
mang day dii bao hd lao ddng khi lam viee ; 2 0 %
BATT ngffdi phyc vu khdng sff dung dung cu
sach khi che bien
- t r e n cac mau xet nghiem deu thay cd ty ie
nhiem VSV trong dd ty le nhiem VSV tren ban tay
NPV la cao nhat: Coliform (72,5%); E.coli
(25,0%); S.au reus (32,5%)
T A I UEU T H A M K H A O
1 Cue An toan thu'c pham - Bp Y te (2005);
"Mdt so cong trinh nghien cffu ve ve sinh an toan thu'c pham Bp Y te HNKH an toan ve sinh thifc pham lan thff i l l Ha Ndi
2 Bui Vi The (2013), Tht/c trang an toan ve smh thUc pham, cdng tac quan ly va kien thffc, thi/c Thuy Nguyen, Hai Phong nam 2012, Luan van 1^ nghiep bac sT chuyen khoa I I , trUcfng (3ai hpc Y khoa Hai Phong, Hai Phong
J Pham Duy Tuyen (2010), thUc trang an toan v^ smh thu'c pham va cong tac quan ly mpt so cd sd djch vu an uong cong cpng tren dja ban thanh ph6 Hai DUPng nam 2010, Luan van thac sT y te cong cpng, tn/dng dai hpc Y khoa Hai Phong, Hal Phong
4 Nguyen Thj Van (2012), thifc trang an toan ve
sinh thUc pham, kien thffc, thai dp eiia ngffdi phyc
vu tai nha hang an udng quan Le Chan, Hal Phong nam 2012, luan van thac sT y te eong cong, tru'dng dai hoc Y khoa Hai Phong, Hai Phdng
5 CDC (2000) Foodborne illness, p 1-17
6 WHO (1997) Epidemiological Surveillance of Foodborne Diseases, Geneva
CHi s o HUYET AP VA LIPID MAU 6' BENH NHAN DAI T H A O DU'O'NG TYP
2 DIEU TRI NGOAI TRU TAI BENH VIEN KIEN AN H A I PHONG
T6M TAT
Nghien cffu du'dc tien hanh tren 123 benh nhan
dai thao dudng typ 2 dieu tri ngoai trii tai benh vien
kien An Hai Phong tff 01/2011 den 06/2011
Ket qua: Nhdm nghien cffu cd tuoi trung binh la
60,4 -I- 9,7; nff chiem 66,7% Ti le dai thao dUdng typ
2 CO tang huyet ap la 48,8%, fang huyet ap gd I:
ap giai doan I I I : 5,7%, Ti le nam bi tang huyet ap
nhieu hdn nff (63,4% so vdi 58,2%) Tuoi cang eao ti
le t§ng huyet ap cang nhieu; d benh nhan tren 70 tud'i,
t9 le tang huyet ap la 60% Thdi gian mac dai thao
mac benh tren 10 nam co ty le tang huyet ap la
66,7% 52,8% dai thao dirdng typ 2 cd tang
Cholesterol; 60,2% cd tang Tryglycerit; 32,5% cd tang
LDL; 39,2% benh nhan cd tang Cholesterol va
Tryglycerit va LDL Nhom dai thao dUdng typ 2 ket
mau cao hdn nhom khong cd tang huyet ap
* SdYte Hai Phdng
Trinh Thi Ly* va cdng sif
S U M M A R Y
BLOOD PRESSURE A N D L I P I D E M I A
I N O U T P A T I E N T W I T H TYPE I I DIABETES TREATED I N K I E N AN
H O S P I T A L H A I PHONG
The study was conducted on 123 outpatient with type 2 diabetes treated in Kien An hospital from 01/2011 to 06/2011
Results: The team has an average age of 50.4 + 9.7; women accounted for 66.7% The rate of type 2 stage I: 28.5%, hypertension stage I I : 14.6%, hypertension stage I I I : 5.7% Percentage of men with hypertension is more than women (63.4% versus 58.2%) As the older patients are, as the rate of hypertension is higher; in patients over 70 years of age, the rate of hypertension is 60% As the duration higher; in patients over 10 years of diabetes, the rate diabetes: 52.8% have Cholesterol increased; 60.2% have Triglycent increased; 32,5% have LDL increased; 39.2% have Triglycerit and Cholesterol increased; 26% have cholesterol, Triglycerit and LDL increased The
Trang 2type 2 diabetes combined with hypertension have the
rate of blood lipid metabolic disorders is more than the
group without hypertension
I DAT VAN DE
Tang huyet ap (THA) va dai thao du'dng
(DTD) la hai benh ly phd bien va hay gap phdl
hdp Tai Viet Nam, ty le benh nhan DTD dong
cho thay THA va DTD thu'dng song hanh vdi
nhau vi cd cung cac yeu t d nguy cP THA la mpt
yeu t d lam tang bien chffng ciia DTD, va ngu'de
lai DTD cung lam cho THA khd kiem scat hOn O
tienh nhan DTD typ 2, THA cd the xuat hien
trffdc khi DTD dffdc chan doan hoac ca hai dffdc
phat hien dong thdi trong benh eanh eiia hpi
chffng chuyen hda So vdi ngffdi DTD ddn thuaii,
than kinh, tang gap 2 lan nguy cd benh vdng
m?c, benh than man va tff vong do mpi nguyen
va tSng gap 4 lan nguy cd dot quy, Theo trung
cho thay cd khoang 7 0 % - 9 0 % benh nhan dai
thao dffdng tip 2 ed rdi loan lipid mau
Chinh vi vay, viec kiem soat huyet ap, lipid mau cung nhi/ du'dng huyet la nhffng van de then chdt ddi vdi benh nhan DTD typ 2, giiip lam cham tien trien ciia benh va ngan ngffa nhffng bien chihig mach mau
II DOI TUONG VA PHU'OTSJG PHAP NGHIEN CUD
2 1 O O I t u ' d n g : 123 benh nhan DTD typ 2 dieu tri ngoai tru tai benh vien Kien An tff 01/2011 den 06/2011,
2.2 Phu'dng i^ap nghien cffu: Md ta cat ngang
Benh nhan dffdc lay mau tTnh mach luc ddi
de dinh lu'dng: Glucose mau, Cholesterol toan phan, triglycerit, HDL, LDL
Oo huyet ap liie sang sdm (tff 4-6 gid sang),
liic cdn dang nam chffa day hoae ban ngay 6if6c
lan each nhau 3 - 5 phiit, lay trung binh eua huyet ap
2.3 Mot so t i e u c h u a n d u n g trong
n g h i e n c f f u :
- Chan doan dai thao dffdng theo WHO 1999;
- Chan doan THA: theo phan loai eua Uy ban phdng chdng huyet ap Hoa Ki (JNC VI)-1997
2.4 Xff ly so lieu nghien cu'u: Xff ly sd
lieu tren phan mem Epi - info
III K I T Q U A NGHIEN CLTU
Bang 1 Phan bd doi tffdng theo nhdm tud'i va gidi
Nhom tuoi
<40
40-49
50-59
60-69
> 70
1
Tuoi trunq binh
So benh nhan
1
13
46
38
25
123
Ti ie % 0.8
10.6 37.4 30.9 20.3
100
60,4 -I- 9,7
Nh$n x6t:l\iO\ trung binh eiia nhdm nghien effu la 60,4
- 49, chu yeu la d tudi tren 50
Bieu do 1: Phan bd ddi tffdng theo gidi
- 9,7; hiem gap d tud'i < 40, it gap d tuoi 40
Trang 3Bieu do 2: Chi so HA theo gidi
Niian xet: Ti le benh nhan cd THA chiem 48,8% Ti le nam bi THA nhieu hdn nff bj THA (63,4% so
vdi 58,2%, p<0,05)
Bieu tfo 3: Giai doan THA d ntiom nghiien cCru
28.5
30 -1 C ^
25
20
15
10 •
5 •
0 • ^
14.6
5.7
I J- y
THA gdi THAgdll THAgdlll Giai doan
Nhan xet: 0 benh nhan dai thao dffdng typ 2, hay gap nhat la THA giai doan I (28,5%), sau den THA
giai doan II (14,6%), it gap nhat la THA giai doan III (5,7%)
Bang2.T\ le THA theo nhdni tud'i d benh nhan dai thao dffdng typ 2
Nhom tuoi
<49
50-59
60-69
> 70
So benh nhan dai
thao du'dng (n = 123)
14
46
25
Benh nhan STS co THA
So BN (n = 60)
3
22
15
Ti ie »/o
21,4 52,6
P
<0,05
<0,05
Nhan xet: Benh nhan dai thao dffdng typ 2, tudi cang cao ti le THA eang nhieu, sff khac biet cd y
nghia thong ke vdi p < 0,05 a benh nhan tren 70 tudi, ty le THA len tdi 60%
Bang 3 Cn so HA iien quan den thdi qian
Thdi gian CTB
So benh nhan bi DTO
• (n = 123) •
B^nh nhan bi SoBN
< 1 nam
(n = 16)
16
4
phat hien dai thao du'dnq tvp 2
1 - 5 nam
(n = 51)
51
25
5 - 1 0 nam
(n = 44)
44
23
> 10 nam (n = 12)
12
S
Trang 4(n = 60)
Nhan xet: Benh nhan dai thao du'dng typ 2 co thdi gian mac benh cang dai thi ti le bi THA cang cao,
su" l(hac biet co y nghia thong l<e vdi p < 0,05 6 benh nhan mac benh tren 10 nam cd ty ie THA len tdi 66,7%
Bang 4 Roi loan chuyen hoa Lipid mau d benh nhan dai thao du'dng typ 2
Lipid mau
( m m o i / l )
Cd roi loan chuyen hoa Lipid mau
Khdng roi loan chuyen hoa Lipid mau
Tang Cholesterol
Tang Tryglycerit
Giam HDL
Tang LDL
Tang ca Cholesterol va Tryglycerit
Tanq ca Cholesterol, Tryqiycerit va LDL
So benh nhan ( n = 1 2 3 )
90
65
11
49
32
Ti le «/o
73,2 28,8 60,2
8,9
32,5 39,2
26%
Nh$n xet: 52,8% benh nhan dai thao du'dng typ 2 c6 tang Cholesterol; 60,2% benh nhan cd tang
Tryglycerit; 32,5% benh nhan cd tang LDL; 39,2% benh nhan cd tang Cholesterol va Tryglycerit; 26% benh nhan cd tang Cholesterol, Tryglycerit va LDL
Bang 5 Roi loan
Lipid mau
( m m o i / l )
Tanq Cholesterol
Tanq Tryglycerit
Giam HDL
Tanq LDL
chuyen hoa Lipid Tiau d benh nhan DTD cd THA
Nhom OTO CO THA ( n = 6 0 )
So benh nhan
35
41
7
22
Ti le %
58,3 68,3 11,7 36,7
va khdnq THA
Nhom OTO khong THA ( n = 6 3 )
S d b e n h nhan
30
33
4
18
Ti ie »/o
47,6 52,4 6,3 28,6
P
< 0,05
< 0 , 0 5
< 0,05
< 0 , 0 5
Nhan xet: Benh nhan dai thao du'dng typ 2 cd THA cd ty le rdi loan chuyen hoa Lipid mau cao hdn
benh nhan khong cd THA
IV KIT LUAN
Benh nhan dai thao du'dng typ 2 dieu tri
ngoai tru tai benh vien Kien An cd tuoi trung binh
la 60,4 + 9,7; niJ chiem 66,7%, gap 2 ian nam
Ti le dai thao du'dng typ 2 cd THA chiem
48,8% Hay gap nhat la THA giai doan I (28,5%),
sau den THA giai doan I I (14,6%), it gap nhat la
THA giai doan I I I (5,7%) Benh nhan nam cd ty le
bi THA nhieu hdn nff (63,4% so vdi 58,2%)
Tuoi cang cao ti le THA cang nhieu; d benh
nhan tren 70 tuoi, ty le THA ien tdi 60%
Benh nhan dai thao difdng cd thdi gian mac
tj^nh cang lau thi ti le bi THA cang cao; d benh nhan
mSc b?nh tren 10 nam cd ty leTHA len tdi 66,7%
52,8% dal thao du'dng typ 2 cd tang
Cholesterol; 60,2% cd tang Tryglycerit; 32,5% cd
tSng LDL; 39,2% benh nhan cd tang Cholesterol
va Tryglycerit; 2 6 % benh nhan cd tang
Cholesterol, Tryglycerit va LDL
Nhdm dai thao dudng typ 2 kem theo THA cd
ty le rdi loan chuyen hoa Lipid mau cao hdn nhdm khdng cd THA
TAI LIEU T H A M KHAO
1 Nguyin Thi Thu Thao (2013), Chuyen tfe roi loan lipid mau d benh nhan dai thao dudng - nguy
CO tCr vong do dot quy va cac bien co tim mach
2 Oo Thi Tinh, Tran Thj Mai (2001), Bien chirng thudng gap cua dai thao duOng tai benh vien Viet Tiep - Hal Phong Ky yeu cac de tai nghien CLTU Nam Bn thd nhat, Tr 306 - 316
3 Nguyin Lan Viet (2007), Tang huyet ap, Benh tim mach, Nha xuat ban Y hoc, Tr 135 - 172
4 Bottemann P, Clasen M (1991), Diabetes mellitus and artenal hypertension V 46, p 558 - 562,
5 Sing H - RB (1998), Prevanlence of type diabetes mellitus and risk of hypertension an coronary artery disease in rural and urban population with low rate of obesity Cardial, sep, V 1, p 65-72,
6 Lewington S et al (2013), standards of medical carestandards of medical care in diabetes