{"id":3889,"date":"2017-05-04T20:33:21","date_gmt":"2017-05-04T20:33:21","guid":{"rendered":"https:\/\/lpfch.org\/bad-for-the-bone-the-toll-of-childhood-chronic-disease\/"},"modified":"2024-02-14T14:07:38","modified_gmt":"2024-02-14T14:07:38","slug":"bad-for-the-bone-the-toll-of-childhood-chronic-disease","status":"publish","type":"post","link":"https:\/\/lpfch.org\/vi\/impact-stories\/bad-for-the-bone-the-toll-of-childhood-chronic-disease\/","title":{"rendered":"C\u00f3 h\u1ea1i cho x\u01b0\u01a1ng: H\u1eadu qu\u1ea3 c\u1ee7a b\u1ec7nh m\u00e3n t\u00ednh \u1edf tr\u1ebb em"},"content":{"rendered":"

B\u00e1c s\u0129 Mary Leonard \u0111ang ch\u1ec9 v\u00e0o \u1ea3nh ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) c\u1ed9t s\u1ed1ng c\u1ee7a m\u1ed9t ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i t\u1eebng \u0111\u01b0\u1ee3c gh\u00e9p t\u1ee7y x\u01b0\u01a1ng khi c\u00f2n nh\u1ecf. \u201c\u0110\u1ed1t s\u1ed1ng \u0111\u00f3 b\u1ecb ch\u00e8n \u00e9p,\u201d Leonard, gi\u00e1o s\u01b0 nhi khoa v\u00e0 y h\u1ecdc, \u0111\u1ed3ng th\u1eddi l\u00e0 ph\u00f3 hi\u1ec7u tr\u01b0\u1edfng ph\u1ee5 tr\u00e1ch nghi\u00ean c\u1ee9u s\u1ee9c kh\u1ecfe b\u00e0 m\u1eb9 v\u00e0 tr\u1ebb em, cho bi\u1ebft. \u201cNh\u1eefng b\u1ec7nh nh\u00e2n \u1edf \u0111\u1ed9 tu\u1ed5i thi\u1ebfu ni\u00ean ho\u1eb7c \u0111\u1ea7u 20 th\u01b0\u1eddng b\u1ecb g\u00e3y x\u01b0\u01a1ng ki\u1ec3u nh\u01b0 \u1edf ng\u01b0\u1eddi gi\u00e0.\u201d<\/p>\n

Ng\u0103n ng\u1eeba g\u00e3y x\u01b0\u01a1ng do lo\u00e3ng x\u01b0\u01a1ng s\u1edbm \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 tr\u1ea3i qua c\u00e1c b\u1ec7nh m\u00e3n t\u00ednh th\u1eddi th\u01a1 \u1ea5u l\u00e0 m\u1ee5c ti\u00eau tr\u1ecdng t\u00e2m trong ch\u01b0\u01a1ng tr\u00ecnh nghi\u00ean c\u1ee9u c\u1ee7a Leonard. B\u00e0 v\u00e0 c\u00e1c \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 ghi nh\u1eadn c\u1ea5u tr\u00fac x\u01b0\u01a1ng, kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 v\u00e0 s\u1ee9c m\u1ea1nh c\u01a1 b\u1ea5t th\u01b0\u1eddng \u1edf tr\u1ebb em v\u00e0 thanh thi\u1ebfu ni\u00ean m\u1eafc c\u00e1c b\u1ec7nh t\u1eeb ung th\u01b0 \u0111\u1ebfn b\u1ec7nh Crohn v\u00e0 gh\u00e9p t\u1ea1ng. T\u00ecnh tr\u1ea1ng b\u1ea5t \u0111\u1ed9ng, vi\u00eam nhi\u1ec5m, k\u00e9m h\u1ea5p thu ch\u1ea5t dinh d\u01b0\u1ee1ng v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng x\u1ea1 tr\u1ecb ho\u1eb7c steroid \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m cho s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a x\u01b0\u01a1ng.<\/p>\n

\u201cCh\u00fang t\u00f4i tin r\u1eb1ng m\u1ed9t khi \u0111\u00e3 qua tu\u1ed5i d\u1eady th\u00ec, x\u01b0\u01a1ng s\u1ebd kh\u00f4ng th\u1ec3 ph\u1ee5c h\u1ed3i l\u1ea1i tr\u1ea1ng th\u00e1i ban \u0111\u1ea7u,\u201d Leonard n\u00f3i. \u201cT\u00f4i c\u1ea3m th\u1ea5y ch\u00fang t\u00f4i \u0111\u00e3 m\u00f4 t\u1ea3 v\u1ea5n \u0111\u1ec1 r\u1ea5t k\u1ef9, v\u00e0 gi\u1edd ch\u00fang ta c\u1ea7n ti\u1ebfn h\u00e0nh c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u1ec3 xem c\u00f3 th\u1ec3 l\u00e0m g\u00ec \u0111\u1ec3 c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe x\u01b0\u01a1ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y. Ch\u00fang t\u00f4i ch\u1ec9 mu\u1ed1n \u0111\u1ea3m b\u1ea3o r\u1eb1ng h\u1ecd b\u01b0\u1edbc v\u00e0o tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh v\u1edbi b\u1ed9 x\u01b0\u01a1ng t\u1ed1t nh\u1ea5t, ch\u1eafc kh\u1ecfe nh\u1ea5t c\u00f3 th\u1ec3 \u2013 v\u1edbi b\u1ed9 x\u01b0\u01a1ng b\u1ec1n v\u1eefng su\u1ed1t \u0111\u1eddi.\u201d<\/p>\n

C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh t\u1eadp th\u1ec3 d\u1ee5c, so s\u00e1nh b\u1ec7nh nh\u00e2n gh\u00e9p th\u1eadn theo ph\u00e1c \u0111\u1ed3 kh\u00f4ng d\u00f9ng steroid v\u1edbi nh\u1eefng ng\u01b0\u1eddi \u0111\u01b0\u1ee3c d\u00f9ng steroid v\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 th\u1eed nghi\u1ec7m c\u00e1c bi\u1ec7n ph\u00e1p can thi\u1ec7p b\u1eb1ng d\u01b0\u1ee3c ph\u1ea9m. T\u1ea1i m\u1ed9t trung t\u00e2m nghi\u00ean c\u1ee9u m\u1edbi c\u1ee7a Stanford tr\u00ean \u0111\u01b0\u1eddng Arastradero \u1edf Palo Alto, c\u1ea3 tr\u1ebb em m\u1eafc b\u1ec7nh m\u00e3n t\u00ednh v\u00e0 nh\u00f3m \u0111\u1ed1i ch\u1ee9ng kh\u1ecfe m\u1ea1nh s\u1ebd tr\u1ea3i qua ba l\u1ea7n \u0111\u00e1nh gi\u00e1: ki\u1ec3m tra s\u1ee9c m\u1ea1nh c\u01a1 b\u1eafp; qu\u00e9t DXA to\u00e0n th\u00e2n \u0111\u1ec3 \u0111\u1ecbnh l\u01b0\u1ee3ng x\u01b0\u01a1ng, c\u01a1 v\u00e0 m\u1ee1; v\u00e0 qu\u00e9t m\u1eaft c\u00e1 ch\u00e2n v\u00e0 c\u1ed5 tay b\u1eb1ng m\u00e1y XtremeCT th\u1ebf h\u1ec7 m\u1edbi nh\u1ea5t. Leonard cho bi\u1ebft, t\u1ed5ng li\u1ec1u b\u1ee9c x\u1ea1 t\u1eeb ba l\u1ea7n ki\u1ec3m tra n\u00e0y \u00edt h\u01a1n m\u1ed9t tu\u1ea7n ti\u1ebfp x\u00fac v\u1edbi b\u1ee9c x\u1ea1 n\u1ec1n khi s\u1ed1ng tr\u00ean Tr\u00e1i \u0111\u1ea5t.<\/p>\n

M\u00e1y XtremeCT l\u00e0 m\u1ed9t trong 10 m\u00e1y t\u01b0\u01a1ng t\u1ef1 \u1edf Hoa K\u1ef3, v\u00e0 l\u00e0 m\u1ed9t trong hai m\u00e1y duy nh\u1ea5t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 tr\u1ebb em m\u1eafc c\u00e1c b\u1ec7nh m\u00e3n t\u00ednh. \u201cT\u00ean c\u1ee7a n\u00f3 l\u00e0 HR-pQCT, nh\u01b0ng ch\u00fang t\u00f4i g\u1ecdi n\u00f3 l\u00e0 m\u00e1y hokey-pokey, v\u00ec b\u1ea1n \u0111\u01b0a tay ph\u1ea3i v\u00e0o; r\u1ed3i \u0111\u01b0a tay ph\u1ea3i ra,\u201d Leonard n\u00f3i. Mi\u1ec5n l\u00e0 b\u1ea1n kh\u00f4ng l\u1eafc m\u1ea1nh m\u00e1y \u2013 d\u01b0\u1eddng nh\u01b0 tr\u1ebb em d\u01b0\u1edbi 5 tu\u1ed5i qu\u00e1 hi\u1ebfu \u0111\u1ed9ng \u0111\u1ec3 \u0111\u01b0\u1ee3c qu\u00e9t \u2013 th\u00ec ch\u1ee5p CT \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao s\u1ebd cho c\u00e1i nh\u00ecn chi ti\u1ebft v\u1ec1 c\u1ea5u tr\u00fac x\u01b0\u01a1ng \u1edf tay v\u00e0 ch\u00e2n. \u201cQu\u00e9t m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng DXA cho b\u1ea1n bi\u1ebft l\u01b0\u1ee3ng x\u01b0\u01a1ng hi\u1ec7n c\u00f3, nh\u01b0ng kh\u00f4ng cho b\u1ea1n bi\u1ebft \u0111\u1ee7 v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng \u2013 \u0111\u1ed9 d\u00e0y, \u0111\u1ed9 x\u1ed1p v\u00e0 c\u1ea5u tr\u00fac vi m\u00f4 c\u1ee7a n\u00f3,\u201d b\u00e0 n\u00f3i. B\u1eb1ng c\u00e1ch so s\u00e1nh c\u00e1c h\u00ecnh \u1ea3nh tr\u01b0\u1edbc v\u00e0 sau khi qu\u00e9t t\u1eeb m\u00e1y HR-pQCT, \u201cch\u00fang ta th\u1ef1c s\u1ef1 c\u00f3 th\u1ec3 xem x\u00e9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111ang t\u00e1c \u0111\u1ed9ng nh\u01b0 th\u1ebf n\u00e0o \u0111\u1ebfn c\u1ea5u tr\u00fac v\u00e0 s\u1ee9c m\u1ea1nh c\u1ee7a x\u01b0\u01a1ng.\u201d<\/p>\n

Leonard nh\u1eadn th\u1ea5y hai h\u00e0m \u00fd t\u1eeb c\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u c\u1ee7a b\u00e0. Th\u1ee9 nh\u1ea5t, m\u1ed9t s\u1ed1 tr\u1ebb em m\u1eafc b\u1ec7nh m\u00e3n t\u00ednh c\u00f3 th\u1ec3 c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c h\u01a1n tr\u01b0\u1edbc v\u00e0 trong giai \u0111o\u1ea1n d\u1eady th\u00ec \u0111\u1ec3 c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3 v\u00e0 gi\u00fap ch\u00fang ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng t\u1ed1t h\u01a1n. B\u00e0 n\u00f3i: \u201cN\u1ebfu b\u1ea1n ch\u1edd \u0111\u1ebfn khi x\u01b0\u01a1ng c\u1ee7a tr\u1ebb ph\u00e1t tri\u1ec3n ho\u00e0n thi\u1ec7n m\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Crohn, ho\u1eb7c n\u1ebfu ch\u00fang kh\u00f4ng \u0111\u01b0\u1ee3c gh\u00e9p th\u1eadn cho \u0111\u1ebfn khi x\u01b0\u01a1ng ph\u00e1t tri\u1ec3n ho\u00e0n thi\u1ec7n, th\u00ec c\u01a1 h\u1ed9i v\u00e0ng \u0111\u00f3 c\u00f3 th\u1ec3 b\u1ecb b\u1ecf l\u1ee1\u201d. Th\u1ee9 hai, khi tu\u1ed5i th\u1ecd c\u1ee7a tr\u1ebb em m\u1eafc c\u00e1c b\u1ec7nh hi\u1ebfm g\u1eb7p v\u00e0 t\u1eebng g\u00e2y t\u1eed vong ng\u00e0y c\u00e0ng t\u0103ng, c\u00e1c b\u00e1c s\u0129 c\u1ea7n ph\u1ea3i l\u01b0\u1eddng tr\u01b0\u1edbc nh\u1eefng \u1ea3nh h\u01b0\u1edfng l\u00e2u d\u00e0i c\u1ee7a b\u1ec7nh t\u1eadt v\u00e0 qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n

\u201cKhi b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh tim b\u1ea9m sinh ph\u1ee9c t\u1ea1p ho\u1eb7c ung th\u01b0 s\u1ed1ng kh\u1ecfe m\u1ea1nh \u0111\u1ebfn tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh, tr\u1ecdng t\u00e2m nghi\u00ean c\u1ee9u c\u1ea7n chuy\u1ec3n t\u1eeb vi\u1ec7c c\u1ea3i thi\u1ec7n t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t sang t\u00ecm hi\u1ec3u m\u1ed9t s\u1ed1 bi\u1ebfn ch\u1ee9ng l\u00e2u d\u00e0i,\u201d Leonard n\u00f3i. \u201cV\u00e0 lo\u00e3ng x\u01b0\u01a1ng v\u00e0 g\u00e3y x\u01b0\u01a1ng l\u00e0 m\u1ed9t ph\u1ea7n trong \u0111\u00f3.\u201d <\/p>\n

C\u00e2u chuy\u1ec7n n\u00e0y ban \u0111\u1ea7u \u0111\u01b0\u1ee3c \u0111\u0103ng t\u1ea3i tr\u00ean T\u1ea1p ch\u00ed Y h\u1ecdc Stanford<\/a>B\u00e0i vi\u1ebft n\u00e0y \u0111\u01b0\u1ee3c \u0111\u0103ng l\u1ea1i v\u1edbi s\u1ef1 cho ph\u00e9p c\u1ee7a V\u0103n ph\u00f2ng Truy\u1ec1n th\u00f4ng v\u00e0 Quan h\u1ec7 C\u00f4ng ch\u00fang thu\u1ed9c Tr\u01b0\u1eddng Y khoa Stanford.<\/em><\/p>","protected":false},"excerpt":{"rendered":"

Ti\u1ebfn s\u0129 Mary Leonard \u0111ang ch\u1ec9 v\u00e0o \u1ea3nh ch\u1ee5p MRI c\u1ed9t s\u1ed1ng c\u1ee7a m\u1ed9t thanh ni\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c gh\u00e9p t\u1ee7y x\u01b0\u01a1ng khi c\u00f2n nh\u1ecf. \u201c\u0110\u1ed1t s\u1ed1ng \u0111\u00f3 l\u00e0\u2026<\/p>","protected":false},"author":17,"featured_media":14316,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[148],"class_list":["post-3889","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-in-the-news"],"acf":[],"yoast_head":"\nBad for the bone: The toll of childhood chronic disease - 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