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8/4/2019 20.GSKHANH XU HUONG HIEN NAY TRONG DT TBMMN
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V vi ngun sng i ngàn
klk
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TM QUAN TRNG� 2005: - 16 triu bnh nhân TBMN ln u
- 5,7 triu bnh nhân t vong� 2030: - 23 triu ngi mc ln u
- 7,8 triu ngi t vong� Chng tc: - Ngi M gc n / Alaska: 5,3% dân s
- M gc Phi: 3,2%, Da trng 2,5%- Gc châu Á: 2,4%
� Mi 45 giây có 01 trng hp TBMMN M.� 87% NMN
THÁCH TH C???Feigin VL, 2007;Centers f or disease Control and Prevention and Heart disease and Strok e
Statistics- 2010 Update.
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HU QU SAU TBMMNHU QU SAU TBMMN
� c tính k hong 40% TBMMN li di chng v a và nng
� 75% s sng sót tái phát trong vòng 5 nm.
� Chi phí: - Anh 7 t bng Anh/nm.- châu Âu 19,6 t Euro /nm.
- Hoa K 51 t USD/nm.
� Quan tâm úng mc n IU TR SAU T QY?
National Institute for Health and Clinical Excellence 2008, London WC1V6NA
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XU HNG HIN NAY
TRONG IU TR NHI MÁU NÃO ?
GS.TS. HOÀNG KHÁNH
TRNG I HC Y DC HU
KLK, 06.8.2011
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Copyright ©2001 American Heart Association
Kidwell, C. S. et al. Stroke 2001;32:1349-1359
Temporal trends in number of rheological/antithrombotic trials by subclass
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TH I GIAN LÀ NÃOTH I GIAN LÀ NÃO -- NH L NGNH L NG
S lng t bào thn k inh c lng b mt trong nhi máu não trên lu in hình do tn thng mch máu l n.
TBTK cht Synap mt Si có myelin mt Gia tng lão hoá
Mt ln 1,2 t 8,3 t t 7140k m/ 4470dm 36 nm
Mt giây 32000 230 triu 200m/ 218 dm 8,7 h
Mt phút 19 triu 14 t 12k m/ 7,5 dm 3,1 tun
Mt ting 120 triu 830 t 714k m/ 447 dm 3,6 nm
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TIN TR IN?TIN TR IN?
K hông tái t i máuK hông tái t i máu
Tái t i máuTái t i máu
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1. Bo v t bào não
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Thi gian là não, chuyn nhanh bnh nhân Thi gian là não, chuyn nhanh bnh nhân
n trung tâm t qun trung tâm t qu� Vn chuyn nhanh bng
xe cp cu
� Các phng tin cn LS
chn oán t qu� Các liu pháp iu tr
ngay ti nhà/trên xe cpcu
1.1.s dng ma giê sunphát, th nghim giaion 3)
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1.3.
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2.Thombolytic: IV, IA2.Thombolytic: IV, IA
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3.
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T phc hi sau t qu? Có? Do gì?
Các nron lành mc các uôi nron và hình thành các
synáp mi :
+ Sa cha li (repairing) mng dn truyn gia cácnron,
+ To iu kin nron hc li (relearning) tái hiphc chc nng sinh lý dn truyn thn kinh
neuroplasticity
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Bng chng phc hi trên ngi và thc nghimBng chng phc hi trên ngi và thc nghim
1. Chp hình nh chc nng bnh nhân nhi máu não 2 bên thy shi phc tn thng vùng vn ng, phù hp vi tin b lâm sàng
2. Trên chut thy trong khu vc tn thng não nron lành mc licác uôi gai và các synap mi t di s kim soát ca YTDDTK
ni sinh hot ng nh các phân t tín hiu.
3. Các công trình nghiên cu mi trên súc vt dùng YTDDTK NGOISINH cng thy các kt qu nh trên mc du cho thuc rt mun
( ZING ME REN & SETH P. FINKLESTEIN 1997 và 2002 )
Các bng chng trên xác nh vai trò YTTTTK trong kin to li machni nron và các synáp
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5.T bào gc5.T bào gc
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Hin nhiên & Trin vngHin nhiên & Trin vng� Liu pháp t bào s c gii quyt hiu qu không
ch t qu mà còn ung th, Parkinson, Alzheimer,
TBMMN, sang chn não ty, bnh thn mn tính, thoáikhp, ái tháo ng, bnh thn«
� Tui th con ngi cng có th tng do ci to các cquan ã già ci bng t bào mi.
� Nn Y hc mi là Y HC TÁI SINH (RegenerativeMedecine ) y ha hn.
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