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r,gnur Sutp
hoai tr?,
chrl khdng c6 li6n
quan
tldn su tdtrg hAm lugng
carixi huydt.
Co ch6
ctla BrI ling
dqog mudi canxi
trong truoog hqp Diy hiQn nay
chrra
duqc 16 retrg.
C6
f
kidn
cho riag 6 m6
bdo bi chdt, mOi truhg
bi
L.i6m,
tao tti6u kiQn

thudn
Iqi cho canxi l6ng
dgng. Song
gi6
thuydt
ndy
cring thi6u nhriag
d6u li6u
aldy
dri dd chring minh
ch6c ch6n. {' ki6n
th6c cho rlag
axit b6o hiah thenh
hong
m6
bdo hoai tt k6t hop
vdi canxi t4o
thdnh
x.iL
phnng
-
canxi, chdt nAy
s6 dud.c
thay thd bdi cdc
g6'c
photphat
ve cacbonat dd tao tfi{i.Dh
c6c mudi cmxi
d6
l6ng

dgng. Di6u ndy rdt
quan
tlang tldi vdi td chtc md bi hoai
trl, nhrmg met kh6c
cring
chua dri bing chring
ch6c ch6o ring co ch6 ady ld
dfng hoda toiu tldi
voi s{
l6ag
dgng canxi
do
loqn
dud'ng. Gdn d6y ohi6u
j'
kidn
cho
ring
sg tdng
ndng d6
photphataza
-
kiim 6 m6
bdo chdt t+o tlidu
Li€a
cho su hiDh thdbh
nhidu
g6'c
photphat
tU do, ddng tidi vdi

tdng dQ
pH
lem
cho Ca* vd PO, dE
hdt
hd.p tao thenh
cac mu6'i
photphat
vd cacbonat
tich tq l4i. Giri thidt ody
ciing
chua
giei
ihich
du0c sr.r
it l6ag
dgng canxi A c5c cd
quaD
vdn
gidu
eazim
photphataza
ki6m nhu
thAn, ai6m mqc ruQt v.v.
Canxi h6a
do loan
dutng
hay
g{p
6

nhrrng
tdn thuong
gey
huf hoai m6
bdo
man tinl n}lu
d
lao
ba dau
(tni
ga),
vnng bd dau h6a cta mof
sd
bCDh tqo
thd td chrfc hat kh6c,
cum ndm Actinomyco,
u hat tu cdu khudn
(botryomycosis),
cAc vqt le'p hay
cgc huydt th6'i lAu ngdy, c6c khdi
u
tho6i hori,
i6
chrlc seo, thinh rn4ch
bi xo vta, bi tdn thunng; Cec
6'
ki
silh tring
nim
trcng td chtc nhu

giun
bao, nang du s6n nlm chdt trong rhO
do
kh6ng hodn
thanh
chu
k;i'
vdng
doi
v.v.
2. Canxi h6a
do fi
cdn
D6 ld
su tich
tq
mu6'i
canxi 0 m6 bdo
c6
li6n
quan
ddn sq tdrg k6o ddi
ham
lrrgng
canxi huy6t. Trong
k}li d6 md bdo bi rinh hufng kh6ng x6y ra
tdn
thudng
trudc
d6.

Vd
d4c didm hinl
th6i
(dqi
rhd vd vi thd) d, sg 16ng dQns Ddy cins
gidng
nhu loqi
tr6n.
Nguy€n
nhAn dAn
d6n sg 16o9 tlgng canxi do di cdn c6 nhidu va ra't
phic
tap. Theo
Jones
(1983)
thi c6 thd do nhtlg trulng hqp sau: 1- Cuaarg bdn
girip
trang nguy6n
phrit,
nhrmg
di6u Lipn ndy il x|y ta b
gia
sric; 2- Suy th{n lim
gidm
su thai
tidt
photphat
dAn ddn sg teng
luong
photphat

v6 cd trong huydt
tuong. Tdn thudng
ben
gi6p
thrt
ph6t
xey ra
hong
trulng hgp ndy clidg h6 trg
cho
sg
l6ug
tlong cami;
3- HiCn tuqng canri h6a lan trdn & v6ch dQ.g m4ah
vd cdc t6' chic kh6c
c6 thd
vi €!g canxi huydt do
qud
Dhi€u Vitamia D
troDg
khdu
phdn
thic 5u. O il6ng
vat c6 thd
e{p
d
gia
sric tlugc cho dn
nhidu vitamin
nhdn

t4o.
Canxi h6a larr
iren trong
td chric hay Eey
ra 6 mQt sd lodi nhu bd, erlu, d6
tai cdc
\ ing kh6c nhau
tren thd
si6i
vdi nhrins t6n
gqi
khec nhau: bQuh dich
ngfm
v6i c6 tinh
chit
&a
phuoag
(enzootic
calcinosis)
& Dric, Ao, Nam Phi, .(n
D6.
Mot beuh
tudng tU
vd t6D
gqi
bCnh suy
mdn Manchester
(Manchester
wasting
disease) d

Jamaica v.v Ngr:di ia cho ring c6
mQt
s6'cdy,
trong 16 c6
59
chfa
mot hqp
chdt steroid-glycosid
gi6'ag
n}lu
1,25 dihydrocholecalciferol
(hoat
h6a chuydn h6a vitamiD D) c6 vai trd chinh trong nhrlng
trudng hqp bCDh niy.
Sq tich fit canxi trong trudng hqp ndy trudc hdt
vd nhidu nhdt lA
d c6c soi
chun
cria
tim, dOng rrrach chri, dOng mach cd. Ngodi ra cdn
thdy cri
rl
sif chun
nlu m6
phdi,
Lhi
quin,
sqn
phd quin
vd van tim.

O bd vi criu, ohrlng ca benh
D4ng canxi cdn l6ng dgng 6'
gdn
co
gdp
chi hu6c, xudng ctng vd
day
hon,
viem
kh6p c6c d6't cd ch6n, khrip bdn, d6ng thdi vdi su- tdng hem luqng
phoipho
vo
co trong m6u canxi h6a v6ch ngdn
ph6'i
c6
khi
d6n d6'n hiQn tuchg c6-t h6a
(ossification).
Trudng hqp tdng tidt adrennocortison
ri ch6, hien
tuang canxi
h6a x6y ra
d
nhidu
td chrlc
kh6c nhau Dhung thudng
rl
da,
ph6'i
vd co van. Oo ch6 cia bdnh

Ddy hien chua bi6t 16.
Tdc hqi cria sq
l6ng
dang
canxi byanh li
phu
thuOc vdo vi tri xey ra va muc
dO cia su kdt tra. N6 c6 thd
gay
tr& ngqi v6 chrlc ning,
giem
rn0t
phda
cudag
dO hoat d0ng cria cd
quan
bl 6ah hudng. Nguy hidm
nhdt
]d carlri
h6a xdy ra
6
tim, thdnh m?ch
quan,
de d6n ddn
nhrlng r6'i loan
tudn
hoin, ihem chi
gay
xudt huydt dOt ngot c6 thd d6n d6n tri vong.
VI. BENH

GUT
(GOUT)
BCnh
Grit
(hay
th6-ng
phong,
iang
s6i
-
podagra)
ld hien tuqng
l6ng
do
g
cdc
tinh
thd Urat trong md bdo c6c cd
quan
khSc niau.
Thudng
g4p
nhdt li
sqn
kh6p, ria c5c kh6p xudng
(*rdt
ti c5c khdp oh6 ng6n chAll,
ng6n
tay),
m6 li€n

kdt
quanh
c6c
khdp, sgn venh tai
vA ddi khi ce tren thanh mac van tim, than
vi
tui xudng. O c6c kh6p xuobg, c6c
ddm tinh thd Urdt hiah
LinI
dugc
bao
quanh
bdi ving
phdn ring
td bAo
phric
t4p vdi nhtllg td bdo
khdng 16
"dj
v{t",
td
bdo da nhan vd tEDg sinh
m6 li6n k6t
r mg
quanh
thdnh
cuc
git
(Tophus).
BCnh

Gnt
hay
g4p
d
gia
cdm
(ei,
vit) l! thdy hdn o
loai
co u',r.
O loei
gi.
cdm urat
liing dqne Iai thdnl cuc
tring trOn thanh
mac xoang n$Ic, bgng, tr6n
bao tim, ngoaj lam
mac.
Irong
than
va nhd'l la o cic khop chdn. O
r,hrin tha
hi€n s{ teng l6n v6 thd tich,
rii r6c tren
m{t than c6 nhfng
hat n}l6 mAu
iring, trcn
m4t cAt
n6'i lcn nhfng hat
miu

tr5ng
xam hay vdng LAng,
cung.
Qua
kinh hidn vi thdy trong
6'ng than cec
finh thd urat tri61
quang,
mo bdo
*utg
quaoh
iho6i
hod, hoqi t1i
ho4c tan roa, b6n carh
c6c tinh thd urat c6 c6c
te bao knong l0 or
vai .
Nhdi urat thQn
(Infaretues
uratique)
Thdy 6 d6ng v4t so sinh trong
nhfng ngdy cldu.
D6 la
do
urat tang
nhi6u
trong co thd, chua thAi
h€'t
qua
nudc tidu

n6n
dgng
lqi trong dng
g6p
tqo thinh
cAc hat trbn. Day ld
hi€n
trdng
sinh lj chi
kh6ng
phai
qud
tdnh b€nh
li. d
dong
vet tnrdng thdnh khi viem
nicm mqc bdng
quang
hay bd th{n ctng th{y
xuit hi6n mudi urat d cac vring
d6. Nguy6n
nhen
gey
nen sq l6ng dqtrg urat
trong
mO bdo hiQn
nay
chrra
ro rdng l6m.
Ta

bidt
ring axit uric vd urat
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