Tải bản đầy đủ (.pdf) (5 trang)

Nhân một trường hợp tan máu có hội chứng kháng thể kháng Phospholipid

Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (276.21 KB, 5 trang )



 !"#$%&
' (&)(&*+*,-

./0123456272.

89:;<=>?9@;
ABC9D=BCAEF9G;=
6H=F9ICJK9LCJ<9MK9LCJN9:ON9:P=N=QPRSBC9PTUF9ICJ_6`?9^<9H=F9ICJK9LCJ<9MK9LCJN9:ON9:P=N=QPR<9IN9LD=>\ F`?<9cCW9H=F9ICJ<9cC9ZWD=>\ K9dNWP?N?OS;CYe_GH<N9:ON9:P=N=QhF@9?i^C9mCYZgFY=n?<;C\L?_8^Y^C9H=F9ICJxDrfP;NFw;9H=F9ICJK9LCJ<9MK9LCJN9:ON9:P=N=Q_
yz3{|}3~32.z3|2.3z3|2.3{3{

%


ĂÂÊÔƠƯĐÊă
âêôơưđĐÔ àÔ
ảãáƯạơằ
ẳẵắđàÔđàÔ
ÊƯạÊơàÔÔ
ặáẳÂầđ
ĐãđđĐđơằ
àÔẩÊÔ
ảẵàÔ Ơãđ
Ôơẫ ấ


ầậ ƯĐ
àÔ ảă Ưđ
ầèƯđÊđảÔ
ÔÔđ ảăƠ Ư
ẻĂâẽôơ
éÔ ƯÂĐắđ
Ê ÔÔ
Ă ÂÊÔ Ơơđ ÊƯầậ
ẹề
ừo;F9ửP=>C9Bh4J?ibC29oữmC6ứCJW89:;<=>?9:LW
SBC9D=BCAEF9G;=
ự\;=PhC4JRiC9cChỷỹỹ
ỷ
4JRiYZgFF9lN<9?cCh
7ỹỹ


234356789




ểđạđễậ
ếÔảăẵÔệơìÂ
ÊẹầậảăẵÔệầỉđề
đẳảĐÔ ẵÔệểẫ
ÔèĐảĐÔđèâẽôơ
ưđ Đ
ảÂÔđẵÔệ

ẵÊẹảĂĩÊÔ íịảòƯ
ÊÔ ƠơưƯĐÊăÔăỏ
ảàÔ ảã Â Êẹ ê
Ôâõóọôơ

%,+ồ

ìàổĂÔà
ấđỗõốơảêộờởờêộõởđ
ỡạớõđếÔĂơìàầẹ
ặđđẳợêẻÔ
ãđƯùĂầậểđĐơđÊ
ủÔêẻÔ ĂãđƯùớõ
ẻÔ ểđạũÔƠĐú
àÂảÊầẫĐỡÂầăả
Ô Ă ãơõ đ Ưầăểđạ đ
ỡàÔỏầẹảùầậÂđ
ảùđễĂơụÔ ỡÔãÔ ầăẫ
Ă Â ỡĂ
ơưƯàĂ
88



!""$%&'()*&+,-./(&.01(234 25678
9: ;3<,(!.&=5%=(>&(?$,@!" -.,
&.01((A(?B,@B&C,(?B,(D,;:$6EF&
&G -./(&F (>& (?$, (&1. "A. H,
(?:,I,B0J3',KL,M" &5&(DNO,PJ
,M" %QRS,PJ6TUJ3',&V,%W.,M" (D

I)O(PJ-.U, %Q X)Y(PJ6EJ?.L (:B Z&W
O["":JPJ@B LJ?.L (?\% (1Z JB I]"":JPJ6
EF&&G*&+,%=(>&(?$,-./(&.01((!.
&=5%^,&3"/("A.%A%_ *&A%67,.0!
&G(&1."A.;3'%%&`;:AJB(5"A.(\
" a6b&Mc,d::"L9(?\%(1Z@B,A(1Z
;e.23_,(f&6
dA%-g(,&F" " a2h%&,iZ,&j&e.
;1&=" LF&Jk(\" al*&A,(&m*&A,
n9n7o23_,(f&OXI)NI)*&A,(&m*&A,
&Go7o23_,(f&X)RS)*&A,(&m*&A,
%5?2:JZ) *&A, (&m *&A, Lp(5 Iq
,J0%:Z?:(p23_,(f&6
dO,M" [)YY)d]L>&(&3<,[)XI)dA%
LJ5-g(,&F"(.01,AZ@B(.01%r,AZ
st]) tTK) btK) 5(qtu) 5(qtbv L>&
(&3<,6b?:(pF.23_,(f&@4 V,;8
(&/Z[)RS,PJ6
EF&&G;3'%JB" (&w"2Q9!.G" ("
%&c%w,(G" (&.(&/((?A L>&(&3<,)AZ
J\%;8,"$%&Z&x OR6
T!.G"&F(&U,"$%&"A.(&/0%=&.01(
*&U y%&Gl&.01(*&U (j&"$%&;z @B(j&
"$%&*&:p:IL!6
{e.(?hlT:J."p2?:JR[[",-XJ|(!"(j&
"$%&(?:,O,B095.;=&$-.U,9:J."q
p2?:J][",P,B0@B*1(&'Z@4 d&J:?:}.
IR[",-X@!)~:@p:-[6]"JP,B06{e.
(?h~:@p:-95.X(.W2.0(?>(U(%&9U€7‚I6
T5.;e.(?hT:J."p2?:JR[[",-O,B06

t&m(?$,LF&&G*&A2W)w,ƒ(U(6„1(
(&3_, %…, %&G b *&+ 2W)(x %&c%&$(
Z&A((?m(U(6 ~3',KL(w,J!†S,PJ@B
EJ?.L(?y@eL>&(&3<,6
{V,(&< @4 JF.(?>&%:?(%:2%^,(&/0
123

%M (&F2/.&F.;5.L‡,6b&G"B.9ˆ%
L>&(&3<,)LF&&Gw;3'%*&+,%Q
2/.&F.;5.L‡,@B%&34,L‡,6{e.(?h
2.0(?>(1Zd:?(%:2@4 Je.X",P*,%GH,
(?:, X[ (.W *1 (1Z @B *&A, @(5"  ‰
ŠT(?:"X",P,B0‹%&:(&/0%A%(?F.%&c,
JG" 9B,x;h&6t>&(?$,(&1."A.;3'%
*&ˆ%Z&‡%(U()J!%G)*&+,%Q(x(&3_,
J:g(%&G6T!.G"2:ZZJp?"$%&%& 234 %&:
(&/0"$%&(&+,(U(*&+,%Q(ˆ%"$%&6

ŒŽ

b&:9Z&:JZ2JB(&B&Z&W(&5" ,5@B:
%/.($:%ƒ5&W.&1(%A%&F%_}.5(?:,%_
(&m6{G0JB(&B&Z&W%/.($:!"B,(1
LB:6n:@r0K8%&c,*&A,(&m*&A,Z&:9q
Z&:JZ2%=(&mLm.&FJG"9B,y&e.&F
%_}.5l(")"$%&"A.)(&W*&)(x%&c%
J!*1()&.01(&|%)256666K8 %&c,B0Lm.
&FJG" 9B,@4 O&=" (?!.%&c,%&f&l
%‡%"A.;+,%="H((?:,&F(&U,"$%&
"A.y%M;8,"$%&@B(j&"$%&)(&3<,

,G0?5%A%2/.&F.9M*&:5Š-M0(&5 J!
(1Z)&8 %&c,(e9M,r(‹6
K8 %&c,*&A,(&m*&A,Z&:9Z&:JZ2JB
LF&Jk*&A(&3<,,HZ%&1" XqR‘ (?:,
2G9U6
XRqI[‘%A%(?3<,&'Z"ˆ%LF&%=%‡%
"A.;+,y(j&"$%&9G.6
X[qIR‘Z&‡’Lh-M0(&5 J!(1Z6
XPO9ULF&&G(?“”R[(.x Lh;8(}.•JB
2/. &F. %ƒ5 &8 %&c, *&A, (&m *&A,
Z&:9Z&:JZ26
K8 %&c,*&A, (&m *&A,Z&:9Z&:JZ2
,HZyZ&‡’NRq†[‘6
][ qR[‘ 9U LF& &G %= &8 %&c,
*&A, (&m *&A, Z&:9Z&:JZ2 %= J! }.5
;1LF&J.Z.9L5;–&F(&U,6
K8 %&c,*&A, (&m *&A,Z&:9Z&:JZ2
;3'%Z&G %&5 (&B& %A%&=" (&p: Z&G
J:$ %ƒ5&FZ&8*&4Zw"I[[S6
456578329


1


"#$%&'()*%#*+,%#+,-./,0123',4#(567
8 9:,';(<#/,4'#=<#/,4->,4?@*#A,#7
B "&6C'<#/,4'#=<#/,4%8DE(.?(F(,4G
0A4HI6J%-K%8.7
% %&6C'<#/,4'#=LLM4?N%.FD.'O(,4G

0A4H7
PK(%#J,4<#/,4'#=<#/,4F#.QF#.?(F(E?A
6K'B5,# 'R 6(S, '#= #(5, BT,4 'U,# 'D;,4
'V,4 ->,4 4WN D8 BI(<#/,4 '#= <#/,4 ?;(
'#A,# F#X, F#.QF#.?(F(E7'#@Y,4 B5,# '#=
#(5, %Z,4 'D.,4 B5,# %[,# %/% B5,# ?\'R
6(S,<#/%7
PK(%#J,4<#/,4 '#= <#/,4F#.QF#.?(F(E
%&'#=B(=*#(5,'(),F#/'#.C%'#JF#/'Q8*
%/%B(=*#(5,B5,#?\'R6(S,<#/%,#@B5,#
?*F*Q B8, -] #5 '#^,477_>(<#('D.,4 %/%
'D@Y,4 #`F '(a, 'D(=, %bF 'c,# #K(%#J,4
<#/,4 '#= <#/,4 F#.QF#.?(F(E '#J F#/'
'#@Y,4%&'U,#'D;,4Q*N-8';,4Db',C,4E.
'U,#'D;,4'V,4->,4I%/%#5%de*8,7_(1*
'Df%X, Qg Eh,4 %#^,4 ->,4 ,#&6 POF8D(,
4(iF %[('#(5, 'U,# 'D8,4 Q*N-8 ';,479U,#
'D;,4'V,4->,4'#@Y,44CFI%/%6;%#6/*
?j,,#@,4%k,4<#>,4?.;('DZD^(?.;,->,4
6/*I%/%6;%#6/*,#]79#D.6B.Q(Q6;%#
6/*6;%'DO.?A,4*N),,#W,4WN,),'U,#
'D;,4 0()6 D*K''#(a* 6/*7l5,# ,#W, %m8
%#i,4'>(%k,4%&Eb*#(5*-8*Bh,40j(%/%
Eb*#(5*%#@j,4Bh,40AD^(?.;,'()*#&87
nK(Q.(<#o,4-f,#'U,#'D;,4D^(?.;,'@j(6/*
'pF'D*,4I'/'DA,40A#q,4'DA,479#@Y,4
?W6 QA,4<#o,4-f,#%#+,-./,?A0()6 D*K'
'#(a*6/*r,a*-=6*K,#d,QsEt,-a,,#:(
6/*0A#.;('gD*K'7
l5,# %[,# 0()6 D*K''#(a* 6/* '#= #(5,

B8,-X*BT,4Eb*#(5*-8*Bh,4I%/%6J%
-K7_8*Bh,4%&'#=Db'EuEK(->(<#(%&'#=
,#X60j(%/% B5,#%[,#Bh,4%bF,#@'#m,4
D*K'#8N0()6 F#i%6;%79D@Y,4 #`F 'V,4
->,4,#(1*4WN'v%%/%6;%#6/*?j,Qs4WN
,),Eb*#(5*0()6 D*K''#(a*6/*r,C,4#d,
234356789





?A#.;('g-.;,D*K'79U,#'D;,4'v%6;%#6/*
?j, 4WN,), '#(a* 6/* ,*>(%/%';,4 <#/%
%k,4 %& '#= 4CF7_^(0j(%/%';,4 'D.,4 w
Bh,4%&'#=?A,#:(6/*?/%#r,#:(6/*'hNr
,#:(6/*48,x l5,#%[,#?W6 QA,4QsE(S,
B(a, Db'-8 E;,4 'ZN 0A. %d e*8, Bf[,#
#@I,4'@j(6/*7PK(%#J,4<#/,4'#=<#/,4
F#.QF#.?(F(E%&'#=4WN,),%/%B5,#%[,#
,#:(6/*%/%';,4<#/%,#@,#:(6/*?/%#r
,#:(6/*48,r,#:(6/*'hN777l5,#,#W,0A.
0(5, 0j(B5,# %[,# -8* Bh,4 %bF 0A ,>,
,#(1*Db'%&'#=?AB5,#%[,#%m8,#:(6/*
6;%'DO.D*K'7na*<#>,42g'DcEt,'j(B5,#%[,#%m8#.;('gD*K'7
"d %#a 'V,4 ->,4 6;%# 6/* 'D.,4 #K(
%#J,4<#/,4'#=<#/,4F#.QF#.?(F(E-y-@`%
,#(1*%>,4'DU,#,4#(),%J*'D),'#a4(j(4([(
'#c%# BT,4 %[ '#R%,4#(56 0A '#O. Ez(?W6

QA,47"d%#a-X*'(),-@`%lD8,%#0A{.E|
4ODQ6>'[,V6 }~~2*b'#(5,,#(1*Na*'^
->,46/*'w%#J%'D.,4%/%'aBA.6.,.r'a
BA. ,K(6>7}~~€ 6O,4*8?6> '[ %d%#a
FD.'O(,"4WN->,46/*7"k,4'D.,4,V6 -&
'Q*6(4([('#c%#%d%#aJ%%#a'()*‚(BDD(,777
"ƒ, %& ,#(1* %d %#a <#/% -@`% ?(), 'h%
,4#(),%J*0A4([('#c%#'U,#'D;,4'V,4->,4
'D.,46;%#6/*,#@J%%#a Na*'^„79*N
,#(),08('Dƒ%m88,'(LM4?N%.FD.'O(,E@Y,4
,#@?Ae*8,'D…,4,#b'0U<3.'#O.,#(1*#5
e*[ '/%-K,40A.DO%OF'.DMr†r8,,O2(,Mr
4?N%.FD.'O(,77'/%-K,40A.,#(1*?.;('aBA.
<#/%,#8*'aBA.,K(6>r'(=*%X*r6.,.%N'OQr
'D.F#.B?8Q'<#I(F#/'e*/'DU,#0()6 0A->,4
6/*'D.,4?ƒ,46;%#7
9()*%#*+,%#+,-./,B5,#?\#K(%#J,4
<#/,4'#=<#/,4F#.QF#.?(F(E 4:6 ,#&6
'()*%#*+,
}79()*%#*+,?W6 QA,4 'v%6;%#%&'#=
'v%-K,46;%##8N'v%'‡,#6;%#7
M79()*%#*+, ?(),e*8,-a,'(1,Qg'#8(
Q[, }#8N,#(1*?X,'#8(?@*'D.,40ƒ,4}ˆ
8



!"#%&%'"()"*+,-./+0"()"*+,12"*
3 415"-6."*-.+178%9:!"#9;!"-./
"-+0 -'"<)/-.+;+="+>?178%@A!"B

9BC4%+= %- D"E0%,";F6 (G"*H@-+J" K-4"* -L %-M"* NO"* ;7 -G"- PQ
R;? (."+%2.* ;."S@V!"178%%&1+J %-W"*;F6(G"*BVX I
-+J" K-4"* -L K-4"* C.1Y+2;+?+" R.CPS;2Z+
[*\#-./[*] E8+"O"*N^%.2_:A\`PN'"
EaB9X I-+J"K-4"*-LK-4"*bV*;/%2?12c
d+"@[*\#-./[*]E8+"e"*N^%.2B
C-D"N24"K-+%&U"-I@12"*VYI -+J
;F6 (G"*Kf6 E8+%4%gh"*%-W"*%,";F6
(G"*K-O"*/= %! ?-)+N!/NiB
j+0 1a-^+%-W"*K-4"*-LK-4"*?-2(c
?-2;+?+Y"h6 %- "*12"*"* /="k%N+0 1a
%4%gJ"-;lm6+n"N&;GE+J%(oYp"*%4%
"-&6 - M%W%%->6+n"Ya%-Nq%g+J;G;+J
15"-%21+%2+Y#/"-+="N+L6Nq%g+JK-4%;G
(oYp"*%-M"*NO"**+r?N+0 1aYI -+J k%
6Z%-Bj+0 1a%-M"* NO"* N7s% ?-T? (o
Yp"*I%)%4%"-&6-d?.1+"(."Y.1#-d?.1+"
1t"*;7s"*?-F"o-I?#%."<+?.11+"#"-&6
K-4"*E+.6+"uEG.(?+11+"B]p%NU%-N+0 1a
%-M"*NO"*;G*+)6 -+L "* /%'k%6Z%-#
*+)6%4%g+>"%-W"*EG"* /%'N^3 vBj+0
1a%-M"* NO"* (w %& -+J 3 ) "> Y /15
N7s%[xy zVc9g5"--7{"*#?-| - ,
KT2YG+B
}8+;+J 15"- N+0 1a%21+%2+Y ;+0 %.2
~AA6*"*G/12"* 9 "*G/N K-M"* %-> M
5"-1Z"*"*7"*K>K-4"*"* /="EGK-4"*
-L*+r?K+L6(24gJ"-;lm6+n"EG%)+-+J"

M1+J %-W"*B /"-+=""> N+0 1aK-O"*
N7s%Y /15+>?(. N&E8+;+0 %21+%2+Y@6*
K* -+J 3 ) N+0 1a%"* %& -L K-O"* NZ
N7s%"-762"*6 M"BP+J 15"-%21+%2+Y;+0
%.2N7s%%-Na"-%-2%4%17{"*-s?%&g+L
-+J";F6(G"*"q"*Hk%6Z%-"-+0 #g+L -+J"
gJ"-"-+0 -J%'3 ."#1+J %-W"*;F6(G"*
N.YZ"*EG"-I;GNLN+0 1a178%N&gh"*
123

%21+%2+Y"-7"*K-O"*NZ-+J 3 )N+0 1aB
P+J 15"-%21+%2+YE8+;+0 @6*K*%F""q"*
%!"N7s%Y /15+>?12"*E"*@A!"(.
N& (w *+)6 Y!" ;+0 *+r? -Z" %-> %4%g+>"
%-W"*Y2N+0 1a%21+%2+Y*F/1.BjLY /15M
-+J 3 )N+0 1a%"*%!"?-)+K>-s?E8+
%4%- M%%-M"*NO"*Hd?.1+"EGK-4"*E+.c
6+"uE8+;+0 -I?*+r?-Z"%->g+>"%-W"*B



^+%-W"* Ed1;.? 12"* gJ"- %)"- -^+
%-W"*K-4"*-LK-4"*?-2(?-2;+?+Y;Gg+L
-+J"gJ"-K-O"*N+L"-5"-12"*(M%4%gJ"m6+n"B-7{"**q?"-I;G (mK>-s?*+.
-^+%-W"*K-4"*-LK-4"*?-2(?-2;+?+YE8+
%4%gJ"- ;l*." m 6+n"#;? (g." N -J
-M"*#E+=6 %! -,"Bu-+%& g+L -+J" k%
6Z%-K>-s?E8+%4%gJ"-;lm6+n"K-4%
%!""*-N>"gJ"-%)"-2Ed1;.?E8+-^+%-W"*
K-4"*-LK-4"*?-2(?-2;+?+Y




Ă ÂÊÔĂ Ơ
ƯĐăăâêQ %1++%.;.((d((6d"2ô-d 12;d 2ô
."+?-2(?-2;+?+Y."+g2Y+d(+"+"ôd1+;+/Bơ2 1c
".;2ôyd?12Y %+Ed[66 "2;2*/#ưăĂ@9Vc@:~B
Đ đÊÊÂĂÊĂÔƠ
ÊÂƯĐăĐê\ +Yd;+"d(2" -d +"Ed(+*.+2"
."Y 6.".*d6d" 2ô ."+?-2(?-2;+?+Y (/"c
Y126dB b1++(-ơ2 1".;2ô.d6.2;2*/#Ă
:àc~ảB
ã đÊáÊĂạĂÊ Ăằ
ẳẳÊÂÂÊĂẵƯĐăăãêP2ắY2(dQ(?+1+".ôd1
+(%-d6+%(12Kd.((2%+.dYắ+-."+?-2(?-2;c
+?+Y(/"Y126dB6#ặĂ@@@c@@:B
ầ   á
ƯĐăăê-d .gY26+".;6."+ôd(.+2"(2ô-d
."+?-2(?-2;+?+Y (/"Y126d y-d 6.2;2*/ẩ
ầặĂ@ẫ:@c@ẫ:àB
áĂĂĂẵĂ
ấĂậÊÂƯââê-d 6.".*d6d"2ô
45657829

31



!"#!$%$ %' ( )'%*!$*!+%*%,-)'%#!,. ::;<==>-==?/
$.',!"(/0(12'3+)',4!5')+!67(,%8%'(9


@ABBCDE
F@G@HFI@IJHFKIH@HLIMGN
GMIJ@@

O()'%*!$*!+%*%,)'%#!,.$.',!"(%$+($$8!""!'/P%$!6(',%)3'!$(,+)(1('((
)$#(('8!"*+%8)%!'/Q'%*!$*!+%*%,)'%#!,.$.',!"()$$!8%)(,1%!( $%3'$!6,%$()$(%$8!""!'/7!$)'%*!$*!+%*%,)'%#!,.$.',!"(%$$(8!',).!!( )5!%""5'(
")'%6($)%!'$$58)$'(*!*).9)%%$9)',(.(")!$5$+5*5$/R)$(*($(')%!'ST(
$)1) )(8)$(!6)'%*!$*!+%*%,)'%#!,.$.',!"(1%!"#!$%$U('!5$%'+(3)$$!8%)(,
1% ("!+.$%$/O( *)%('1)$()(, 1% ) 8!"#%')%!' !68!%8!%, )', )'%8!)35+)%!'
V+!U('!WX/Y!8+%'%8)+$."*!"$)$1(++)$("!+.$%$1(($%3'%6%8)'+.%"*!U(,/P'8!'85+%!'9
1(' $%3'$!6!88+5$%!' 8!"#%'(, 1% !( $%3'$!6)5!%""5'( ,%$()$( )( *($('91(
$!5+,%'Z!6[U(+)*\.',!"(!6)'%*!$*!+%*%,)'%#!,.$.',!"(/
]^E_`DabcCdefgh`bgh`ifgfaCdefj`aEbEdaD`B^

234356789




7



×