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V v i ngu n s ng kl k

i ngn

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T M QUAN TR NG
2005: - 16 tri u b nh nhn TBMN l n u - 5,7 tri u b nh nhn t vong 2030: - 23 tri u ng i m c l n u - 7,8 tri u ng i t vong Ch ng t c: - Ng i M g c n / Alaska: 5,3% dn s - M g c Phi: 3,2%, Da tr ng 2,5% - G c chu : 2,4% M i 45 giy c 01 tr ng h p TBMMN M . 87% NMN

THCH TH C???
Feigin VL, 2007; Centers for disease Control and Prevention and Heart disease and Stroke Statistics- 2010 Update.
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H U QU SAU TBMMN c tnh kho ng 40% TBMMN l i di ch ng v a v n ng 75% s s ng st ti pht trong vng 5 n m. Chi ph: - Anh 7 t b ng Anh/n m. - chu u 19,6 t Euro /n m. - Hoa K 51 t USD/n m. Quan tm ng m c n I U TR SAU T Q Y?

National Institute for Health and Clinical Excellence 2008, London WC1V6NA
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TR

NG

IH CYD

C HU

XU H NG HI N NAY TRONG I U TR NH I MU NO ?

GS.TS. HONG KHNH


KL K, 06.8.2011
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Temporal trends in number of neuroprotective trials by subclass

Kidwell, C. S. et al. Stroke 2001;32:1349-1359

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Copyright 2001 American Heart Association

Temporal trends in number of rheological/antithrombotic trials by subclass

Kidwell, C. S. et al. Stroke 2001;32:1349-1359

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Copyright 2001 American Heart Association

Time trends of acute stroke trials by decade subdivided by agent mechanism of action

Kidwell, C. S. et al. Stroke 2001;32:1349-1359

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Copyright 2001 American Heart Association

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TH I GIAN L NO -

NH L

NG

S l ng t bo th n kinh c l ng b m t trong nh i mu no trn l u i n hnh do t n th ng m ch mu l n.


TBTK ch t M tl n M t giy M t pht M t ti ng 1,2 t 32000 19 tri u 120 tri u Synap m t 8,3 t t 230 tri u 14 t 830 t S i c myelin m t 7140km/ 4470d m 200m/ 218 d m 12km/ 7,5 d m 714km/ 447 d m Gia t ng lo ho 36 n m 8,7 h 3,1 tu n 3,6 n m

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TI N TRI N?

Khng ti t

i mu

Ti t

i mu

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XU H

NG?

1. B o v t bo no, Nano 2. Tiu huy t kh i..., Nano 3. L y huy t kh i b ng c h c, 4. Tnh m m d o & sinh th n kinh, 5. T bo g c,

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1. B o v t bo no

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Th i gian l no, chuy n nhanh b nh nhn n trung tm t qu


V n chuy n nhanh b ng xe c p c u Cc ph ng ti n c n LS ch n on t qu Cc li u php i u tr ngay t i nh/trn xe c p c u 1.1.s d ng ma gi sun pht, th nghi m giai o n 3)
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1.2.

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1.3.

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2.Thombolytic: IV, IA

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3.

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4.NEUROPLASTICITY &
NEUROGENESIS

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T ph c h i sau

t qu ? C? Do g?

Cc n ron lnh m c cc ui n ron v hnh thnh cc synp m i : + S a ch a l i (repairing) m ng d n truy n gi a cc n ron, + T o i u ki n n ron h c l i (relearning) ph c ch c n ng sinh l d n truy n th n kinh ti h i

neuroplasticity
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B ng ch ng ph c h i trn ng

i v th c nghi m

1. Ch p hnh nh ch c n ng b nh nhn nh i mu no 2 bn th y s h i ph c t n th ng vng v n ng, ph h p v i ti n b lm sng 2. Trn chu t th y trong khu v c t n th ng no n ron lnh m c l i cc ui gai v cc synap m i t d i s ki m sot c a YTDDTK n i sinh ho t ng nh cc phn t tn hi u. 3. Cc cng trnh nghin c u m i trn sc v t dng YTDDTK NGO I SINH c ng th y cc k t qu nh trn m c d u cho thu c r t mu n
( ZING ME REN & SETH P. FINKLESTEIN 1997 v 2002 )

Cc b ng ch ng trn xc n i n ron v cc synp


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nh vai tr YTTTTK trong ki n t o l i mach

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5.T bo g c

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Hi n nhin & Tri n v ng:


- Neuroplasticity, Neurogenesis, stem cell (do tc ng c a NGF n i sinh c a no): sinh l, di n ra hng ngy gi cho no lnh m nh v s a ch a cc t n th ng. - V y dng NGF i u tr giai an sau t q y l h p quy lu t sinh l t nhin c a no. D phng: t ng sinh m ch ( sinh tn m ch ) i u tr giai o n c p: b o v t bo ( b o v t ch c no) Giai o n S Q: T o m ng n i m i (plasticity, neurogenesis) JING MEI REN & SETH P. FINKLESTEIN,Masachusett General hospital & Havard Medical
school Boston, CNS Growth Factor Research Laboratory .Department of Neurology
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Hi n nhin & Tri n v ng


Li u php t bo s c gi i quy t hi u qu khng ch t qu m cn ung th , Parkinson, Alzheimer, TBMMN, sang ch n no t y, b nh th n m n tnh, thoi kh p, i tho ng, b nh th n Tu i th con ng i c ng c th t ng do c i t o cc c quan gi c i b ng t bo m i. N n Y h c m i l Y H C TI SINH (Regenerative Medecine ) y h a h n.

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