DEMA-CVN

GII THIU

CC TI BO CO TI HI NGH
TIM MCH MIN TRUNG- TY NGUYN
M RNG LN TH VI TI BUN MA
THUT THNG 8 NM 2011

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V vi ngun sng i ngn

klk

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TM QUAN TRNG
2005:

- 16 triu bnh nhn TBMN ln u

- 5,7 triu bnh nhn t vong
2030:
- 23 triu ngi mc ln u
- 7,8 triu ngi t vong
Chng tc: - Ngi M gc n / Alaska: 5,3% dn s
- M gc Phi: 3,2%, Da trng 2,5%
- Gc chu : 2,4%
Mi 45 giy c 01 trng hp TBMMN M.
87% NMN

THCH THC???
Feigin VL, 2007;
Centers for disease Control and Prevention and Heart disease and Stroke
Statistics- 2010 Update.
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HU QU SAU TBMMN
c tnh khong 40% TBMMN li di chng va v nng
75% s sng st ti pht trong vng 5 nm.
Chi ph: - Anh 7 t bng Anh/nm.
- chu u 19,6 t Euro /nm.
- Hoa K 51 t USD/nm.
Quan tm ng mc n IU TR SAU T QY?
National Institute for Health and Clinical Excellence 2008, London WC1V6NA
8/29/2011

TRNG I HC Y DC HU

XU HNG HIN NAY

TRONG IU TR NHI MU NO ?

GS.TS. HONG KHNH

KLK, 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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THI GIAN L NO - NH LNG

S lng t bo thn kinh c lng b mt trong nhi mu no trn lu in
hnh do tn thng mch mu ln.
TBTK cht

Synap mt

Si c myelin mt

Mt ln

1,2 t

8,3 t t

7140km/ 4470dm

Mt giy

32000

230 triu

200m/ 218 dm

Mt pht

19 triu

14 t

Mt ting

120 triu

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830 t

12km/ 7,5 dm
714km/ 447 dm

Gia tng lo ho
36 nm
8,7 h
3,1 tun
3,6 nm

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TIN TRIN?

Khng ti ti mu

Ti ti mu

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XU HNG?
1. Bo v t bo no, Nano
2. Tiu huyt khi..., Nano
3. Ly huyt khi bng c hc,
4. Tnh mm do & sinh thn kinh,
5. T bo gc,

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1. Bo v t bo no

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Thi gian l no, chuyn nhanh bnh nhn

n trung tm t qu
Vn chuyn nhanh bng
xe cp cu
Cc phng tin cn LS
chn on t qu
Cc liu php iu tr
ngay ti nh/trn xe cp
cu
1.1.s dng ma gi sun
pht, th nghim giai
on 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 phc hi sau t qu? C? Do g?

Cc nron lnh mc cc ui nron v hnh thnh cc

synp mi :
+ Sa cha li (repairing) mng dn truyn gia cc
nron,

+ To iu kin nron hc li (relearning) ti hi

phc chc nng sinh l dn truyn thn kinh

neuroplasticity
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Bng chng phc hi trn ngi v thc nghim

1. Chp hnh nh chc nng bnh nhn nhi mu no 2 bn thy s
hi phc tn thng vng vn ng, ph hp vi tin b lm sng
2. Trn chut thy trong khu vc tn thng no nron lnh mc li
cc ui gai v cc synap mi t di s kim sot ca YTDDTK
ni sinh hot ng nh cc phn t tn hiu.
3. Cc cng trnh nghin cu mi trn sc vt dng YTDDTK NGOI
SINH cng thy cc kt qu nh trn mc du cho thuc rt mun
( ZING ME REN & SETH P. FINKLESTEIN 1997 v 2002 )

Cc bng chng trn xc nh vai tr YTTTTK trong kin to li mach

ni nron v cc synp
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5.T bo gc

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Hin nhin & Trin vng:

- Neuroplasticity, Neurogenesis, stem cell (do tc ng
ca NGF ni sinh ca no): sinh l, din ra hng ngy gi
cho no lnh mnh v sa cha cc tn thng.
- Vy dng NGF iu tr giai an sau t qy l hp
quy lut sinh l t nhin ca no.
D phng: tng sinh mch ( sinh tn mch )
iu tr giai on cp: bo v t bo ( bo v t chc no)
Giai on SQ: To mng ni mi (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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Hin nhin & Trin vng

Liu php t bo s c gii quyt hiu qu khng
ch t qu m cn ung th, Parkinson, Alzheimer,
TBMMN, sang chn no ty, bnh thn mn tnh, thoi
khp, i tho ng, bnh thn
Tui th con ngi cng c th tng do ci to cc c
quan gi ci bng t bo mi.
Nn Y hc mi l Y HC TI SINH (Regenerative
Medecine ) y ha hn.

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