{"id":32463,"date":"2022-05-07T16:30:19","date_gmt":"2022-05-07T09:30:19","guid":{"rendered":"https:\/\/www.hmm88i.com\/drug\/?p=32463"},"modified":"2022-05-07T16:32:12","modified_gmt":"2022-05-07T09:32:12","slug":"vi-sao-phai-chung-ngua-vac-xin-3-loai-vi-khuan-s-pneumonia-n-meningitidis-va-h-influenza-o-tre-so-sinh-nguoi-cat-lach","status":"publish","type":"post","link":"https:\/\/hmm88i.com\/drug\/vi-sao-phai-chung-ngua-vac-xin-3-loai-vi-khuan-s-pneumonia-n-meningitidis-va-h-influenza-o-tre-so-sinh-nguoi-cat-lach\/","title":{"rendered":"V\u00ec sao ph\u1ea3i ch\u1ee7ng ng\u1eeba v\u1eafc xin 3 lo\u1ea1i vi khu\u1ea9n (S. pneumonia, N. meningitidis, v\u00e0 H. influenza) \u1edf tr\u1ebb s\u01a1 sinh\/ ng\u01b0\u1eddi c\u1eaft l\u00e1ch?"},"content":{"rendered":"
Nh\u00e0 thu\u1ed1c L\u01b0u V\u0103n Ho\u00e0ng<\/a> – V\u00ec sao ph\u1ea3i ch\u1ee7ng ng\u1eeba v\u1eafc xin 3 lo\u1ea1i vi khu\u1ea9n (S. pneumonia, N. meningitidis, v\u00e0 H. influenza) \u1edf tr\u1ebb s\u01a1 sinh\/ ng\u01b0\u1eddi c\u1eaft l\u00e1ch?<\/a><\/strong><\/p>\n T\u00e1c gi\u1ea3: Bs. Phan Tr\u00fac<\/b><\/p>\n
\n2. Tr\u1ebb s\u01a1 sinh\/ L\u00e1ch c\u00f3 v\u1ea5n \u0111\u1ec1 g\u00ec v\u1edbi 3 con n\u00e0y?
\n3. Vacxin l\u00e0m c\u00e1ch n\u00e0o v\u01b0\u1ee3t qua nh\u1eefng tr\u1edf ng\u1ea1i n\u00e0y?<\/div>\n
\n1. C\u00f3 2 lo\u1ea1i t\u1ebf b\u00e0o lympho B, g\u1ed3m B1 v\u00e0 B2<\/b>. Th\u00f4ng th\u01b0\u1eddng lympho B ch\u1ec9 s\u1ea3n xu\u1ea5t ra \u0111\u01b0\u1ee3c kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u v\u1edbi kh\u00e1ng nguy\u00ean khi \u0111\u1ee7 2 \u0111i\u1ec1u ki\u1ec7n:
\na. KN \u0111\u01b0\u1ee3c b\u1eaft gi\u1eef b\u1edfi t\u1ebf b\u00e0o tr\u00ecnh di\u1ec7n KN, v\u00e0 tr\u00ecnh di\u1ec7n KN cho lympho T
\nb. Lympho T s\u1ebd k\u1ebft n\u1ed1i v\u1edbi B v\u00e0 \u0111i\u1ec1u khi\u1ec3n t\u1ebf b\u00e0o B s\u1ea3n xu\u1ea5t KT c\u0169ng nh\u01b0 t\u1ea1o ra t\u1ebf b\u00e0o B nh\u1edb trong trung t\u00e2m m\u1ea7m (Germinal center<\/b>) c\u1ee7a h\u1ea1ch b\u1ea1ch huy\u1ebft (\u2026)
\n2. C\u00e1ch s\u1ea3n xu\u1ea5t KT \u0111\u00f3 l\u00e0 c\u00e1ch x\u1eed s\u1ef1 c\u1ee7a B2, tuy nhi\u00ean kh\u00f4ng ph\u1ea3i KN n\u00e0o c\u0169ng k\u00edch ho\u1ea1t B2 theo c\u00e1ch \u0111\u00f3. B\u1edfi v\u00ec n\u1ebfu KN \u0111\u00f3 kh\u00f4ng th\u1ec3 tr\u00ecnh di\u1ec7n, th\u00ec c\u01a1 ch\u1ebf kh\u00e1c ph\u1ea3i ho\u1ea1t \u0111\u1ed9ng, l\u00fac n\u00e0y c\u00e1c lympho B1 s\u1ebd b\u1eaft gi\u1eef, v\u00e0 B1 tr\u1ef1c ti\u1ebfp ho\u1ea1t ho\u00e1 (kh\u00f4ng c\u1ea7n lympho T n\u1eefa), s\u1ea3n xu\u1ea5t c\u00e1c KT tuy kh\u00f4ng c\u00f3 t\u00ednh \u0111\u1eb7c hi\u1ec7u cao nh\u01b0ng \u0111\u1ee7 \u0111\u1ec3 d\u1eb9p nh\u1eefng anh ch\u00e0ng KN lo\u1ea1i n\u00e0y (t\u1ea5t nhi\u00ean kh\u00f4ng c\u00f3 lympho nh\u1edb t\u1ea1o th\u00e0nh – \u1edf \u0111\u00e2y xin kh\u00f4ng \u0111i s\u00e2u v\u00e0o B1a v\u00e0 B1b). R\u1ed3i, c\u00f9ng v\u00e0o b\u00e0i nh\u00e9, vi\u1ebft t\u00f3m t\u1eaft th\u00f4i, mu\u1ed1n b\u00ecnh lu\u1eadn g\u00ec th\u00ec comment nhe:<\/div>\nKh\u00e1ng nguy\u00ean (KN) x\u00e2m nh\u1eadp c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c chia l\u00e0m 2 lo\u1ea1i:<\/strong><\/h2>\n
T\u1ebf b\u00e0o B \u1edf v\u00f9ng r\u00eca (Marginal zone B cell \u2013 MZ B cell): Trung t\u00e2m c\u1ee7a c\u00e2u chuy\u1ec7n<\/b><\/h2>\n
\nNh\u1eefng t\u1ebf b\u00e0o B n\u00e0y hi\u1ec7n di\u1ec7n s\u1ed1 l\u01b0\u1ee3ng th\u1ea5p l\u00fac sinh, v\u00e0 ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u1edf th\u1eddi s\u01a1 sinh. MZ B cells tr\u01b0\u1edfng th\u00e0nh sau 2 tu\u1ed5i, l\u00fac n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng t\u1ea1o \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch hi\u1ec7u qu\u1ea3 v\u1edbi polysaccharides. V\u00ec v\u1eady, s\u1ef1 s\u1ea3n xu\u1ea5t kh\u00e1ng th\u1ec3 k\u00e9m hi\u1ec7u qu\u1ea3: Tr\u1ebb em d\u01b0\u1edbi 2 tu\u1ed5i c\u00f3 s\u1ed1 l\u01b0\u1ee3ng th\u1ea5p IgG2 v\u00e0 IgG4, m\u00e3i \u0111\u1ebfn 5-10 tu\u1ed5i m\u1edbi \u0111\u1ea1t m\u1ee9c c\u1ee7a ng\u01b0\u1eddi l\u1edbn. Trong khi \u0111\u00f3 IgG2 l\u00e0 Ig hi\u1ec7u qu\u1ea3 nh\u1ea5t ch\u1ed1ng l\u1ea1i m\u1ed9t s\u1ed1 polysaccharides. Ch\u00ednh v\u00ec nh\u1eefng l\u00fd do n\u00e0y, tr\u1ebb em v\u00e0 nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng suy gi\u1ea3m ch\u1ee9c n\u0103ng l\u00e1ch (ng\u01b0\u1eddi gi\u00e0, d\u00f9ng thu\u1ed1c) ho\u1eb7c c\u1eaft l\u00e1ch r\u1ea5t nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c vi khu\u1ea9n c\u00f3 v\u1ecf, v\u00e0 vi\u1ec7c d\u00f9ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng\/ vacxin l\u00e0 c\u1ea7n thi\u1ebft.<\/div>\nCD21 v\u00e0 b\u1ed5 th\u1ec3<\/b><\/h3>\n