3

- / — / ' 2 0 1

DI/OC HOC • •

SO 491 * NAM THLf 57 * THANG RA 1 KY * ISSN 0866 - 7861

TAP CHI Dirge HOC ISSN 0866 - 7861

3/2017 (So 491 NAM 57)

MUC LUC NGHIEN CUD - KY THUAT

i BAM THANH XUAN, NGUYEN NGOC CHltN, TR|NH TH! HOA, NGUYEN TH| PHUONG THUY: Nghien ci)u bao chi vi nang probiotic chtra vi khuan Lactobacillus acidophilus blng phuwng phap dong tu tir nhu tucmg 2

i HUYNH TH| MY DUYEN, HUYNH VAN H6A, BO TH| HONG TUOI: Banh gia tac dung ire chi sir phat thin t i bao ung thur da day cua vien nen noi chira curcumin tren mo hinh gay ung thiz da day a chuot nhlt thing 5

< NGUYEN TH| KIM THU, BANG KIM THU, BUI THANH TUNG: Banh gia tac dung ire chi enzym xanthin oxidase in vitro cua la va vd r i cay dau tim {Mows alba L.) 8

» TRAN VIET HUNG, LE BiNH CHI, NGUYEN TH| HANG, DUONG MINH TAN: Xay dung quy trinh dinh lirgng apigenin bing HPLC trong dirge lieu ciichoavang 12

> NG6 TH| LIT, NGUYEN HUONG GIANG, LE TH! THANH NHI, BO KY BAO, LAC KlEN TRlEU, NGUYEN TH| MINH THU: Xay dung va i>ng dung quy trinh dinh tinh, dinh lugng aflatoxin B1, B2, G1, G2 trong thirc pham chirc nang bing phirang phap sic ky long khoi phi 15

> VU DUC LCYI, NGUYEN TlEN VUNG: Mot s i hap chit phan lap tit la cay da cam (Hedyotis capitellata Wall, ex G. Don) thu hai tai tinh Thai Nguyen 18

. HOANG THAI HOA, NGUYEN THUONG DONG, BAO THANH HlEN, NGHlEM BUC TRONG, NGUYEN HOANG TUAN: Nghien ecru dac diem hinh thai va vi hoc cua cay tarn bop (Physalis angulata L), thupc hp Ca (Solanaceae) 21

> NGUYEN HOANG TUAN: BO sung loai cay thuoc mdi cam cii san ho (Hoya erythrina Rintz) cho he thirc vat Viet Nam 25

. NGUYEN TH| KIM THU, MAC BiNH HUNG: Tong hgp va thir hoat tinh sinh hoc cua cac dan xuit chira halogen cua 3-nitro-2-phenyl-2H-chromen 28

» NGUYEN TH| NGA, BO DUY CUdNG, VU BiNH HOA, NGUYEN HOANG ANH: Doc tinh tren gan a benh nhan nhiim HIV cd diiu tri dir phdng lao bing isoniazid tai phong kham ngoai trii HIV/AIDS - Khoa Truyen nhiem, Benh vien Bach Mai 31

> LE MAI HUONG, TRAN TH| HONG HA, HOANG KIM CHI, TRAN TH| NHU HANG, LE HUU CUONG, NGUYEN BiNH LUYEN, BUI ANH VAN, VU MANH HUNG: Nghien ciru tac dung cua chi pham SS-G tir sa sung (Sipunculus nudus) va nim hau thu (Hericium erinaceus) len sire khoe va chirc nang sinh ly ciia chuot dire thi nghiem 34

» TRAN PHI HOANG YEN, TRAN TH| KlEU DIEM, TRAN THANH BAO: Ban ting hgp va danh gia tac dong bao ve cua 3,3',4',7- tetra-O-acetylquercetin si> dung mo hinh suy giam tri nha dai han tren chupt nhit tring 39

» NGUYEN BiNH NGUYEN, BAO TH| KIM OANH, NGUYEN HAl NAM: Bade diu nghien ci>u ting hgp va thiit lap tap chuan captopril disulfid 41

» NGUYEN TH| HA, NGUYEN TH| THU TRANG, CHU NGOC CHAU, NGUYEN VAN TAl: Nghien ciru ting hgp natri alendrenat 48

» BUI HONG CUONG, PHAM THAI HA VAN: Nghien ciru thanh phan hoa hpc va tac dung sinh hoc cua cao dac bai thuoc Ky phu theo huwng cai thien tuan hoan nao 52

» PHAM VAN SON, LU TH| KIM CHI, PHAN NGUYEN TRUONG THANG, NGUYEN NGOC VINH: Nghien cuu phan lap hypophyllanthin tir cay diep ha chau ding (Phyllanthus amaws Schum. et Thonn.) lam chat dii chiiu 55

» TRAN ANH VU, LE TH| THU CUC: Xay dung quy trinh dinh lirgng apigenin-7-glucosid trong cao va chi pham kern chira dirang cam cue di thuc [Matricaria chamomilla L.J bing phuung phap sic ky long 59

• HA VAN OANH, NGUYEN HOANG TUAN, CHU TH| THANH HUYEN: Bo sung loai cam cu num {Hoya nummularioides Costantin) cho he thuc vatViitNam 63

» NGUYEN CANH QUANG, PHUONG THANH HOA, LE BiNH CHI: Xay dung phutrng phap dinh lugng ding thai paracetamol va tramadol hoac cafein bing dien di mao quan 67

• LU TH! KIM CHI, VO TH| NGOC DINH, NGUYEN NGOC VINH: Phan lap va thiit lap chat chuan vitexin tir cay lac tien (Pass/flora foetida Linn.) 70

• VU THI AN HOA, TRAN NGOC BAO, NGUYEN NGOC CHlEN: Tii uu hoa cdng thirc bao chi tieu phan nano glipizid vdi chit mang PLGA va chitosan 73

• TA MANH HUNG, NGUYEN TH| BUNG, NGUYEN TH| HONG HANH: Binh Irrang methylprednisolon trong huyet hrang ngu>di bang phuang phap UPLC-MS/MS 77

PHARMACEUTICAL JOURNAL ISSN 0866 - 7861

3/2017 (N°491 Vol. 57) CONTENTS

RESEARCH - TECHNIQUES

• BAM THANH XUAN, NGUYEN NGQC CHlEN, TR|NH TH| HOA, NGUYEN TH| PHUONG THUY: Study on formulation of probiotic microcapsules of Lactobacillus acidophilus by emulsion/internal congelation 2

• HUYNH TH| MY BUYEN, HUYNH VAN HOA, BO TH! HONG TUOI: Anticancer activity of gastric floating solid dispersion tablets of curcumin on the stomach cancer-induced model of mice 5

• NGUYEN TH! KIM THU, BANG KIM THU, BUI THANH TUNG: Inhibitory property in vitro of the leaves and root bark of Mows alba L. on the xanthine oxidase ezyme 8

• TRAN VIET HUNG, LE BiNH CHI, NGUYEN TH| HANG, DUONG MINH TAN: Development of an HPLC method for assay of apigenin in Chrysanthemum indicum L. 12

• NGCI THI LU, NGUYEN H U O N G GIANG, LE TH| THANH NHI, BO KY BAO, LAC KlEN TRlEU, NGUYEN TH| MINH T H U : Development of an LC/MS-MS procdure for determination of aflatoxin B1, B2, G1, G2 in functional foods 15

• VU BUC LOI, NGUYEN TlEN VUNG: Some phytochemical compounds isolated from the plant Hedyotis capitellata Wall, ex G. Don) grown in Thai Nguyen province 18

• HOANG THAI HCA, NGUYEN THUONG DONG, BAO THANH HlEN, NGHlEM BUC TRONG, NGUYEN HOANG TUAN: Morphological and microscopic characteristics of Physalis angulata L. (Solanaceae) 21

• NGUYEN HOANG TUAN: Hoya erythrina Rintz - A new record of medicinal plant species to Vietnam's flora 25

• NGUYEN TH! KIM THU, MAC BiNH HUNG: Synthesis and bioactivities of some halogen-containing derivatives of 3-nitro-2-phenyl-2H-chromene 28

• NGUYEN TH! NGA, BO DUY CUfrNG, VU BiNH H6A, NGUYEN HOANG ANH: Hepatotoxicity in the isoniazid-treated HIV-outpitients of the outpatient clinic for HIV/AIDS, Contageous disease Department of Bach Mai Hospital 31

• LE MAI HUONG, TRAN TH! H6NG HA, HOANG KIM CHI, TRAN TH! NHU HANG, LE HUU CUCfNG, NGUYEN BiNH LUYEN, BUI ANH VAN, VU MANH HUNG: Corroborant and masculine potency-invigorating effects of the SS-G preparation made from Sipunculus nudus L. and Hericium erinaceus on experimental male rats 34

• TRAN PHI HOANG YEN, TRAN TH! KlEU DlEM, TRAN THANH BAO: Semisynthesis and estimation of the neuroprotective property of 3,3',4',7-tetra-O-acetylquercetin by the model of long-termed memory dysfuntion in mice 39

• NGUYEN BiNH NGUYEN, BAO TH! KIM OANH, NGUYEN HAl NAM: Synthesis captopril disulfide and establishing a standard impurity of it 41

• NGUYEN TH! HA, NGUYEN TH! THU TRANG, CHU NGOC CHAU, NGUYEN VAN TAl: Study on synthesis of sodium alendronate 48

• BUI HONG CUONG, PHAM THAI HA VAN: Study on the chemical composition and the cerebral circulation improving bioactivity of the Qi fu spissum (condensed extracts from the compound herbal remedy Qi fu) 52

• PHAM VAN SON, LU TH! KIM CHI, PHAN NGUYEN TRUONG THANG, NGUYEN NGQC VINH: Isolation of hypophyllanthin from Phyllanthus amaws Schum. et Thonn. and establishment of its standard substance 55

• TRAN ANH VO, LE TH! THU CUC: An HPLC for quantitave determination of apigenin-7-glucoside in the extracts from the domesticated chamomile (Matricaria chamomilla L.) and related cosmetic creams 59

• HA VAN OANH, NGUYEN HOANG TUAN, CHU TH! THANH HUYEN: Hoya nummularioides Costantin - A new record of medicinal plant species to Vietnam's flora 63

• NGUYEN CANH QUANG, PHUONG THANH HOA, LE BiNH CHI: Development of a capillary zone electrophoresis method for simoultaneous determination of paracetamol and tramadol 67

• LU TH| KIM CHI, VU TH! NGOC DINH, NGUYEN NGOC VINH: Isolation and structural confirmation of vitexin from the leaves of Passiflora foetida Linn. 70

• VU TH! AN HOA, TRAN NGOC BAO, NGUYEN NGOC CHlEN: Optimization of the formulation of glipizid nanoparticles with PLGA as carrier and chitosan as coating 73

• TA MANH HUNG, NGUYEN TH! DUNG, NGUYEN TH| HONG HANH: Determination of human plasma methylprednisolone by UPLC-MS/MS 77

TIN TRONG NGANH 8 0 NEWS IN BRANCH 8 0

• Nghien C C P U - Ky thuat

Doc tinh tren gan a benh nhan nhiem HIV co dieu trj dy phdng lao bang isoniazid tai phong kham ngoai trii HIV/AIDS -

Khoa Truyen nhiem, Benh vien Bach Mai Nguyen Thi Nga1, Do Duy Cirdug2, Vu Dinh Hoa1*, Nguyen Hoang Anh1

' Trucrng Dai hoc Duac Ha Npi 2 Khoa Truyen nhiem - Benh vien Bach Mai

"E-mail: vudinhhoa@gmail.com Summary

To investigate the hepatotoxicity characteristics of 833 HIV-infected adults receiving isoniazid preventive therapy (IPT) and to determine the risk factors associated with hepatotoxicity, retrospective and descriptive studies were performed on a medical record collection of 833 adult HIV patients with IPT. Hepatotoxicity was observed in 29/833 (3.5 %) patients and commonly occurred in range of the 9h to the 12h week during the first 3 months of IPT. All hepatotoxicity patients had transient symptoms and 31% of those patients with transaminase decrease to normal level, 62 % had transaminase of grade 1 and 7% had transaminase of grade 2. The baseline levels of ALT and AST, gender and HCV co-infection were statistically associated with INH hepatotoxicity in univariate analysis with respective HR, (95 % CI): 1.03 (1.01 - 1.04); 1.02 (1.01 - 1.04); 4.68 (1.63- 13.44) and 5.21 (2.31 - 11.76). In multivariate analysis, baseline ALT and HCV co-infection were independent predictors for observed hepatotoxicity (HR, 95 %CI: 1.02 (1.00- 1.03) and 3.82 (1.59 - 9.18), respectively). Isoniazid induced hepatotoxicity is transient and can be recovered with baseline ALT and HCV co-infection were predictors. In other words, current IPT appeared to be safe for HIV adult patients.

Keyword: Isoniazid, hepatotoxicity, HIV, tuberculosis, IPT.

Oat van de Lao la nguyen nhan chinh d i n den to vong cho

ngodi nhiem HIV. Phac d6 dy phong lao bang isoniazid (Isoniazid preventive therapy - IPT) da chdng minh kha nang lam giam den 62% so trodng hap mac lao d ngirdi nhiem HIV [1]. Tuy nhien kha nang gay doc tinh tren gan do isoniazid (INH) lam giam hieu qua dieu trj, dong gdp dang ke vao so khdng tuan thu, to do gay th l t bai dieu trj hoac benh nhan bo dieu trj va lam gia tang kha nang tai phat hoac khang thuoc [2 ]. Nam 2010, Trung tarn Do phong va Kiem soat benh cua Hoa Ky (Center for Disease Control and Prevention = CDC) cdng b6 17 trodng hop ton thoong gan nghiem trpng trong do co 5 trodng hop to vong va 4 trodng hop phai cay ghep gan trong giai doan 2004 - 2008. Bao cao nay da gay lo ngai ve do an toan cua INH trong dieu trj do phdng lao tidm an P1 . Ke to do den nay, da co nhieu nghien cdu ve doc tinh tren gan lien quan den IPT d quan the benh nhan nhidm HIV dope tien hanh, nhong ket qua ve ty le doc tinh tren gan kha dao ddng gioa cac nghien cdu [4 '5]. Hien nay, Bo Y td da co hodng dan trong dieu trj do phong lao d cac benh nhan nhidm HIV nhong van choa cd bao cao hoan chinh nao mo ta dac diem doc tinh tren gan khi ap dung IPT d quan the benh nhan Viet Nam. Vi vay, chung tdi tien hanh de tai nay vdi muc tieu khao sat dac diem ve doc tinh tren gan cua benh nhan nhiem HIV so dung phac do do phong lao bdng INH

va phan tich cac yeu to nguy co co lien quan ddnso xuat hien cua doc tinh tren gan d nhong benh nhan nay.

Doi tirong va phirorig phap nghien CLFU

Doi toong nghien cdu Nghien cdu loa chpn cac benh nhan nhi lm HIV tren

18 tuoi dope dp phong lao bang INH to 1/5/2014 den 31/12/2014 tai Phdng kham ngoai tru HIV-AIDS, Khoa Truyen nhiem, Benh vien Bach Mai. Loai trd khdi nghien cdu cac benh an cua benh nhan khdng cd xet nghiem men gan trodc hoac trong qua trinh dieu trj dp phdng lao va cac benh nhan cd men gan trodc dp phdng lao tang tren ba Ian gidi han tren blnh thodng.

Phoong phap nghien cdu Nghien cdu hoi cdu mo ta theo doi benh nhan theo

thdi gian. Cac thong tin nghien cdu dope thu thap to benh an gom cd cac thong tin chung nho tuoi, gidi, benh mac kern; cac thong tin v§ dac diem lam sang nho trieu chdng dpc tinh tren gan do thuoc; cac thong tin vd xet nghiem sinh hda gom cd aspartat aminotransferase (AST), alanin aminotransferase (ALT) trodc trong va sau dp phdng lao.

Tieu chuan danh gia dpc tinh tren gan dope xac djnh la mot trong hai trodng hop sau: (1) AST hoac ALT tang tren ba Ian gidi han tren binh thodng ket hop them trieu chdng lam sang (chan an, ndn, buon ndn, node tieu sam mau, vang da); (2) AST hoac ALT tang tren 5 Ian gidi han tren binh thodng (ULN) cd hoac khdng ket hop

TAP CHI DUOC HOC - 3/2017 (SO 491 NAM 57) 31

• Nghien C I F U - Ky thuat

them trieu chdng lam sang. Tieu chuan nay dope xay dpng can cd vao do lieu cua cac nghien cdu trodc day ve dpc tinh tren gan trong dieu trj bang IPT [6"81.

Nghien cdu tien hanh xac djnh ty Id ghi nhan dpc tinh tren gan, xac suat xuat hien dpc tinh theo thdi gian, bidn phap xd tri va kdt qua cua xd tri neu co trong qua trinh didu trj. Cac yeu to cd lien quan ddn dpc tinh tren gan dope xac djnh thong qua hoi quy Cox don bien va da bidn. So lieu hdi cdu dope nhap vao co so do lieu Access Office 2010, sau do dope xd ly bang phan mem SPSS 20.0.

Ket qua nghien c d u

Dac diem doc tinh tren gan Cd 912 benh nhan nhi lm HIV tren 18 tuoi dope

dp phdng lao bdng INH to 1/5/2014 den 31/12/2014. Bang 1: Dac diem doc tinh tren gan khi

Cac benh an bj loai trd gom cd 77 benh nhan dope dp phdng lao sau 31/12/2014, 14 benh nhan khdng cd xet nghiem men gan trodc dp phdng lao, 19 benh nhan khdng cd xet nghiem men gan trong khi dp phdng lao va 46 benh nhan cd men gan trodc dp phdng lao tang tren ba Ian gidi han tren binh thodng. Nho vay, cd 833 benh an phu hop vdi tieu chuan Ipa chpn va tieu chuan loai trd dope doa vao nghien cdu. Dac diem chung cua benh nhan trong nghien cdu: ti le nam gidi va no gidi la 58,1% va 41,9%. Dp tuoi trung binh cua benh nhan la 36,7 tuoi trong do 91,8% ngodi dodi 50 tuoi. Benh mac kern dope ghi nhan chu ydu la vidm gan virus, trong do ty le viem gan C chidm 28,8%, viem gan B la 8,0%, dong nhidm viem gan B va C la 5,3%. Dac diem cac dpc tinh tren gan dope ghi nhan va trinh bay trong bang 1.

dung phac do du> phong lao b&ng INH Dac diem So luvng (%)

Ty le benh nhan gap doc tinh tren gan (n = 833) 29 (3.5) Thai gian trung binh ghi nhan dpc tinh tren gan (tuan) 11,4 ±9,4

0 - 1 2 tuan 19(65,5)

Ty le ghi nhan doc tinh tren gan theo cac khoang thai gian theo doi 1 2 - 2 4 tuan 9(31,1) 24 - 36 tuan 1 (3,4)

Kdt qua bang 1 cho thdy cd 29 benh nhan ghi nhan xuat hien dpc tinh tren gan chiem ti le 3,5%. Trong 29 benh nhan nay cd 28 trodng hop men gan tang tren 5 Ian gidi han tren binh thodng va 1 trodng hop men gan tang tren 3 Ian gidi han tren binh thodng kern theo trieu chdng lam sang nho met mdi, ndn, buon ndn. Thdi gian trung binh ghi nhan dpc tinh tren gan la 11,4 tuan. Ty le ghi nhan dpc tinh tren gan tap trung nhieu nhat vao khoang thdi gian to 0 - 1 2 tudn.

Xu> tri khi gap doc tinh tren gan Cac bien phap xd tri khi gap dpc tinh tren gan tren

benh nhan nhiem HIV dope dp phdng lao bang INH cung dope ghi nhan va trinh bay trong bang 2.

Bang 2: XCr tri va kdt qua xd tri khi gap dpc tinh tren gan Dac diem So lirong (%)

Xi> tri khi qap doc tinh (n=29) Dirnq thuoc 25 (86,2) Tiep tuc diinq thudc 4(13,8)

Ket qua theo doi/xd tri dpc tinh tren gan (n = 29) Giam ve binh thudng (AST, ALT < ULN) 9(31,3) Giam ve giai doan 1

Men gan cua ( U | _ N < A S T A L T < 3 x U L N ) 18(62,0) benh nhan L . . ; . . , „

Giam ve giai doan 2 (3xULN<AST,ALT<5xULN)

2(6,7)

Trieu chimp Mat di trong qua trinh theo doi 29(100) lam sang Khong mkt di 0(0)

Uiiri B i a n d i e u tri (tuan)

Thai gian (tuln) 0 12 24 36 48 52 So benh nhan 833 792 738 698 25 0

Hinh 1: Xac suat gap doc tinh tren gan theo thoi gian dieu til tren benh nhan nhiem HIV duxyc dir phdng lao

bdng isoniazid Thdi gian dpc tinh tren gan dope ghi nhan dope md

ta chi tiet hon trong hinh 1. Trong khoang thdi gian to 8 den 12 tuan dau dieu trj, dp doc dodng bieu dien xac suat gap dpc tinh tang dot bien gpi y dpc tinh tren gan cd kha nang xudt hien cao trong khoang thdi gian nay. Sau 24 tuan, nguy co gap dpc tinh con rat it. So benh nhan dope theo ddi sau 36 tuan la rat it ndn ket qua giai doan nay cd the khdng chinh xac.

ULN: upper limit normal, giai han tren cua nguvng binh thuvng.

Trong 29 benh nhan gap dbc tinh tren gan cd 25 (86,2%) benh nhan dope dong INH va 4 (13,8%) benh nhan khdng ghi nhan dope bien phap xo tri va van tiep tuc dung thuoc. Tuy nhidn, tat ca cac benh nhan deu cd men gan giam dan sau do. Cu the, cd 9 (31%) benh nhan cd men gan vd binh thodng, 18 (62%) benh nhan ve giai doan 1 va 2 (6,7%) benh nhan ye giai doan 2. Cac trieu chdng lam sang cung mat ddn di trong qua trinh theo ddi.

Phan tich cac yeu to lien quan Cac yeu to cd the lien quan den kha nang xuat hien

ddc tinh tren gan dope doa vao phan tich hdi quy Cox gom cdtuoi, gidi tinh, chi sd khdi cothe, chi so AST, ALT va CD4 ban ddu, dong nhiem viem gan B, dong nhidm vidm gan C, dung kern nevirapin, efavirenz, lopinavir/ ritonavir hay cotrimoxazol. Ket qua phan tich cac yeu to lien quan dope trinh bay trong bang 3.

32 TAP CHI DUOC HOC - 3/2017 (SO 491 NAM 57)

• Nghien C L F U - Ky thuat

Bang 3: Cac yeu to lien quan den kha nang xuit hien doc tinh tren gan

Yeu to Phan tich don bien Phan tich da bien

Yeu to Hazard ratio (95% CI) P Hazard ratio (95% CI) p

AST ban dau 1,02(1,01 -1 ,04) 0,005 ALT ban dau 1,03(1,01 -1 ,04) 0,000 1,02(1,00-1,03) 0,043 Nam gidi 4,68(1,63-13,44) 0,004 Viem gan C 5,21 (2,31-11,76) 0.000 3.82(1.59-9,18) 0.003

Cac yeu to co lien quan den kha nang xuat hien dpc tinh tren gan dupe ghi nhan trong phan tich hoi quy Cox dan bien gom co gidi tinh nam vdi HR (95%CI): 4,68 (1,63 - 13,44), AST ban dau vdi HR (95%CI): 1,02 (1,01 - 1,04), ALT ban dau vdi HR (95%CI): 1,03 (1,01 - 1,04) va viem gan C vdi HR (95%CI): 5,21 (2,31 -11,76). Tuy nhien, trong phan tich da bidn co hai y l u t6 dp doan dpc lap kha nang xuat hien dpc tinh tren gan dupe ghi nhan la gia tri ALT ban dau vdi HR (95%CI): 1,02 (1,00 - i ,03) va viem gan C vdi HR (95% CI): 3,82 (1,59-9,18).

Ban luan Nghien CLFU cua chung toi ghi nhan ty le dpc tinh tren

gan d benh nhan HIV dung IPT la 3,5% va day la ket qua tuang doi cao so vdi cac nghien cdu khac tren the g i d i [ 4 9 ] . Trade tien phai ghi nhan ti le benh nhan dong nhiem viem gan C trong nghien CLFU cua chung toi la (28,8%) va day cd the la nguyen nhan dan den ti le dpc tfnh ghi nhan dupe kha cao. Oi lu nay cang dupe the hien rd trong phan tich hoi quy Cox trong do viem gan C la yeu to dpc lap dp doan kha nang xuat hien dpc tinh trong do nguy ca d benh nhan viem gan C cd the cao han d i n gan 4 Ian so vdi cac benh nhan khdng dong nhiem viem gan C. Hiep hoi Long nguc Hoa Ky cung da khuyen cao theo ddi chat che men gan cua benh nhan m l c kern viem gan C [101. Bdi vay, cac dan vj then khai IPT d benh nhan HIV can phai giam sat chat che men gan cua cac benh nhan cd dong nhiem viem gan C de tu do dua ra cac bien phap xu tri kip thdi doi vdi ddi tupng dac biet nay. Mot ydu to cd lien quan den dpc tinh tren gan nua thu dupe tu nghien cuu la gia trj ALT trudc dieu trj. Da cd nghien cuu ghi nhan phat hien nay trudc day [6L Ket qua nay mot Ian nua nhan manh tarn quan trpng cua v i le k i lm tra men gan trudc khi dung IPT, dieu ma khdng phai tat ca cac benh nhan deu dupe thuc hien nhu ket qua sang Ipc benh nhan ban dau trong nghien cuu nay da chi ra. Neu benh nhan cd men gan tang tren gidi han binh thudng trudc dieu trj IPT thi can theo ddi men gan va trieu chung lam sang chat che.

Thdi gian gap ddc tinh tren gan thudng tap trung trong khoang 3 thang dau dieu trj. Tuy nhien, day chua han la thdi gian thuc su xu i t hien nhi lu dpc tfnh tren gan ma cd the chi la thdi diem tap trung cac ghi nhan dpc tinh tren gan dupe cu the hda b ing xet nghiem men gan. Theo hudng dan cua Bp Y t l , benh nhan c i n dupe kiem tra thudng quy men gan 6 thang mot l in . Ket qua trong nghien cuu nay gpi y rang ddc tinh tren gan cd the da xui t hien vdi t i n sd kha cao

trudc khoang thdi gian nay va cac bac sT dieu trj da chu ddng chi djnh xet nghiem theo ddi chuc nang gan ngay trong giai doan d i u cua IPT. Zegabriel Tedla va CS. cung cho rang dpc tinh tren gan thudng t i p trung xui t hien trong ba thang dau dieu t r j [ 4 ] . Vi vay, ket qua nghien cuu cua chung toi cung nhu cac bang chung tu cac nghien cuu khac gpi y rang benh nhan nen dupe giam sat chuc nang gan thudng xuyen han d giai doan dau cua IPT nh im phat hien cac trudng hop dpc tinh tren gan va tu do cd giai phap xu tri kjp thai.

Trong 29 benh nhan gap dpc tinh tren gan, cd 25 benh nhan dupe chi djnh dung thuoc va 4 benh nhan van tiep tuc dung phac do IPT ma khdng ghi nhan dupe bien phap xu tri nao khac. Trong cac nghien cuu trudc day cung cho th iy tac dung khdng mong muln la yeu to nguy ca cao lien quan den quyl t djnh dung didu trj IPT Chi cd 6,7% benh nhan cd su hoi phuc d muc dp kern, tuc la men gan chi giam ve giai doan 2, con lai 93,3% benh nhan cd men gan giam ve binh thudng hoac giai doan 1. Trong 4 benh nhan khdng dupe xu tri, cd 3 benh nhan men gan tu khdi phuc ve giai doan 1 va 1 benh nhan men gan khdi phuc ve muc binh thudng. Nhu vay cd the thay r ing cac trieu chung dpc tinh tren gan thudng tu mat di du benh nhan cd dupe xu tri hay khdng va tu do gpi y r ing dpc tinh tren gan d benh nhan nhi lm HIV dupe du phdng lao bang INH chi mang tinh chat thoang qua va benh nhan cd xu hudng tu hoi phuc. Nghien cuu cua Nolan va CS. cung cho thay ty le benh nhan gap dpc tinh tren gan do du phdng lao thap han so vdi cac bao cao trudc day va gpi y tinh an toan cung nhu Ipi ich cua phac do IPT mien la viec theo ddi va tarn soat cac benh nhan nguy ca cao dupe then khai chat che ®.

Trong nghien cuu cua chung toi, nhieu yeu to dua vao tim hi lu nhung khdng thay cd tuang quan vdi kha nang xu i t hien dpc tinh tren gan trong do cd viec dung thuoc ARV. Cac thuoc ARV dac biet la nevirapin dupe cho la cd kha nang gay dpc tinh tren gan cao lai khdng the hien ro anh hudng trong phan tich cua chung toi. Ket qua nay cung da dupe cdng b l trong nghien cuu trudc day trong do viec dung ARV hay cac thuoc ARV cu the nhu nevirapin va efavirenz khdng anh hudng d i n ddc tinh tren gan [4]. Vdi lupng benh nhan kha Idn trong nghien cuu nay, viec khdng tim thay moi tuang qan giua viec dung cac thuoc ARV vdi bien co tren gan gpi y r ing cd the hau nhu khdng cd tac dung cpng hop gay ddc tinh tren gan giua thuoc ARV va INH trong phac do du phdng.

Nghien cuu cua chung toi v l n con ton tai mot so han che. Thu nhlt, ban ch i t nghien cuu hoi cuu nen nhieu sd lieu cd the khdng thu thap dupe day du va tu do cd the d i n tdi sai lech trong mot so k i t qua, cu t h l la thai gian xuat hien dpc tinh. Thu hai, nghien cuu danh gia ton thuang gan chi dua tren chi so men gan ma khdng can cu vao cac thong s i sang Ipc khac nhu bilirubin. D i lu nay cd t h l dan d i n kha nang phat hien khdng day du cac b inh nhan gap dpc tinh tren gan

TAP CHI DlTOC HOC - 3/2017 (SO 491 N A M 57) 33

• Nghien ci>u - Ky thuat

khi ap dung IPT. Tuy nhien, cung nhu nhieu nghien CLFU

hoi CLFU khac tien hanh t r w c day v l ITnh VLFC nay, viec du*a ra mot dinh nghTa dan gian la dieu can thiet va chi so men gan cung co the coi la yeu to quan trpng hang dau trong danh gia ton thuang gan do thuoc. Viec danh gia mot each chinh xac va toan dien han se can doi hoi tien hanh cac nghien CLFU tien CLFU nh lm ghi nhan day du han cac chi tieu nghien CLFU.

Ket luan Nghien CLFU ghi nhan mot ty le dang ke benh nhan

xuat hien dpc tinh tren gan trong vong ba thang d l u dieu tri. Tuy nhien ph ln Idn dpc tinh mang tinh chi t nhe va thoang qua. Gia trj ALT ban d l u va d ing nhi im viem gan C la nhumg y l u t l dpc lap co lien quan d i n kha nang xuat hien dpc tinh tren gan khi ap dung IPT.

Tai lieu tham khao 1. Woldehanna S., Volmink J. (2004), "Treatment of latent

tuberculosis infection in HIV infected persons", The Cochrane Database of Systematic Reviews, (1):CD000171, Epub 2004/02/20.

2. Kaona F. A., Tuba M. (2004), "An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment", BMC Public Health., 4, 68, Epub 2004/12/31.

3. Center fDoCaP (2010), "Severe isoniazid-associated liver injuries among persons being treated for latent tuberculosis infection - United States, 2004-2008", Morbidity and Mortality Weekly Report., 59(8), 224-229, Epub 2010/03/06.

4. Tedla Z., Nyirenda S., Peeler C , Agizew T, Sibanda T, Motsamai O. et al. (2010), "Isoniazid-associated hepatitis and antiretroviral drugs during tuberculosis prophylaxis

in HIV-infected adults in Botswana", Am. J. Respir. Crit. Care Med., 182(2), 278-285, Epub 2010/04/10.

5. Durovni B., Saraceni V. (2013), "Effect of improved tuberculosis screening and isoniazid preventive therapy on incidence of tuberculosis and death in patients with HIV in clinics in Rio de Janeiro, Brazil: a stepped wedge, cluster-randomised trial", The Lancet Infectious Diseases, 13(10), 852-858.

6. Gray E. L, Goldberg H. F. (2016), "Baseline abnormal liver function tests are more important than age in the development of isoniazid-induced hepatoxicity for patients receiving preventive therapy for latent tuberculosis infection", Intern. Med. J., 46(3), 281-287, Epub 2015/12/10.

7. Tedla Z., Nguyen M. L., Sibanda T, Nyirenda S., Agizew T. B., Girde S., et al. ( 2015), "Isoniazid-associated hepatitis in adults infected with HIV receiving 36 months of isoniazid prophylaxis in Botswana", Chest, 147(5), 1376-1384, Epub 2014/10/24.

8. Coca N. S., Oliveira M. S., Voieta I., Antunes C. M., Lambertucci J. R. (2010) "Antituberculosis drug-induced hepatotoxicity: a comparison between patients with and without human immunodeficiency virus seropositivity", Revista da Sociedade Brasileira de Medicina Tropical, 43(6), 624-628, Epub 2010/12/25.

9. Nolan C. M. (1999), "Hepatotoxicity associated with isoniazid preventive therapy: a 7-year survey from a public health tuberculosis clinic", JAMA, 281(11), 1014-1018, Epub 1999/03/23.

10. Saukkonen J. J., Cohn D. L. (2006), "An official ATS statement: hepatotoxicity of antituberculosis therapy", American J. of Respiratory and Critical Care Medicine, 174(8), 935-952.

11. Codecasa L. R., Murgia N., Ferrarese M., Delmastro M., Repossi A. C., Casali L., etal. (2013), "Isoniazid preventive treatment: predictors of adverse events and treatment completion", Int. J. Tuberc Lung Dis., 17(7), 903-908, Epub 2013/05/09.

(Ngay nhan bai: 05/12/2016 - Ngay phan bien: 22/01/2017 - Ngay duyet dang: 07/03/2017)

Nghien cihi tac dung cua che pham SS-G tir sa sung {Sipunculus nudus) va nam hau thu {Hericium erinaceus) len sire khoe va chirc nang sinh ly cua chuot dire thi nghiem

Le Mai Huong1*, Tran Thi Hong Ha1, Hoang Kim Chi1, Tran Thi Nhu Hang1 Le Huu Cuo'ng1, Nguyen Dinh Luyen1, Bui Anh Van1, Vu Manh Hung2

1 Vien H6a hoc ede hap chat thien nhien, Vien Khoa hoc va Cong nghe Viet Nam 2 Bomon Duac ly, Hoc vien Quan Y, Bo Qudc phdng

'E-mail: lehuongl258@gmail.com Summary

As the peanut-worm (Sipunculus nudus Linnaeus) has been used in folk medicine for male sexual dysfunction, the effects of the preparation SS-G consisting ofS. nudus and Hericium erinaceus extracts (as the main components) on male health and sexual function of rat (Rattus norvegicus Rattus) were investigated. Two various doses of The preparation were given orally to male rats at dose of 2.25 g (dose 1) and 6.75 g/kg (b.w.) (dose 2). The SS-G not only helped to gain body weight, but also enhance testis, seminal vesicles and prostate gland weights of the experimental animals. Besides, SS-G at dose 2 obviously increased the number of sperms and viable sperm ratio of male rats at day

34 TAP CHI DUOC HOC - 3/2017 (SO 491 NAM 57)