NHI MU C TIM

Nhi mu c tim l bnh l nguy him e do tnh mng do tc nghn t ngt mch mu nui tim.Khi c tim hon ton khng c cung cp mu th c vng c tim s hoi t gy triu chng au ngc d di .ng thi tim l ni co bp duy tr lu lng mu n cc c quan khc, do khi khng cn cung cp mu s to ra mt n in hc v tim khng duy tr nhp co bp u n v gy lon nhp trong nhng gi u thng l rung tht v ngng tim sau ngi bnh s t vong.Mt s bnh nhn nu may mn thot cht thng phi i mt vi bnh vn cn tin trin hoc bin chng suy tim ... Vic ghi nhn sm triu chng cng nh chn on sm l vic rt quan trng c th cu sng bnh nhn nhi mu c tim. Nhng du hiu no cn nghi ng nhi mu c tim? Biu hin thng gp l au ngc tri d di, ko di hn 15-30 pht .au c khi km v m hi v kh th, mt nhiu, khng dm vn ng nng v gia tng cn au.au c th lan ra cnh tay cng tay tri n ngn t v p t bn tay tri, hoc c th lan sau lng hoc hm di tri. nhng ngi c tin s bnh thiu mu c tim, au ngc d di khng gim sau khi s dng nitroglycerine hoc isosrbide dinitrate (Risordane) ngm di li, cn tham vn bc s ngay.i vi nhng ngi trn 40 tui,c tiu ng, tng lipid mu, ht thuc l ,bo ph m trc y cha c chn on bnh thiu mu c tim(thiu nng vnh) khi triu chng au vn tip tc cn n cc c s y t ngay bc s gip tm nguyn nhn au ngc c phi do nhi mu c tim hay khng. Trong qu trnh di chuyn n c s y t cn di chuyn bng cc phng tin an ton(xe cp cu hoc tc-xi), trnh vn ng gng sc trong qu trnh di chuyn. Mt s ngi b nhi mu c tim c th ch biu hin bng kh th nh hay mt khi vn ng m khng au ngc. Do c th nhi mu c tim s b b st. Cho nn trong cuc sng hng ngy chng ta vn c th gp nhng trng hp ch than mt trc vi gi sau t nhin t vong lm cho gia nh nn nhn rt hoang mang. Cc xt nghim no cn lm khi nghi ng nhi mu c tim ? Mc d khai bnh l kh quan trng nhng quyt nh chn on l cc xt nghim v n khch quan v trung thc hn trong nh bnh.Bc s ca bn s cho bn thc hin cc xt nghim sau y khi nghi ng bn c bnh nhi mu c tim nu bn c cn au ngc tri nhiu v ko di 10-30 pht.

Xt nghim u tin cn lm l in Tm (ECG): Ty theo hnh nh sng ECG m quyt nh x tr ban u: Nu on ST chnh ln trn ECG in hnh nhi mu c tim cp(ch gp 50% bnh nhn nhi mu c tim), cn s dng aspirin v nitroglycerine v cc thuc tiu si huyt ngay(nu khng c chng ch nh theo phn quyt ca bc s) v nhp vin theo di ngay.Ti bnh vin, bnh nhn nhi mu c tim s c theo di ECG v thc hin xt nghim mu (men tim,glucose mu, creatinine) Nu thay i ST khng c trng ( ST chnh xung, hoc gn bnh thng) cn theo di tip tc, c th x tr ban u vi nitroglycerine v aspirin khi nghi ng c bnh thiu mu c tim cp.Cn xc minh hoc loi tr nhi mu c tim bng xt nghim tm hoi t c tim. Xt nghim mu tm tn thng c tim: Khi c tim b hoi t do nhi mu, mt s thnh phn c tim c gii phng ra v si vo mu do ngi ta s xt nghim mu tm nhng thnh phn ny. Nu au ngc xy ra < 6 gi th nn chn xt nghim Myoglobine,CB-MB v c th xt nghim li sau 6-8 gi. Nu au ngc xy ra > 6 gi nn lm xt nghim CK-MB v Troponin I hoc T. cc c s y t cha c trang b cc xt nghim trn thng s dng SGOT & SGPT , LDH tham kho mc d chnh xc khng bng nhng cng l du hiu gi . Hu nh cc nc tin tin t b xt nghim SGOT &SGPT trong qui trnh chn on nhi mu c tim cp.

Khi xt nghim cho thy tr s tng cao th c th chn on nhi mu c timv bc s s iu chnh iu tr trc theo hng tch cc hn Cc xt nghim khc: Ch xem xt sau khi c chn on r rng hoc nhm loi tr bnh l khc m khng ngh n nhi mu c tim. Chp Xquang tim phi: nh gi thm tnh trng phi nh c trn kh -trn dch mng phi hay khng, cng nh xem xt bng tim c ln khng. Siu m tim: nhm xem xt c tn thng cu trc ( phnh vch tim, trn dch mng tim ) v xem xt chc nng co bp tim c tt hay khng. Bn cn lm g khi c cn au ngc ko di ? Khi cn au ngc nh m t xy ra bn cn lu nh sau: Ngng ngay hot ng v cng vic ang lm v d ang li xe nn tp xe vo l, bo ngay thn nhn (bng in thoi), c th nm ngh, s dng thuc nitroglycerine ngm di li nu bn c bc s ca bn chn on bnh mch vnh trc y . Nu sau 10-30 pht tnh trng au ngc khng , c bit khi s dng nitroglycerine ngm di li . Cn c a i nhp vin nagy bng phng tin an ton v nhanh nht. Nhng x tr no c thc hin ti bnh vin? Ti bnh vin khi bn than phin au ngc tri nhiu km v m hi,sau khi bc s o huyt p v thm khm cho bn, cc xt nghim cn thit s thc hin khn trng .ECG l xt nghim quyt nh ban u bn c b nhi mu c tim hay khng c th iu tr sm vi thuc tiu si huyt. Nu chn on c xc minh l c nhi mu c tim, ngi bnh s c chm sc cht ch hn ti ging. c theo di ECG lin tc ti ging, o huyt p thng xuyn Thit lp ng truyn tnh mch . Th oxy S dng thuc dn mch vnh(Nitroglycerin, Risordane), thuc n nh tim (thuc c ch bta(metoprolol, atenolol...).Xem xt thuc lm tan cc mu ng trong mch vnh(streptokinase, alteplase,,rPA..) v thuc aspirin... Nu au nhiu cn phi s dng thuc gim au mnh :Morphin tim tnh mch gim au. Vi s dng ngn hn c kim sot theo ch dn bc s ngi bnh s khng lo b nghin. mt s nc tin tin, khi cn thit v nguy cp do tc ng mch vnh ngi ta c th nong ng mch vnh ngay mu trong mch vnh c th lu thng tr li. Mt s lu i vi bnh nhn nhi mu c tim

Trc khi xut vin v nhi mu c tim , ngi b nhi mu c tim s kim tra tim mch trc khi xut vin nh xt nghim men tim, thc hin nghim php gng sc nh gi kh nng gng sc m qua bc s s khuyn ngi bnh c php gng sc n mc no trong sinh hot hng ngy. Ngi bnh cn tun th li dn ca bc s v ch n, vn ng th lc thng xuyn vi mc cho php,cch dng thuc v thi gian ti khm. Cn cnh gic vi nhng cn au ngc v cc du hiu khc v sau nhi mu c tim khng c ngha l bnh ht hn m phi iu tr tip tc v tn thng mch vnh c th xy ra nhng nhnh ng mch khc mt khi nguy c ca n khng khc phc( huyt p cao, tiu ng, tng m trong mu...)

NHI MU C TIM CP
Nguyn nhn
X va ng mch v v mng x va tc ng mch vnh. Co tht ng mch vnh (bao gm c do cocaine).

Bc tch ng mch ch lan n ng mch vnh (thng ng mch vnh P NMCT vng honh). Thuyn tc ng mch vnh (vd, do vim ni tm mc, van tim nhn to, huyt khi thnh tim, u nhy). Vim mch mu (vd: bnh Takayasu, hi chng Kawasaki). Vim c tim (hoi t c tim, d khng gy bnh ng mch vnh).

Biu hin lm sng

Cn au tht ngc (in hnh l cm gic b p sau xng c c th lan n c, hm, vai, hoc cnh tay ) ko di > 30 pht. Triu chng i km: kh th, v m hi, bun nn, nn , nh trng ngc.

Khong 32% NMCT khng c nhn bit ngay t u bi v tht s yn lng hoc c biu hin au ngc khng in hnh hoc c triu chng khng c hiu nh cm gic kh hoc nh b cm.

Khm thc th.

Du hiu ca thiu mu c tim: T4, ting thi ca h van 2 l mi xut hin do ri lon chc nng c nh, T2 nghch o. Du hiu ca suy tim: p lc tnh mch cnh, rales phi, T3 (+)

Du hiu x va ng mch ni khc: ting thi ng mch i hoc ng mch cnh, mch phn xa.

Xt nghim chn on
ECG Men tim / huyt thanh: troponin tim pht hin c mc nh ca hoi t c tim, v vy c li chn on v nhi mu bnh nhn b CTN khng n nh c CPK-MB (-) chn on NMCT nghi ng xy ra khong 2-10 ngy trc v nu nghi CPK-MB (+) gi. Siu m tim: bt thng vn ng vng mi xut hin (nhng ph thuc rt nhiu vo ngi c v ngi lm siu m).

Hnh 1-4: Tin trin ECG trong NMCT cp

Hnh 1-5: S phng thch men tim vo trong dng mu sau NMCT cp.

 nhy cm ca CPK-MB v Troponin trong vic pht hin NMCT khng r c ST chnh ln. Men tim Trc 6 gi Hn 6 gi sau khi bt u b nhi mu CPK-MB > 4.7ng/ml 53% 91% Troponin T >= 0.18 ng/ml 51% 94% Troponin I >= 0.1 ng/ml. 66% 100%

iu tr tiu huyt khi Ch nh Chng ch nh Cc triu chng ca NMCT ko di >= 30 pht v <12 gi Tuyt i v ST tng > 1mm >=2 chuyn o lin tip hoc cc triu chng ca NMCT trn phi hp vi block nhnh T Bt c mt trng hp xut huyt ni s no trc , mi xut hin. huyt trong vng mt nm.

U tn sinh ni s, ti phnh hoc d dng ng t Xut huyt ni ang din ra

Gii hn v tui:

Nghi ng c bc tch ng mch ch. Tng i:

Bnh nhn trn 75 tui th tiu huyt khi c s dng l HA tm thu >180 hp l nhng tng nguy c xut huyt ni s. INR >2, c a d chy mu Gii hn v thi gian: Chn thng hoc phu thut ln trong vng 2-4 tun. Dng thuc tiu huyt khi cng sm th li ch cng ln. Hi sc tim phi ko di (>10 pht) Li ch ca thuc sau 12 gi th khng r nhng nn xem xt bnh nhn au ngc 12-24 gi m ST vn cn Mi b xut huyt ni (trong vng 2-4 tun). chnh ln. m thng mch mu khng p c

Tip xc vi Streptokinase trc (khi d nh dng Str Thai k

Thuc tiu huyt khi Alteplase (TPA) Streptokinase (SK) Reteplase (RPA)

Liu 15mg bolus tnh mch, sau 0.75mg/kg (ti a 50mg) trong 30 pht ri 0.5mgkg (ti a 35mg) trong 60 pht. 1.5 triu n v, tnh mch trong 30-60 pht. 10 U tnh mch, lp li trong 30 pht, ch 1 ln.

Ti to lng mch mu tin pht (primary angioplasty).

Vic l chn ti to lng mch mu tin pht hay dng thuc tiu huyt khi vn cn ang tranh lun. Cc nghin cu phn tch tng hp cho thy: th thut ny lm gim c 20% t vong hoc b NMCT v gim t qu 65% nu do thy thuc c k nng tt thc hin trong vng 60-120 pht sau au ngc. V vy, nn xem xt y l mt iu tr thay th cho thuc tiu si huyt nu bnh vin c phng v cc bc s v tim mch hc can thip c kinh nghim, nu bnh nhn c chng ch nh iu tr tin si huyt, c chong tim, c nhi mu c tim trc rng, hoc c phu thut bc cu ni mch vnh trc y. Tuy nhin khng c vic xem xt chn la phng php ti ti mu no lm chm tr thi gian bt u iu tr ti ti mu. iu tr chng huyt khi Thuc Aspirine 162 n 325mg ung mi ngy Liu u tin: nhai nt hoc nghin Heparine tnh mch Li bn Gam 23% t vong do mch mu Gam 49% ti nhi mu khng gy t vong.

Cha chng minh c hiu qu v t l t vong.

Tim thng tnh mch 60v/kg (ti a l 4000 Lm tng s thng ng mch vng nhi mu khi n v) iu tr sau Alteplase. V vy ch c ch nh trong iu tr phi hp vi Alteplase 12v/kg/gi truyn tnh mch (ti a 1000v/gi), iu chnh liu sao cho a PTT t (BMj 313:652, 1996 and AJC 77:551, 1996) 50-70 giy. Thuc c ch GP IIb/IIIa C hiu qu trong trng hp iu tr ti to lng mch mu tin pht. (TIMI-14, Circulation 99:2720, 1999).

iu tr b sung Thuc Thuc chn Bta Metoprolol 5mg tim tnh mc mi 5 pht x 3 ln, ri 25mg ung mi 6 gi, iu chnh liu ty theo s dung np. Nitrates Trinitroglycerine (TNG) tnh mch 10-1000 g/pht

Li bn 15% t vong do mch mu. Chng ch nh nu tn s tim < 60, HA tm thu < 100, suy tim trung bnh hoc nng, block nh tht II, III, bnh l co tht ph qun trm trng Dng TNG tnh mch trong 24-48 gi u da trn s phn tch tng hp cho thy 35% t vong (Lancet 1:1088,1988)

Thuc c ch men chuyn angiotensine captopril 6.25mg, 3 ln trong ngy hoc lisinopril 5mg mi ngy, ri iu chnh ty theo s dung np ca bnh nhn. Oxygen Morphine

Chng ch nh trong nhi mu tht P v gim th tch mu. t vong 10% 4-6 tun, 19% t vong sau 4 nm (SAVE, N Engl J Med 327:669, 1992; GISS-3, Lancet 343:1115, 1994; ISIS-4. Lancet 345:669, 1995) hiu qu nhiu nht bnh nhn b NMCT trc , chng ch nh khi HA nng hoc suy thn. au, lo lng, dn tnh mch tin ti.

Bin chng Chong tim

V thnh t do

Thng lin tht t c nh

Bin chng c hc sau NMCT Biu hin lm sng iu tr t l gp: < 5% in hnh trong vng 48 gi uCatheter ng mch phi, thuc sau nhi mu c tim tng co si c, thuc vn mch, t bng di nghch ni ng mch ch, ti to ng mch vnh. T l gp: < 6% Khi phc th tch, thuc tng si c, chc d mng ngoi tim, in hnh l trong 2 3 ngy sau nhi mu cphu thut. tim huyt p v tn s tim thong qua (rch mng ngoi tim) chn p tim hoc t t. T l gp: 2-4% in hnh l trong vng 5 ngyThuc tng si c, t bng di u sau nhi mu c tim 90% c ting thi minghch ni ng mch ch, thuc xut hin, rung miu. dn mch, li tiu, phu thut. t l gp: 1% in hnh l trong vng 5 ngyThuc dn mch, li tiu, t u sau nhi mu c tim. 50% c ting thibng di nghch ni ng mch mi xut hin, him khi c rung miu. ch, phu thut.

Ri lon nhp tim sau nhi mu c tim ri lon nhp Rung nh (t l 10-16%)

iu tr Shock in chuyn nhp nu huyt ng bt n hoc c thiu mu cc b.

Thuc chn Bta v / hoc digoxin Procainamide hoc amiodarone, heparin. Nhp nhanh tht hay rung tht. Phc b n Thuc chng lon nhp v shock in chuyn nhp dng xut hin sm (< 48 gi sau nhi mu) hoc hoc kh rung phi hp vi hi sinh tim cao khng c tin lng xu. cp. Truyn tnh mch lidocainetrong 624 gi ri nh gi li. Tng liu thuc chn Bta nu bnh nhn dung np c, bi ph K v Mg, iu tr thiu mu c tim. Nhp chm xoang Nu c triu chng dng atropine. Nu c triu chng v khng tr t my to nhp. Atropine v epinephrine t my to nhp. Khng iu tr. Nu c triu chng atropine, nu c triu chng

V tm thu Block nh tht 1 Block nh tht 2, type I

v khng tr t my to nhp Block nh tht 2, type II t my to nhp Block 2 nhnh (block nhnh T, Block nhnh Cn nhc t my to nhp P+ Block phn nhnh T trc hoc block phn nhnh T sau) Block thay i hoc block 3 nhnh (block 2 t my to nhp. nhnh + block nh tht 1) Khi c ch nh t my to nhp, t my qua da (tm thi) c thc hin trc tin kch thch tim trong khi ch i, t my to nhp qua ng tnh mch. Khi dng to nhp qua da nh l mt bin php nn th chng ta phi m bo c rng my to nhp ny gy ra c nht bt c tim. t my to nhp qua ng tnh mch tt nht l di s hng dn ca mng soi X-quang.

Bin chng Huyt khi tht T

Bin chng khc nhau ca NMCT Du hiu lm sng iu tr T l gp 20-40% Thuc chng ng 3 6 thng. Yu t nguy c: nhi mu c tim vng trc mm rng. Thnh tht T phnh thnh ti nhPhu thut nu c suy tim ra ngoi, khng co bp. huyt ti din, c huyt khi thuyn tc, c ri lon nhp tim. T l gp: 8-15% ST tng ko di khng phi lun lun l c phnh vch tht. Thnh tht b v bt li cPhu thut. nh huyt khi v mng ngoi tim. T l gp: 10-20% Aspirine liu cao, thuc khng vim nonsteroids. Hn ch dng in hnh l xy ra 1-4 ngythuc khng ng. sau nhi mu c tim. Ting c mng tim (+). Him khi bng ECG. T l gp: < 4% Aspirine liu cao, thuc khng vim non-steroids. in hnh l xy ra sau 2-10 tun sau NMCT. C biu hin st, kh , vim mng ngoi tim, vim mng phi

Phnh vch tht

Ti phnh gi vch tht Vim mng ngoi tim

Hi chng Dressler

Tin lng
Ni chung, t vong trong vng 30 ngy l 6.0 7.5%

Phn loi Killip Nhm I II III IV (Am J Caridiol 20:457, 1967)

nh ngha Khng c suy tim huyt C T3 v/ hoc rale y phi Ph phi Chong tim

T l t vong 6% 17% 30-40% 60-80%

Nhm I II III IV

Phn loi Forrester Ch s tim (L/pht/m2) P mao mch phi bt T l t vong (mmHg) >2.2 < 18 3% <2.2 >2.2 <2.2 >18 <18 >18 9% 23% 51%

(N.Engl J Med 295:1356, 1976)

Nhi mu c tim do x va ng mch

Ngy: 23-04-2011 huyetap.net Nhi mu c tim l tnh trng ca mt phn c tim b hy khi lng mu cung cp n phn b gim st. Ty theo bao nhiu c tim b hy, bnh c th nh hoc nng. Nu c cha b hy hn th gi l au tim.

Nhi mu c tim l thut ng m ngi ta dng ch cho tnh trng b nghn t ngt mch vnh. iu ny trong y khoa gi l tc mch vnh c th dn n t vong nhng a s l cn sng. T vong c th xy ra khi s tt nghn gy ra ri lon nhp tim hoc tn thng c tim lan rng. Trong c 2 trng hp ny th c tim u khng cn kh nng bm mu cung cp oxi cho no v nhng c quan khc. a s trng hp nhi mu c tim xy ra ngi c tnh trng bnh l mch vnh ( x va mch vnh ).

iu g xy ra i vi nhng trng hp x va mch vnh?

Trong bnh ng mch vnh (x va ng mch) chn thng lp trong ca ng mch dn n s hnh thnh nhng mng lm dy ln ca lp trong ng mch. Nhng mng hnh thnh nh th no trong vic p ng vi chn thng, nhng mng ny t lp gia v c th t lp ngoi di chuyn vo lp trong . y chng ti to li (bng cch phn chia) v tng hp nn lp m lin kt. Qu trnh xm nhp, phn chia, tng hp tp trung trong lp trong ny gy ra dy lp trong. Khi cholesterol, nhng m khc, t bo vim(bch cu) vo ch pht trin dy ln ny to nn mt mng x va. K nhng mng ny pht trin v chng cht nhng m so (m si) v nhng canxi tha thi (canxi l cht cng trong rng v xng).V th nhng mng ny thng cng l l do ti sao thnh thong x va mch mu c lin quan n s cng ng mch.

Ai b nhng mng x va mch mu v ci g xy ra vi nhng mng x va ?

a s nhng ngi ln tui u c mt s mng x va trong lp trong ca ng mch vnh. Ngay c nhng ngi tr thp nin 20 thng c nhng mng dy lp trong khu tr mch vnh. S phn b, mc (s lng mng x va) v t l pht trin nhng mng x va trong ng mch thay i rt ln mi ngi khc nhau. mng x va chc ny c th pht trin mt cch chm chp nhng c mt trong cn nguyn vn v khng c cc mu ng trn b mt ny.

Nguyn nhn ca nhi mu c tim l g ?

Vic v mng x va trong mch vnh l s kin sinh bnh u tin trong nhi mu c tim. Khi mng x va v ra, cc mu ng bt thnh lnh hnh thnh trong ng mch ch mng x va b v. Chy mu thng km theo vi v mng x va. Ri th cc mu ng lm tt ng mch vnh v gim tc mu n tim. Hu qu ca nhng bin c ny mch vnh l vn c bn ca trn 75% ngi b nhi mu c tim.

Mt ngi cn sng sau nhi mu c tim th b iu g ?

Theo nhng nghin cu trong y khoa, 50-70% ngi cn sng trong ln nhi mu u tin. Nhng ngi cht do nhi mu c tim v gim tc mu trong mch vnh gy ra s bt thng trong nhp tim v tn thng c tim lan rng. Hnh 4 cho thy tim ca bnh nhn cht sau nhi mu c tim 5 ngy. Hnh nh cho thy tim b nhi mu tht tri v lt ct xem vch c. Khong 90% nhi mu c tim lin quan n tht tri, l ni bm mu giu oxi n cc c quan. 10% khc lin quan n tht phi, ni bm mu vo phi. Nu mt ngi cn sng sau nhi mu c tim,c tim c th tr li bnh thng hoc tr thnh vng c cht. S lng v s khe mnh ca phn c tim cn li quyt nh cht lng cuc sng cng nh ko di tui th ca bnh nhn sau nhi mu c tim. Nhi mu c tim cng gy ngt qung dng in tim bnh thng dn n ri lon nhp. Nhi mu c tim cng lm yu i lc bm ca tim gy ra kh th do suy tim. Mi bin chng ca c tim ny c th xy ra bt k lc no trong qu trnh hi phc to so c tim.

Mt ngi c th b hn mt ln nhi mu c tim khng ?

Vng. Khng phi l khng thng thng, ngi bnh mch vnh c th c hn mt ln nhi mu c tim trong cuc sng. S tht, bng vic xem xt c tim khi m xc nhng nh bnh hc c th ni nhi mu c tim xy ra khi no. Theo cch th nhi mu c tim mi c th xut hin mt vng nu nht, nhi mu c tim bn cp th mu vng v nhi mu c tim lnh th c so trng ca c tim. Nhi mu c tim l mt cp cu khn trng; s sng cn ca ngi bnh quyt nh bi c c cp cu kp thi, ng cch hay khng. So vi cn au tht ngc th nhi mu c tim l tnh trng trm trng v nguy him hn nhiu. C th gi nhi mu c tim nh

mt hu qu, mt kt thc xu, mt bin chng cp mang tnh tai bin v nhi mu c tim cng li rt nhiu bin chng nguy him.

Bin chng sau ca bnh nhi mu c tim Cc bin chng sau nhi mu c tim c chia lm 3 loi: bin chng sm, bin chng th pht v bin chng mun.

Bin chng th pht

Hi chng Dressler gp t 3 4% trng hp, xut hin t 1 4 tun sau khi bnh khi pht. Biu hin lm sng l hi chng vim mng ngoi tim: au sau xng c, au tng ln khi th su, khi ho, khi vn ng, gim bt khi ngi hoc ci v ng trc. Nghe c th pht hin ting c mng ngoi tim. Trn dch mng phi, thm nhim phi. Chp Xquang lng ngc: hnh nh trn dch mng ngoi tim v mng phi. in tm : khng c du hiu hoi t lan rng v ti pht (dng chn on phn bit vi nhi mu c tim). Xt nghim mu: bch cu tng, a nhn trung tnh tng, tc mu lng tng. iu tr bng cocticoid c th khi nhanh hn. Tuy nhin hi chng d ti pht v khi ti pht nhiu s tr nn rt phin phc cho ngi bnh.

Cc chng au:
Nhng ngi c tin cn au tht ngc, tin cn nhi mu c tim, nhng ngi c nguy c nhiu v nhi mu c tim (nh x va mch vnh, b nhiu cn tng huyt p, i tho ng, mp ph, ri lon lipid mu, nghin thuc l) nu chm c triu chng l phi x l bt ng, gim au ngay v chuyn ngay bnh nhn n bnh vin bng xe chuyn dng cp cu tim mch. C nh th mi hn ch c cc bin chng v t vong do nhi mu c tim. - au thn kinh nhy cm: L cc cn au ngc lan ta, cng trung bnh, ging nh cm gic au m, nng n vng trc tim. Nhng ngi c chng au ny thng l nhng ngi hay lo lng, ng thi b suy nhc v th lc v tm thn. Liu php tm l v cc thuc trn tnh thng c th gii quyt c. - au kiu thp khp: Thng gi l vim quanh khp vai cnh tay, hi chng vai bn tay, hay gp vai v tay tri. i khi cha bng cc thuc gim au thng thng cng khi. Mt s trng hp phi dng cocticoid. Trnh tim thuc vo trong khp nht l khi bnh nhn ang dng thuc chng ng. Trong mt s trng hp nhi mu c tim thoi trin c th gp x cng cn gn tay, co rt v c th dn n Dupuytren. - Chng au tht ngc sau nhi mu c tim: khi c du hiu nhi mu c tim ti pht, phi iu tr nh nhi mu c tim cp.

Phng vch tim: L hu qu xa ca nhi mu xuyn thnh tim. Biu hin: nghe tim c ting p ph th tm thu, trn mm tim. Xquang thy hnh nh mt cung gin n th tm thu, ch yu b tri. in tm : c s tn ti ca du hiu tn thng, ng thi vi du hiu hoi t.

Lam gi de han che bien chung do nhoi mau co tim? Quy tc khn trng c coi l s 1 trong nguyn l iu tr nhi mu c tim v 2 l do: - T vong ca nhi mu c tim xy ra vi t l cao nht chnh l vo gi u tin, ri ngy u ca nhi mu c tim v c bn do ri lon nhp tim mt bin chng nng nht ca nhi mu c tim li xy ra rt bt thn v d gy t vong nht l rung tht. Cc ngoi tm thu tht c th chuyn nhanh thnh rung tht, cn ng ph cc k khn trng. - Bin php iu tr c bn hu hiu nht i vi nhi mu c tim li ch s c tc dng nu tin hnh sm, nht l bin php lm tan huyt khi mch vnh bng cc thuc tiu si huyt, c hiu trong 2 gi u tin hoc 4 gi u tin ca nhi mu c tim, qu 6

gi th khng tc dng na v vng hoi t lan ton b b dy ca thnh tm tht, gi l nhi mu c tim xuyn thnh. Chnh v th bng gi no cng phi chuyn bnh nhn nhi mu c tim n bnh vin chuyn v tim mch hoc khu chm sc c bit cng sm cng tt. Thi gian n c bnh vin sm hay mun c ngha sng cn. V ch c nhng ni ny mi m bo chn on chc chn v iu tr ng quy tc hn ch bin chng v t vong, k c nhng gi sau, ngy sau, tun sau ca nhi mu c tim, khi m loi bin chng khc l suy tim tru mch, sc tim li thng xy ra. Ngay khi nm vin vn nn nh nhi mu c tim l bnh rt nng, d bin chng cht ngi.

Nhi mu c tim l nguyn nhn gy sc tim

Ngy: 06-01-2011 Sc tim ch l mt trong nhiu loi sc khc nhau. c tnh trong khong 1 triu bnh nhn b nhi mu c tim cp M mi nm th c ti 70.000 150.000 bnh nhn b sc tim. Ngy nay mc d c nhiu tin b trong vic iu tr nhi mu c tim nhng nu nhi mu c tim m c sc tim th t l t vong vn c bit cao (60 80%).

Nhi mu c tim l nguyn nhn gy sc tim

Sc tim dn n ri lon nhp tim

Nhi mu c tim cp l nguyn nhn hng u ca sc tim c bit l nhi mu trc rng v c mt vng c tim ln b hoi t. Cc nguyn nhn khc c th l do: h hai l cp do t dy chng trong nhi mu c tim hoc vim ni tm mc nhim khun. Thng vch lin tht cp trong nhi mu c tim. Vim c tim cp. Giai on cui ca bnh c tim gin. Cc bnh van tim nng (h van hai l, h van ng mch ch ), p tim cp. Ri lon nhp nng. Mt s trng hp sau m tim phi nhn to. Bnh thng gp nhng ngi gi v nhng ngi mc bnh i tho ng, ngi c tin s nhi mu c tim, bnh mch mu ngoi vi, bnh mch mu no, x va nhiu mch

Cc bin php x tr
Nhanh chng xc nh tnh trng sc tim ca bnh nhn, loi tr cc nguyn nhn khc gy ra huyt p thp. Bnh nhn cn c iu tr ti cc chuyn khoa tim mch hoc khoa cp cu, iu tr tch cc. Nu bnh nhn t th tt c th cho th qua ng mi, nu bnh nhn c ri lon nhp th hoc suy h hp nng th cn t ni kh qun v cho th my ng ch . Thit lp mt ng truyn tnh mch. t catherter tnh mch trung tm theo di, tt nht l c thit b Swan-Ganz theo di cung lng tim v p lc ng mch phi. Theo di bo ho xy ng mch v lng nc tiu (t thng tiu). m bo tt th tch tun hon sao cho p lc nh phi t 10-14 mmHg v PAWP t 1820 mmHg. Kim sot tt cc ri lon nhp tim km theo nu c (nhanh tht: sc in, nhp chm qu: t my to nhp). Kim sot cc ri lon thng bng kim toan v nc in gii. Trong iu tr sc tim, theo di huyt ng l yu t quyt nh iu chnh v can thip kp thi.

Cc bin php can thip cp cu

Bm bng ngc dng trong ng mch ch (MC): Dng mt qu bng to v di t trong MC t on trn ca MC xung cho n tn MC bng trc ch chia ra ng mch chu. Vic bm bng v lm xp nh kh heli do mt my bm ngoi ni vi bng v lm vic theo chu chuyn ca tim. Bng s c bm phng ln trong thi k tm trng v lm xp i trong thi k tm thu, do vy s lm tng dng mu n ng mch vnh (MV) trong thi k tm trng v ch yu lm gim p lc hu gnh trong k tm thu nn lm gim gnh nng cho tim. Chng ch nh khi c h ch nng, tch thnh MC, bnh l mch ngoi vi. Cc nghin cu cho thy, t khi ra i loi bng bm ny lm gim ng k t l t vong do sc tim. Dieu tri nguyen nhan

Nu do nhi mu c tim cp: Khi sc tim xy ra th cc bin php ti ti mu MV cng t ra cp thit: l cc bin php dng thuc tiu si huyt; Can thip MV qua da hoc phu thut lm cu ni ch vnh. Nu sc tim do cc nguyn nhn khc cn c iu tr tch cc theo nguyn nhn: Bnh nhn c p tim cp phi xc nh v chc dch ngay. Bnh nhn c bnh van tim cn c phu thut sa hoc thay van tim. Vim c tim cp hoc bnh c tim vn cn l vn nan gii, vic iu tr cn nhiu kh khn, ch yu vn l iu tr triu chng. Trong nhiu trng hp ngi ta tin hnh chy my tim phi nhn to (Hemopump) cp cu nhng trng hp sc tim v cho kt qu tt.

Bnh ng mch vnh: nguyn nhn, triu chng, chn on v iu tr

Bs. Ts. Trng Quang Bnh

ng mch vnh l ng mch no, c chc nng g? Tim l mt b phn c chc nng bm mu n nui cc c quan trong c th. S lm vic lin tc, sut ngy m nh vy s cn mt lng ln nng lng. ng mch vnh l tn gi ca cc ng mch (M )dn mu (cht dinh dng,nng lng) n nui tim cho tim c th hon thnh chc nng ca n. Bnh ng mch vnh l bnh nh th no? Danh t bnh ng mch (M) vnh dng ch tnh trng bnh l lm cho lng M vnh b hp li (hoc tc nghn), tnh trng hp hay tc nghn lng M vnh l x va M. Khi lng M vnh b hp n mt mc no th dng mu n nui tim s khng v dn n tnh trng thiu mu c tim. Mt s danh t khc cng c dng ch bnh M vnh: nh suy M vnh, thiu mu c tim, thiu nng vnh, bnh tim thiu mu cc b Nguyn nhn ca bnh M vnh? Hu ht cc trng hp bnh M vnh l do x va M gy nn. Nguyn nhn ca x va M th cha c xc nh r rng. Hin nay, khi ni n nguyn nhn ca bnh l M vnh ngi ta dng n khi nim yu t nguy c (YTNC) ca bnh M vnh.

YTNC ca bnh M vnh l g? YTNC ca bnh M vnh l nhng yu t m khi hin din mt c th no th lm cho c th c t l mc bnh M vnh, t l thng tt, t l t vong do M vnh cao hn cc c th khc. YTNC ca bnh M vnh l nhng yu t no? l: tng huyt p, ri lon lipid mu (LDL cao, HDI thp, Triglyceride cao). Ht thuc l, Bo ph, i tho ng, gia nh c ngi b bnh M vnh sm, Tui cao Hu qu ca bnh M vnh? Hp lng M vnh s gy ra tnh trng thiu mu c tim, tnh trng ny c th ko di lu ngy. Bnh nhn s b au ngc, suy tim, ri lon nhp tim v nguy c b nhi mu c tim cp. Khi mng x va trong lng M vnh v ra th s lm bt tc hon ton Mvnh v gy ra thiu mu c tim cp tnh, nng n, hoi t c tim cn c gi l nhi mu c tim cp. T l t vong do nhi mu c tim cp rt cao. Bnh nhn qua c cn nhi mu c tim cp c th s b suy tim sau nhi mu c tim, b ri lon nhp tim sau nhi mu c tim. Triu chng ca tnh trng thiu mu c tim? * au ngc: triu chng ca thiu mu c tim thng gp nht l au tht ngc. au khi pht khi gng sc, ngay sau xng c, au nhi, tht cht, lan ra vai tri, cnh tay tri, bn tay tri. au gim i khi ngh tnh hoc khi dng thuc dn mch. Nu cn au xut hin lc ngh tnh hoc cn au qu trm trng hoc cn au ko di trn 30 pht th phi ngh n l bnh nhn b nhi mu c tim cp. * Cng c nhng trng hp bnh nhn b thiu mu c tim m khng c triu chng au ngc. Nhng trng hp gi l thiu mu c tim yn lng. Trong trng hp ny bnh nhn c th c biu hin nh h van hai l, suy tim, ri lon nhp tim Chn on bnh Mvnh nh th no? 1.Chn on thiu mu c tim da vo vic khai thc triu chng au ngc ca bnh nhn. Nhng du hiu th hin tnh trng thiu mu c tim yn lng l nhng ch im khin cho BS i tm thm v nguyn nhn v pht hin ra tnh trng thiu mu c tim. 2. Chn on da vo in tm . Tnh trng thiu mu c tim lm thay i v tnh cht din hc ca tim. in tm c th pht hin c nhng thay i v in hc . V vy, in tm l mt cng c trong chn on thiu mu c tim. Cng cn lu l c nhng tnh trng bnh l khc cng c th cho ra nhng du hiu in tm ging nh thiu mu c tim cho ra. 3. Siu m tim. Tnh trng thiu mu c tim lm nh hng n s co bp ca tim. Thiu mu c tim vng no th c tim vng s b ri lon. Siu m tim l mt

phng tin gip cho BS thy c s co bp ca c tim. V vy, nhng vng gim ng do thiu mu c tim gy ra s c pht hin bi siu m tim. 4. in tm v siu m tim lc gng sc. Vi tnh trng lng ng mch vnhch hp mt mc va phi th triu chng thiu mu c tim ch xy ra khi gng sc. Ngha l bnh nhn ch au ngc khi gng sc v nhng thay i v in tm v v siu m tim ch xut hin khi bnh nhn gng sc m thi. V vy, c nhng bnh nhn b thiu mu c tim m in tm v siu m tim hon ton bnh thng. Trong nhng trng hp ny, in tm hc siu m tim thc hin lc gng sc s gip chn on c tnh trng thiu mu c tim. 5. X hnh ti mu c tim. Dng cht ng v phng x bm vo mch mu. Nhng vng no ca c tim b thiu mu nui s gim hoc khng bt c cht ng v phng x. Dng my scan pht hin nhng vng nh vy v chn on thiu mu c tim. 6. Chp ng mch vnh chn lc, cn quang. Phng php ny c xeml tiu chun vng chn on bnh ng mch vnh. Thng qua bin php ny BS bit c tnh trng ca h thng ng mch vnh ca bnh nhn: hp, tc, ti u, bao nhiu mch mu b t thng 7. Chp CT a lp ct. Phng tin ny gip pht hin tnh trng vi ho ng mch vnh ch khng gip chn on tnh trng thiu mu c tim. Hin nay phng tin ny cha c cng nhn trong qui trnh chn on thiu mu c tim. iu tr bnh M vnh nh th no? Hin ti c 3 phng php iu tr bnh M vnh: iu tr ni khoa (dng thuc): 1. iu tr cc yu t nguy c ca bnh M vnh bnh khng tin trin nng thm: iu tr tng huyt p, iu tr ri lon lipide mu, iu tr i tho ng, b ht thuc l, gim cn nng t cn nng l tng, thay i li sng 2. iu tr phng nga nhi mu c tim cp: dng cc loi thuc khng kt dnh tiu cu phng nga ng mu gy tc mch vnh: Aspirine,Clopidogrel 3. iu tr chng cn au tht ngc bng cc loi thuc dn mch. iu tr can thip M vnh (nong rng lng M, t khung gi trong lng M vnh). 1. Dng cho cc trng hp au ngc do thiu mu c tim m t hoc khng p ng vi thuc iu tr ni khoa.

2. Dng cho cc trng hp b au tht ngc khng n nh hoc nhi mu c tim cp. iu tr phu thut bc cu M vnh 1. Dng cho cc trng hp M vnh b tn thng nhiu ch, tn thng ko di cho cc trng hp m can thip M vnh khng th can thip c. 2. y l mt cuc m ln, dng cc mch mu khc ca ngay chnh bn thn bnh nhn lm cu ni qua ch M vnh b hp Vit Nam chit xut thnh cng enzyme phng, cha tai bin mch mu no v nhi mu c tim Gn y mt loi enzyme c trong giun t (a long) c tc dng phng v h tr iu tr cc di chng cho bnh nhn b tai bin mch no (t qu) v bnh nhn b nhi mu c tim c cc phng tin thng tin i chng nhc n kh nhiu. y l kt qu nghin cu thnh cng ca cc nh khoa hc Vin Cng ngh sinh hc thuc Vin Khoa hc v Cng ngh Vit Nam. Tc gi, PGS.TS.Nguyn Th Ngc Dao nguyn Ph vin trng Vin Cng ngh sinh hc Vit Nam cho bit: - a long cha mt loi enzyme c tc dng thu phn fibrin (cc mu ng) v c cc nc nh Nht Bn, Hn Quc, Trung Quc v Canada s dng rt nhiu trong d phng v iu tr h tr cc bnh tim mch, tai bin mch mu no. L mt bc s nghin cu trong ngnh cng ngh sinh hc, ti cng vi cc cng s bt tay vo ti KC04-17 thuc chng trnh "Nghin cu v pht trin Cng ngh sinh hc" giai on 20012005. Chng ti tm ra loi giun qu (perionys escavatus) c cha enzyme c hot tnh thu phn fibrin rt mnh. Sau , chng ti tch chit thnh cng enzyme lumbrokinase c trong loi giun ny. ti c nh gi xut sc v c B Khoa hc v Cng ngh tng bng khen. Xin PGS cho bit tc dng cha bnh ca enzyme lumbrokinase? - Enzyme lumbrokinase c tc dng trc tip thu phn fibrin (tiu cc mu ng) trong khi cc cht hot ho khc vn thng dng nh tPA (tisuse plasminogen activator), c tc dng phi hot ho plasminogen thnh plasmin, t plasmin mi thu phn c fibrin. Ngoi tc dng trc tip thu phn fibrin, lumbrokinase cn c tc dng hot ho ging nh tPA. Vi tc dng kp nh vy dng lumbrokinase cho hiu qu cao m gi thnh li thp, mang li li ch rt ln cho ngi bnh. Lumbrokinase c s dng trong trng hp no, tha PGS? - Lumbrokinase c dng trong:

* H tr iu tr v phc hi cho bnh nhn b tai bin mch mu no (t qu), nhi mu c tim v cc bnh l lin quan n cc mu ng, ci thin cc di chng nh lit, teo c, ni ngng, t b chn tay.... * D phng tai bin mch mu no (t qu), nhi mu c tim bnh nhn c nguy c cao nh tng huyt p v cc bnh l lin quan n mch vnh... * H tr iu tr cho bnh nhn tiu ng, c bit l bnh nhn c hoi t u chi do tai bin ca bnh tiu ng v cc bnh l lin quan n mch mu nh vim tc mch. S dng lumbrokinase lu di c tc dng ph g khng? - Trn th gii lumbrokinase c s dng t nm 1980 cho n nay, cng nh ti Vit Nam cha ghi nhn tc dng ph no ca lumbrokinase, do ngi bnh c th s dng lu di. Sn phm lumbrokinase c ng dng nh th no, tha PGS?

- Sau khi nghin cu thnh cng, t nm 2006, chng ti tin hnh bc nghin cu tip theo ng dng cho nhu cu iu tr thc tin. Gn y, chng ti hp tc cng vi Cng ty u t v Pht trin Y t bo ch thnh cng sn phm LUMBROTINE (lumbrokinase) phc v cho nhu cu iu tr ca hng triu ngi bnh. Hin nay, sn phm c cc nh thuc v c ngi bnh khp ni n nhn.

Thnh phn Mi vin nang Nattokinase c cha Nattokinase 300 FU, vi ngun nguyn liu c nhp khu t Nht Bn, sn xut trn dy chuyn hin i ca HD Pharma, s l mt mn qu nng cao cht lng cuc sng ca ngi cao tui. C ch tc dng

Nattokinase l mt enzyme c chit xut t u tng, ln men theo phng php dng vi khun Bacillus natto. Nattokinase c tc dng phng v ph cc cc mu ng (do c kh nng tiu hy Fibrin). Cc cc mu ng (huyt khi) c hnh thnh khi cc si fibrin tch ly trong mch mu. Cc cc mu ng trong cc mch mu c th di chuyn ln no lm cn tr vic cung cp oxy cho cc m no gy ra cc bnh l nguy him nh: tai bin mch mu no, suy no, gim tr nh, t qu. Cc cc mu ng tim gy ra cc bnh l nh: au tht ngc, nhi mu c tim. Cng dng - Gip tng cng tun hon no v lu thng mu. - Phng v iu tr tai bin mch mu no, au tht ngc, n nh huyt p. - Tng cng sinh lc, ci thin tnh trng mt mi v suy gim tr nh ngi cao tui. Cch dng - Phng bnh: Ngy 02 ln, mi ln 1-2 vin ung trc ba n 30 pht. - H tr iu tr: Ngy 2-3 ln, mi ln 2 vin ung trc ba n 30 pht. Quy cch: Hp/ 3 v nhm/ 10 vin nang. Theo Gordon Research Institue Nattokinase l g? Nattokinase l mt enzyme hot huyt mnh c ngun gc t mn n truyn thng ca Nht Bn c tn l Natto. N l mt loi gia v dn gian v l mt phng thuc c truyn cha bnh tim mch. Natto c sn xut bng cch dng Bacillus natto mt loi vi khun c ch, khi m vi ht u nnh sn sinh ra enzyme Nattokinase. Trong cc loi thc phm c cha enzyme th ch c Natto l cha Nattokinase. Nattokinase c tm ra nhn th no? Bc s Hyroyuki Sumi nghin cu trong thi gian di cc Enzyme hot huyt v khm ph ra Nattokinase nm 1980 khi ng ang ging dy ti khoa Ha Sinh trng i hc Chicago. Sau khi th trn 173 loi thc phm thin nhin Bc

s Sumi pht hin ra iu ng ang tm kim khi ng nh ri Natto vo cc mu ng nhn to trong a Petri iu kin 370 C (xp x nhit c th). Cc mu ng gp Natto tan dn v tan hon ton sau 18 gi. Bc s Sumi t tn cho Enzyme khm ph c l Nattokinase. Cc mu ng nguy him nh th no? Cc mu ng xut hin khi di Protein c tn l Fibrin tch ly trong lng mch. tim cc mu ng l nguyn nhn gy tc cc dng mch mu ti nui m v c tim. Nu dng mch mu b chn, Oxy cung cp cho cc c b gim hoc khng cn. iu ny dn n chng au tht ngc v cn au tim. Cc mu ng trong cc tm tht ca tim c th di chuyn ln no. Trong no, cc mu ng c th gy tc nghn cc mch mu ln no v gy ra cc bin chng: Tai bin mch mu no, suy no, suy gim tr nh, t qu. Nhng Enzyme lm tan cc mu ng c sinh ra thnh t bo trong lng mch mu khp c th nh: trong ng mch, h thng mao mch v mch bch huyt,.. ngi gi vic sn sinh cc enzym ny b suy gim dn n victnh trng hnh thnh cc cc mu ng bt k v tr no trong c th. Nhng nghin cu gn y cho thy s tc nghn dng mu ln no c th gy suy gim v mt tr nh ngi cao tui. Cch Nattokinase lm tan cc cc mu ng? Nattokinase lm tan c hiu Fibrin. Thm na n cng tng cng sn sinh ra Plasmin (enzym ni sinh trong c th lm tan Fibrin) v cc cht lm tan cc mu ng khc nh Urokinase. Nattokinase thc s mnh hn nhng thuc lm tan mu ng thng thng T_Pas nh Urokinase ch hiu qu khi dng ng tim tnh mch v thng khng hiu qu khi ng mch ca bnh nhn t qu v au tim chai cng nhiu v tr. Nattokinase c th gip ngn nga s chai cng vi liu dng 100mg mi ngy. Li ch ca Nattokinase trn bnh cao huyt p Nm 1995, cc nh nghin cu ca trng Cao ng Y Miyazaki v trng i hc Kurashiki ca Nht Bn nghin cu hiu qu ca Nattokinase trn bnh cao huyt p. Cc nh nghin cu khng nh Nattokinase l cht c ch enzym bin i angiotensin (ACE). ACE lm cho lng mch mu b hp li v gy tng huyt p. Nattokinase c ch ACE nn c tc dng lm gim huyt p.

Phng php phng nga v cha tr tai bin mch mu no

Ngy: 24-03-2011

Nhng bnh nhn mc cc bnh v tim mch, tiu ng, cao huyt p, cholesterol hoc triglyceride trong mu cao, s gy x va ng mch. Cc mng x va tri ln s lm tc nghn mch v hnh thnh cc cc huyt khi trong lng mch.

V, b no con ngi hot ng c l nh s lu thng tun hon thng sut ca mu trong lng mch, khi dng mu lu thng b cn tr do qu trnh hnh thnh huyt khi (cc mu ng) xy ra ng mch dn mu ln nui no, gy tc nghn mch, dn n tnh trng no b thiu oxy t ngt, lm cht mt phn cc t bo thn kinh, khin cho bnh nhn b hn m, lit na thn ngi hoc t vong nu khng pht hin v iu tr kp thi. Hin tng ny c gi l t qu hay tai bin mch mu no.

Bn cnh khi cc mng x va hay huyt khi hnh thnh trong lng mch dn mu v tim, khin ng mch vnh cung cp mu cho c tim b tc dn, gy lon nhp v t to ra cc cn au tim. Bin chng ca bnh cnh ny rt nguy him, c th dn n t vong. Y khoa thng gi bnh cnh ny l nhi mu c tim. Phong ngua va tranh tai phat hai benh ly tren bang cac bien phap sau: Vic phng nga huyt khi ng l rt quan trng gim cc nguy c gy t qu, nhi mu c tim, thiu nng tun hon no. Mt khc, khi mc bnh th d ti pht v nguy him hn gp nhiu ln. Mt ch sng lnh mnh, thng xuyn vn ng kt hp vi vic n ung hp l, khng ht thuc v ung ru bia nhiu, s gip gim nguy c mc huyt khi v x va ng mch. Bn cnh , bnh nhn cn c kt hp vic kim sot huyt p, iu ha ng huyt, gim m xu trong mu. c bit, pht minh ca GS Sumi Hyroyuki (Nht Bn) v Enzym Nattokinase vi hiu qu lm tan cc mu ng chnh l cuc cch mng trong vic phng nga v h tr iu tr cc bnh l c lin quan n cc mu ng. Pht minh trn mang li s sng cho bit bao ngi ang ng trc nguy c t qu v nhi mu c tim.

Nattokinase: Powerful Enzyme Prevents Heart Attack and Stroke

Cardiovascular disease is the leading cause of death for men and women
According to the U.S. Centers for Disease Control, each year about 700,000 people suffer a stroke, the leading cause of serious, long-term disability in the United States. The American Heart Association estimates that nearly every year, about 1 million Americans will suffer a heart attack.

-Sponsored AdsAbout 700,000 of these will be first-time heart attack sufferers, while approximately 500,000 will be people who have previously had a heart attack. It all adds up to this: contrary to popular belief, heart attack and stroke account for more deaths than all cancers and injuries combined, and one out of every 2.4 deaths is attributable to cardiovascular disease. How is that possible in the richest, most highly educated country on earth? Most of us all get too little exercise, accumulate too much stress, and eat a poor diet laden with saturated fat, refined sugar and too little fiber. Add to that list the habit of smoking and the answer is quite clear. (Although there is a considerably higher prevalence of cigarette smoking in Japan than in the U.S., mortality from CVD among men in Japan is still less than half of that in the U.S.3) And to make matters worse, a study published in The Journal of the American Medical Association (3/6/2002) indicates that exposure to air pollution can cause some 10,000 fatal heart attacks a year in the U.S.! Mainstream health care has banded together with the pharmaceutical industry to offer a temporary quick fix for the number one killer of our time. Statin drugs reduce cholesterol. Aspirin and warfarin thin the blood. Anti-hypertension medications reduce blood pressure. Bypass surgery, and angioplasty clear the arteries. Essentially, they all help prolong the life of a patient with cardiovascular disease (CVD). But none of these drugs or procedures is without risk or side effects. Well, we've got good news for you! CVD risk can be greatly reduced by modifying lifestyle and adding nutritional supplements proven to support cardiovascular health. Most of us are aware that eating a lighter, more balanced diet, quitting tobacco and exercising regularly are enough to head

off most cases of heart disease before they ever happen. Now there's something else you can do. Nattokinase has been shown to support normal blood pressure, dissolve blood clots and prevent them from forming in the first place!

What Is Nattokinase?
Nattokinase is a potent fibrinolytic (anti-clotting) enzyme complex extracted and highly purified from a traditional Japanese food called Natto. Natto is a fermented cheese-like food that has been used in Japanese culture for more than 1,000 years for its popular taste, and as a folk remedy for heart and vascular diseases. Research has shown that Nattokinase supports the body in breaking up and dissolving the unhealthy coagulation of blood. In fact, it has been shown to have four times greater fibrinolytic activity than plasmin.4

How is it made?
Natto is produced by a fermentation process by adding the bacteria Bacillus subtilis to boiled soybeans. The resulting Nattokinase enzyme is produced when Bacillus subtilis acts on the soybeans. While other soy foods contain enzymes, it is only the natto preparation that contains the specific Nattokinase enzyme. How was Nattokinase discovered? Japanese researcher Dr. Hiroyuki Sumi had spent many years searching for a natural thrombolytic agent that could successfully dissolve blood clots associated with heart attacks and stroke. Finally in 1980, after testing more than 173 natural foods, Sumi found what he was looking for. Natto, a traditional Japanese soy cheese, was dropped onto an artificial thrombus (fibrin) in a petri dish and allowed to stand at 37C (approximately body temperature). Over the next 18 hours, the thrombus around the natto completely dissolved! Sumi named the newly discovered enzyme Nattokinase, which means "enzyme in natto." Dr. Sumi remarked that Nattokinase showed "a potency matched by no other enzyme." 56

How blood clots form

Blood clotting is a natural process that allows the blood to thicken and form a clot or thrombus of blood cells. When a blood vessel is injured, platelets clump together and strands of the blood protein fibrin glue them together in order to stop the bleeding. Eventually the clot helps form a protective scab over a healing wound. If our bodies did not have the ability to clot blood, we would bleed to death after even a minor cut, which was often the case with hemophiliacs. But sometimes blood clots form even when a person has not been wounded or cut. Although most blood clots naturally dissolve on their own without complications, there are two situations in which they can wreak havoc before they are reabsorbed by the body.

1. A thrombus can form in an artery which could block the flow of blood and cut off oxygen supply. This can trigger a heart attack and result in damage, destruction (infarction), or even death of the tissues (necrosis) in the heart. In the brain, blood clots also block blood and oxygen from reaching necessary areas, which can result in senility and/or stroke.5 2. A piece of the blood clot could form in one of the heart's chambers and then travel through the bloodstream, lodging in either an organ or an artery and cutting off the blood supply from that point, causing an embolism. An embolism is especially dangerous when it ends up in a lung. The most common cause of these emboli are blood clots that form during atrial fibrillation. This is a disorder found in about 2 million Americans. In atrial fibrillation the heart's two small upper chambers (the atria) quiver instead of beating effectively. Some blood isn't pumped completely out of them when the heart beats, so it pools and clots. When a blood clot enters the circulation and lodges in a narrowed artery of the brain, a stroke occurs.

The chances of developing thrombi increase as we age

Although the human body produces more than 20 enzymes for making blood clots, it produces only one enzymeplasminfor dissolving them. The problem is, as we age the production of plasmin slows down, making the blood more prone to coagulation. And since plasmin is produced by endothelial cells throughout the body, it is possible to develop blood clots anywhere in the body. To make matters worse, fibrinogen levels rise as we age.7 And high levels of fibrinogen levels usually lead to increased platelet aggregation, blood clots, and eventually heart attack or stroke. In fact, high fibrinogen levels are considered a more dangerous risk factor for heart attack and stroke than high cholesterol. A study of 2,116 men found that those with high LDL (bad) cholesterol but low fibrinogen levels had only one sixth the risk for heart attack than the men with low LDL and high fibrinogen.8

How does it work

Nattokinase enhances the body's natural ability to fight blood clots, and has an advantage over blood thinners because it has a prolonged effect without side effects. Nattokinase:

Supports normal blood pressure Prevents blood clots from forming Dissolves existing blood clots Dissolves fibrin

Enhances the body's production of plasmin and other clot-dissolving agents, including urokinase

Research studies
Nattokinase has been the subject of 17 studies, including two small human trials. In 1990, Dr. Sumi's research team published a series of studies demonstrating the fibrinolytic effects of Nattokinase.9 Here are some of them:

Dissolves blood clots

Researchers from JCR Pharmaceuticals, Oklahoma State University, and Miyazaki Medical College, tested Nattokinase on 12 healthy Japanese volunteers (6 men and 6 women, between the ages of 21 and 55). The researchers gave the volunteers 7 ounces of natto (the food) before breakfast, and then tracked fibrinolytic activity through a series of blood plasma tests. In one test, a blood sample was taken and a thrombus (clot) was artificially induced. The amount of time needed to dissolve the clot was cut in half within 2 hours of treatment, compared to the control group. Additionally, the volunteers retained an enhanced ability to dissolve blood clots for up to 8 hours.9 Dr. Sumi's team also induced blood clots in a major leg vein in male dogs that had been given either four capsules of Nattokinase (250 mg per capsule) or four placebo capsules. Angiograms (x-rays of blood vessels) showed that the blood clots in the dogs that received Nattokinase had completely dissolved within 5 hours of treatment, and that normal blood circulation had been restored. Blood clots in the dogs who received the placebo showed no sign of dissolving 18 hours after the treatment.9 Researchers from Biotechnology Research Laboratories and JCR Pharmaceuticals Co. of Kobe, Japan, tested Nattokinase's ability to dissolve a blood clot in the carotid arteries of rats. Animals treated with Nattokinase regained 62 percent of blood flow, whereas those treated with plasmin regained just 15.8 percent of blood flow.19 In another laboratory study, endothelial damage was induced in the femoral arteries of rats that had been given Nattokinase. In normal circumstances, a thickening of the artery walls and blood clotting would occur, but they were both suppressed because of Nattokinase's fibrinolytic activity.10

Helps reduce high blood pressure

Human volunteers with high blood pressure were given 30 grams of natto extract (equivalent to 7 ounces of natto food), orally for 4 consecutive days. In 4 out of 5 volunteers, the systolic blood pressure decreased on average from 173.8 to 154.8. Diastolic blood pressure decreased on average from 101.0 to 91.2. This data represents

about a 10.9 percent drop in systolic blood pressure and a 9.7 percent drop in diastolic blood pressure.5911 Wistar rats that were given natto extract showed a significant drop in systolic blood pressure also, from an average of 166 to 145 in just two hours, which further decreased to an average of 144 in 3 hours. This data represents an approximate 12.7 percent drop in systolic blood pressure also, from an average of 166 to 145 in just two hours, which further decreased to an average of 144 in three hours. This data represents an approximate 12.7 percent drop in systolic blood pressure within two hours.5,9,11 These tests all indicate that Nattokinase generates a heightened ability in the body to dissolve blood clots.

Restores blood circulation

This is one of the most dramatic, documented stories about the effects of Nattokinase. A 58-year-old man had a blood clot in the retina of his right eye that caused fluid build up and bleeding. He started losing his vision in that eye and was admitted to a university hospital, where researchers prescribed a 3-ounce dose of natto to be taken before bed every night, in order to get the benefit of Nattokinase. The man's bleeding completely stopped by the tenth day, and by the 20th day, his vision returned and he was released from the hospital. He continued to eat natto twice a week. When he had a retinal angiogram two months later, it showed that the blood clot was completely gone.12

Is Nattokinase for everyone?

This soy extract is considered extremely useful for those wanting a safe, drugless, nonaspirin alternative for healthy blood flow. Nattokinase is also a safe alternative for those who are off their feet because of illness, injury (including paralysis), or surgery.

Excellent for periods of inactivity

In the past few years, medical professionals began alerting the public about the increasing evidence that long flights and car trips put people at risk for deep vein thrombosis (DVT) a blood clot that develops in a deep vein, usually in the leg. DVT is more common in women than in men, and in those over 40 years of age.

Deep vein thrombosis

DVTblood clots inside veins found deep in extremities or body cavitiesis a common disorder. A venous thrombus is a clump of blood cells, platelets, and fibrin (clot) which attaches to the inside walls of veins, can grow in size, and break off to travel downstream from the clot. If the clot stays localized, it can cause swelling and vein irritation. If part of

it breaks off, it can cause blockage downstream, or become an embolus and result in a pulmonary embolus. In some instances, deep vein thrombosis may also contribute to other serious medical problems such as heart attack and stroke.

How safe is Nattokinase?

It is very safe when used according to the recommended dosage. People with ulcers, recent or pending surgery, or recent major trauma should not take Nattokinase. Anyone who has ever had neurosurgery or ischemic stroke in the previous six months should not take Nattokinase, as well as those who have had intracranial bleeding. Generally, people with bleeding disorders, or taking anti-clotting medication, should use this product only under the close supervision of a medical doctor. Researchers have found that Nattokinase is four times more potent than plasmin, and works even more effectively than warfarin drugs because it continues to work for long periods of time, and it doesn't produce any side effects.

Conclusion
The traditional Japanese food Natto has been used safely for more than 1,000 years. The safety record of its potent fibrinolytic enzyme, Nattokinase, is based upon the long-term traditional use of the food and recent scientific studies. Nattokinase has many benefits including its prolonged effects, cost effectiveness, and its ability to be used preventatively. It is a naturally occurring, food-based dietary supplement that has demonstrated stability in the gastrointestinal tract, as well as to changes in pH and temperature. It is definitely a nutritional supplement to consider adding to a cardiovascular health maintenance plan.

u nnh ( Nattokinase ) v kh nng ngn nga cc bnh v tim mch - Hng l Th , Kiu bo Nht Bn

Li dn

Trc khi i vo ch chnh ca bi vit : u nnhNattokinase v kh nng ngn nga cc bnh v tim mch, tc gi xin gii thiu tht s lc mt s nt c trng v cc chng bnh ny trong t trng tm vo nhng hot cht c trong u nnh hay u nnh ln men (Natto) gi vai tr kh c o qua pht hin ca cc nh khoa hc, chuyn gia nghin cu y khoa trn th gii cng b trong hn 20 nm qua. Thnh qu nghin cu v enzym Nattokinase--t ht u nnh nu chn c ln men-- rt tnh c ca GS Sumi Hiroyuki (Nht bn) l mt pht hin k th mang li kt qu tt p cho bit bao ngi ang ng trc nguy c t qu, tai bin mch mu no cng nh dn mu c tim, co tht ng mch vnhTc gi ngh rng khng th l gii mt cch khoa hc v mt hn th v trong khi tm hiu tc dng ca Nattokinase nu khng c trang b mt kin thc ti thiu v ngnh y, c bit l b mn Tim Mch hin i. V l xin mi bn c chu khlm quen vi nhng kin thc c bn di y nht l ch n s tc ng v chuyn ha ni sinh ca nhng Enzym lm ng mu do lng m trong mu qu cao gy nn, v Enzym (Plasmin) duy nht lm ph tan nhng vn (cc)mu tn ng bm cht ni mc-- cn tr dng mu a dng kh tr v tim, ln no b duy tr mi hot ng bnh thng ca c th duy tr s sng . Nu nhng con vn chuyn lun lu tun hon ny trc trc thtai bin s n vi chng ta, c th s phn ng kch lit t triu chng tim p mnh, hi hp, kh th n au tht ngc, t qu, bi lit v cui cng l dn n iu au bun nht khi tri tim ngng p hay t bo no b hoi t do thiu mu hoc dng kh. Trong qu trnh , Nattokinase s phi lm g khi c np vo c th qua b my tiu ha, liu n c ch tht s hay ch l s tng tng t v qung co ? Li gii ny s bt u t y Mt khc, iu quan trng nht m tc gi xin mn php nhc li Thc phm chc nng khng phi l thuc tr bnh trc tip v thng c thi phng tip th, a phn mang tnh cht la gt nht l qua cc chiu thc thng mi truyn tiu a cp nh chng ta thy. Hai l y khng phi mt bi bo hc thut (Academic paper) m l mt bi chuyn kho v vy tc gi trnh ghi ch rm r tng chi tit trch dn m ch chung vo phn t liu tham kho cui bi cho d c, mong cc tc gi lin quan thng cm v lng th. Ngi vit s khng vui khi bi bo v Nattokinase ny b li dng tuyn truyn, qung co cho mt loi thc phm chc nng i t Nattokinase m cht lng ca chng khng thng qua kim nh cht lng ca c quan y t c trch nhim ca nc s ti v khng c s ng ca tc gi.

Li khuyn m chng ti mun gi n bn c l hy tr v vi thin nhin, c cuc sng lnh mnh v an vui vi nhng ht u nnh ng nh qu bu m to ha ban cho gn gn sc khe, trong ngn nga c cc chng tim mch, t qu m chi ph cha tr v cng tn km, khng k bao nhiu iu au kh khc khi gp tai bin

Ni dung gm c 3 chng :
1. V cc bin chng tim mch. 2. Natto l g ? 3. Pht hin c o ca GS Sumi Hiroyuki (Nht bn) Ngoi ra chng ti cn nh km mt bi phng vn GS Sumi Hiroyuki bn c tham kho.

Phn mt
V cc bin chng tim mch Theo bo co ca T chc Y t th gii (WHO), t qu (tai bin mch mu no) l tnh trng ri lon chc nng thn kinh gm hai loi chnh l nhi mu no v xut huyt no. Trong , 80% t qu l do nhi mu no. Tn thng ny lm gim t ngt hoc ngng hon ton vic cung cp mu n no.

Cholesterol th phm gy tai bin

n tui 50 khi khm sc khe nh k, chng ta thng yu cu cc bc s lm hng lot xt nghim c bn nh th nc tiu, phn, musau khi o nhp tim, huyt p. Ti sao chng ta thng thy bc s t ng nghe vo ngc ngay khi bt u khm, g nh vo khp gi, nhn vo sc din v trong qu trnh trao i, v bc s kh knh tm hiu sinh hot thng nht nh ch n ung, vn ng, gic ng, ngh ngi v c chu k kinh nguyt ca n gii lm g ? c bit l bn cnh in tm v in no , vic chp X-quang, Siu m hay Chp ct lp in ton (CT.Scanner), Ni soi, Sinh thit (Biopsy) v hng lot xt nghim chuyn su bt buc khi c yu t no b nghi ng c vn mc d nhng ch s v hm lng m ( Cholesterol v Triglyceride ) trong mu, huyt p, mch p thng c xem xt u tin, cho bit c th ni chung v qu tim ni ring bnh thng hoc c g trc trc m mt thng khng th thy c. T tui 49 tr i, nh cu ni 49

cha qua 53 ti, chu k sinh hc ca con ngi bt u xy ra nhiu xo trn, bc vo lp ngi tri thin mnh v vy vic khm ph ra mt chng bnh nan y no trong c th l iu bnh thng. Vn quan trng l pht hin sm ngn nga v cha tr trc khi qu mun nh bnh i tho ng, tim mch, ung thdn n cc bin chng khc nh thn kinh, tun hon, tiu ha, h hp, vn ng (xng khp) hay tai mt gy ic hoc m la (cc bin chng nghim trng ca bnh i tho ng). M, hng nm c khong 6 triu ngi b suy tim, trong s ny khong 1,5 triu b bnh tim mch v 1/3 ca con s b t vong. Khong 1/5 trong s cc trng hp b bnh tim mch khng h c triu chng hay cnh bo trc. T sut n ng ngi M cht v bnh tim l khong 200/100.000 dn s trong khi ngi Scotland l 320/100.000 ; Anh l 250/100.000 cao gp hai ln so vi cc nc nh Ha Lan, Php. Ring Nht bn t sut n ng cht v bnh tim ch l 20/100.000 dn s, mc thp nht trong cc nc pht trin. Vo nm 1970 nhiu nghin cu cho thy t sut t vong v bnh tim lin quan mt thit vi lng tiu th cht bo ng vt. Hai ln thc nghim lm sng ln Hoa k vi 360,000 ngi tham gia cng a n kt lun rng nhng ngi n nhiu cht bo ng vt c nguy c bnh tim rt cao so vi nhng ngi n chay, khng n hay n t cht bo ng vt. Cng l ngi Nht nhng ngi Nht trong nc vn c t sut cht v bnh tim thp hn ngi sng ti M l mt so snh th v. Tuy nhin quan h gia Cholesterol v ch n ung, mc hp thu cht bo ng vt vn cn nhiu b n, v c khi ngc li, khng theo cng thc t l thun k trn, khng phi n nhiu cht bo ng vt l hm lng cholesterol trong mu cao, c th c chc nng t n iu chnh sn lng cholesterol cn thit cho bn thn n duy tr s n nh, tc l nu lng cholesterol t thc n gim (hay thiu) th c th s tng cng sn xut cholesterol; ngc li nu cholesterol t thc n tng th c th s gim vic sn xut v c khong 20 gen dnh dng n qu trnh iu chnh v chuyn ha ny. V d mt gen c tn Neuropeptide (NPY) ng vai tr iu chnh mc cn thit v c nhng ngi vi mt bn ca gen c mc cholesterol cao hn nhng ngi khng c bn gen . V vy cng cn c kin nghi ng rng Nhng bng chng khoa hc ng sau mi lin h gia ch n ung, cholesterol v bnh tim rt mong manh (TS Nguyn vn Tun). Cholesterol l mt loi m (lipid) rt quan trng i vi hot ng sng ca c th, gi vai tr trung tm xy dng mng t bo, cc hormon sinh dc, ti to Vitamin D v thc y qu trnh tiu ha, tuy nhin nu hm lng Cholesterol trong mu tng qu mc s lm tng nguy c b x va ng mch, km theo

 l bnh tng huyt p, bnh mch vnh vi cc bin chng nguy him nh nhi mu c tim, t qu. V phng din ha hc, Cholesterol l mt cht bo, da vo cu trc phn t, cht bo trong thc phm di ba dng chnh: - Khng bo ha dng a phn (poly-unsaturated). - Khng bo ha dng n phn (mono-unsaturated). - Bo ha (saturated). Cht bo bo ha l nhng cht bo c ngun gc t ng vt (k c sa, phmai) trong nhit trung bnh (25 C) chng l mt khi c trong khi cht bo khng bo ha dng n thng tm thy trong tri olives, u phng, tri b cn cht bo khng bo ha dng a phn thng thy trong ng (bp), m, rau ci trong quan trng nht l Cholesterol di dng bo ha trong ng vt v mt s thc vt nh du da. Cholesterol c ch bin trong Gan .Cholesterol LDL c chuyn t Gan n ni (b phn) no trong c th cn, cn HDL th c ch vo Gan sn xut ra Hormon hay thi ra ngoi qua ti mt. H thng ch bin v vn chuyn Cholesterol lm vic mt cch nhp nhng trong c th khe mnh, sing nng c mt khp c th con ngi nhng khi c th b au tim (nhi muheart attack) th cc phn t Cholesterol n tp trung dn cc lm ri lon, tc nghn ng mchv vy cc nh khoa hc cho rng Cholesterol l th phm gy huyt p cao gy tai bin tim mch. Ni c nhiu nht trong c th l no v h thng thn kinh v Cholesterol lm bc tng ngn phn bn trong v bn ngoi thn kinh t bo khng thm nc v chnh v c tnh khng tan (trong nc v trong mu) nn gy ra hiu ng ngc li l to cn tr tun hon hay lu thng mu huyt trong c th khi vn thnh cc. Trong c th, Cholesterol c chuyn ch trong cc ht phn t hnh cu (sperical particles) gm c nhiu cht Lipoprotein. Nhng phn t hnh cu ny chuyn ch Cholesterol i khp c th, mi phn t c th chuyn ch 1500 phn t (molecules) v hnh trnh ca chng thng ko di 24 gi. Nhng c nhiu loi phn t mang trch nhim vn chuyn khc nhau: * Loi lipoprotein c t trng cao ( High density lipoprotein : HDL )tt, phi trn >35 mg/dl. * Loi lipoprotein c trng lng thp ( Low density lipoprotein : LDL )xu, phi di < 160 mg/dl.

Ngi ta c bit 60% - 80% Cholesterol trong mu c chuyn ch bng LDL v khong 15 - 20% c chuyn ch bng HDL. Phn cn li, di 25% c cc phn t khc vn chuyn. Cholesterol b kh t cc t bo vn chuyn, a vo Gan x l trc khi thi ra ngoi l loi HDL (tt) v loi t Gan i vo cc t bo l loi xu (LDL). Thng thng hm lng HDL t hn LDL theo t l 1/3 hay 1/5 v LDL l hm lng biu kin nh bnh m trong mu ca bnh nhn theo kt qu xt nghim . Cholesterol l mt trong nhng nguyn nhn nghn tim, Cholesterol cng nhiu th mc nguy him cng cao.Tnh trng tc nghn tim cn gi l x va ng mch (Arteriosclerosis) tc cc mch tim b gim kh nng n hi (co bp) v khi ng mch khng cn n hi th mu v oxy khng th n cung cp cho c tim, tim s khng vn hnh bnh thng, to ra tnh trng kh th. Chng x cng ng mch thng thng l X va ng mch (atherosclerosis) nh hng n cc ng mch chuyn mu vo tim, no, thn v chi vi triu chng d thy l khi cholesterol bt u lng ng (tch t) thnh nhng vt bo trn lp ngoi ca ng mch. Nhng vt bo ny l nhng tiu thc bo (microphages), l mt t bo mu trng m chc nng ca chng l n (th tiu) nhng t bo b h hi hay cht. Theo thi gian, cc tiu thc bo ny bm vo vch ca ng mch v lm cho s lun chuyn ca ng mch tr nn bt bnh thng. Calcium cng tch t v vy ngi b bnh au tim thng b vi ha ng mch. Tiu cu ( Platelet ), nhng t bo mu c nhim v lm nhng vn cc mu ( Clot ), tch t pha trn mng thnh mt khi cng bao quanh vnh ng mch, gy ra chng huyt khi (Thrombus), huyt khi tch t lu ngy s dy lm bt ng knh ca ng mch v lm tt nghn hon ton. ng mch c th b v hay mt huyt khi c th b tch ri (bung) ra lm bt cc ng mch nh. Thnh phn ca huyt khi l nhng cht bo, chng rt d v v t nhin ngn cn lu thng , lm cho tim mt ngun cung cp mu. S kin ny xy ra khi mu chy qua nhng ng mch v thnh nhng mnh nh, thi nhng cht bo ra ngoi, hnh thnh nhng cc mu (vn), mi lc mt ln dn lm nghn hon ton ng mch. Hin tng ny ch xy ra trong vng vi pht v hu qu cui cng l chng huyt khi ng mch vnh (Coronary Thrombosis), bnh nhn cm thy au ngc khng chu ng ni. Nu ng mch b nghn ko di, c tim s hoi t v cui cng l bnh nhn t vong v b nhi mu c tim (MyoCardial Infarction). Ni tm li huyt khi l cht si ( Fibre ), chnh cht si ny lm cho ng knh ca ng mch b hp dn gy au tht ngc (Angina) khi ng mch b tht li, lm cho mu khng lu thng vo tim theo mt tc cn thit v n chnh l th phm a n ci cht bi chng nhi mu c tim .

Cc loi Bnh tim mch ph bin nht

- Bnh ng mch vnh ( Coronary Artery Disease ). - Bnh nhi mu c tim ( Myocardial Infarction ) . - Bnh tng huyt p ( Hypertension ). - Bnh c tim dn khng r nguyn do ( Idiopathic Dileated Cardiomyopathy ) . - Vim c tim(Myocarditis)Bnh C tim ( Cardiomyopathies ). - Bnh hp van tim ( Valvular Heart Disease ). - Bnh c tim ph ln ( Hypertropic Cardiomyopathy ). - Bnh c tim hn ch ( Restrictive Cardiomyopathy ). - Bnh mng tim ( Percardial Disease ). - Bnh tim bm sinh ( Congetinal Heart Disease ) . - Ri lon nhp tim ( Arythmias ) . - Chng thiu mu ( Ischaemia ) bnh thiu mu ( Ischaemic Heart Disease )

C th tm lc li nh sau :
1. Cht bo bo ha c khuynh hng kch thch gan sn xut thm cholesterol v lm tng hm lng ca m trong mu ln cao. Hu qu l lm x cng ng mch, lm nghn mch vnh ca tim, gy au tht ngc, tng nguy c t qu tim, tng huyt p ng mch c th dn n tai bin mch mo no. 2. Nm 1998, nghin cu ca nhm Cherl-Ho-Lee ( S.J. Cho, M.A Juillerat v C.H Lee) pht hin c ch ca hiu qu lm gim Cholesterol trong gan nh protein u nnh tc ng thy phn (hydrolysate) lm tan-- cc loi m (cht bo) c trong gan khi c th hp th nhng loi cht bo bo ha qua thc phm, gim lng th th LHL-R (Low Density Lipoprotein Receptor) nh vy C quan qun l thuc v thc phm Hoa K (FDA) cng nhn protein ca u nnh l mt hot cht lm gim (hn ch) bnh tim mch (Cardiovascular Disease) vo nm 1999. 50 % bnh nhn c hm lng m trong mu cao chu u cht v cc chng tim mch v chi ph tr liu ln n 200 t

USD/nm. Chnh Protein ca u nnh (SPI) ch khng phi Isoflavones (u nnh) kt hp lm gim m trong mu thp i (The American Journal of Clinical Nutrition Vol. 83) do tc ng sinh hc tch cc ca Peptides ca u nnh khi thm thu vo t bo gan (Hepatic cells) . 3. H thng phn hy si Fibrin t Fibrinogen* (nt huyt khi l trung gian xy ra nhi mu c tim cp (AMI)l mt h enzym ni sinh trong huyt tng c tn l Plasmin (TS Sumi Hiroyuki chng minh Nattokinase mnh gp 4 ln so vi Plasmin) c kh nng tiu tn (phn gii) Fibrin, bnh thng ha hot ng lu thng trong ng mch, mu huyt tr li trng thi lun chuyn t nhin sau khi cm c mu nh nhng si Fibrin hm li, lm ng mu (vt thng) gip c th khng mt mu qu nhiu (bng huyt).

Si Fibrin
Fibrinogen l mt cht c trong huyt tng ( yu t ng mu ) chu tc ng ca Enzym thrombin sinh ra mt loi protein khng ha tan gi l Fibrin trong giai on cui ca qu trnh ng mu. Mc Fibrinogen bnh thng trong huyt tng l 2-4 g/l. Hot tnh phn hy Fibrin c duy tr bnh thng trong cn bng ni m bi mt s cht c ch tun hon. S dng thuc tan huyt khi ngoi sinh lm hot ha h thng th tiu Fibrin bnh thng qua nhiu con ng khc nhau, tt c nhng con ng cui cng dn ti vic bin Plasminogen thnh Plasmin, c tc dng phn gii huyt khi trong vng 24-48 gi sau khi tr liu.

C 5 loi thuc tan huyt khi ( FDA Hoa k ):

- Alteplase (t-PA) c ngun gc t ti tng hp DNAngn nga AMI (Nhi mu c tim cp) l thuc tan huyt khi c hiu, khng gy hiu ng phn hy ton thn m ch tp trung vo v tr hnh thnh huyt khi (ngha l chng kt hp chn lc vi Plasminogen gn vi Fibrin) nhng ch l tng i, vi liu cao vn c th gy hiu ng khng mong mun. - Streptokinase c ngun gc t cu khun tan mu Betangn nga AMI. - Urokinase (UK) c ngun gc t cht tit t bo thn ngi (nc tiu)tr huyt khi tnh mch su, nghn mch phi. - Tng hp hot ha Streptokinase Plasminogen Anisoylat ha (APSAC) ngn nga AMI.

- Tenecteplase, mt dng bin i Plasminogen thnh plasmin c hiu qu hn t-PA v Alteplase l d dng v dng vin tim tnh mch thuc qua nhanh qua 5 giy c th lm tng hiu lc ca vic iu tr sm nhi mu c tim cp. Trong Streptokinase l mt hot cht Plasminogen ph bin nhng gy phn ng ph l c kh nng phn hy h thng ( ton thn ), tim tng cm ng lm tng t huyt khi thng qua vic tng gii phng Thrombin ( t huyt) c gi l hiu ng tr ng tr li lm chm tc tan huyt sm. Urokinase v Streptokinase thuc cng loi thuc nhng Urokinase t hn rt nhiu v vy Streptoninase thng l thuc hng u dng iu tr AMI. iu ng lu Chy mu lin tc l bin chng nguy him nht ca tr liu lm tan huyt khi, gi l hin tng bng huyt ( khng cm mu ). Chy mu do tr liu lm tan huyt khi c th gy chy mu ni tng nh hoc nng. Chy mu t pht t nghim trng bao gm cc hin tng nh t mu b mt, i ra mu, chy mu rng li v ho ra mu. Chy mu t pht nng bao gm chy mu no, sau mng bng, sinh dc tit niu v ng tiu ha. Chy mu thng xy ra nht ti cc v tr lun ng thng (Catheter) bm thuc hay rt dch hoc v tr chc tnh mch. Hin nay Wafarin ( mt cht dn xut Coumarin ) l thuc chng ng ng ung c s dng rng ri nht v l liu php l tng iu tr huyt khi tnh mch su cp v tc mch phi cp. Wafarin c xem l loi thuc l tng phng nga t qu cho bnh nhn rung nh, ri lon chc nng tht nng v bnh van tim.Tuy nhin cc bc s chuyn khoa ti Nht bn khuyn co l khi s dng Wafarin cha bnh, chng ng mu (huyt khi) th trnh n Natto v Vitamin K s cn tr tc dng ca thuc nht l nhng bnh nhn c huyt khi tnh mch. Qu trnh ng mu l s tng tc v chuyn ha phc tp ca cc t bo, protein v cc hormon ti ch. Ri lon ng mu v ngng kt tiu cu lm tng nguy c huyt khi v cc bin c tc mch, ti tc mch sau iu tr ti thng mch vnh. u tin thnh mch vnh (ni mc) b tn thng gii phng Thromboxan kch thch kt tp tiu cu. S hnh thnh nt tiu cu l giai on u tin trong hai giai on ring bit ca qu trnh hnh thnh cc mu ng v c l l giai on ch yu lm ngng chy mu. Giai on hai bao gm mt chui phn ng phi hp sn sinh Thrombin, Thrombin xc tc chuyn Fibrinogen thnh Fibrin. Cc t bo hng cu dnh vo li si Fibrin cui cng hnh thnh cc mu ng thc s. Ni chung, huyt khi tnh mch gm c si Fibrin v cc t bo hng cu, trong khi huyt khi ng mch c hnh thnh t s kt tp tiu cu. V vy cc thuc chng kt tp tiu cu

c dng ngn nga huyt khi ng mch cn cc thuc chng ng c s dng ngn nga huyt khi tnh mch. Aspirin l cht chng tiu cu ( huyt khi ng mch ) hu hiu tuy nhin c nhiu phn ng khng mong mun nh lm long mu, xut huyt ni mc bao tnu dng trong mt thi gian di. V vy Bc s chuyn khoa thng cho bnh nhn ung Aspirin liu thp (81 mg) nga bnh huyt khi tch t trong mch mu, tng cng lu thng mu huyt cho nhng ngi c huyt p cao. i vi ngi khng dung np c Aspirin th thay bng Clopidogel . Kt qu lm gim t l t vong, nhi mu c tim, tai bin mch mu notng t nh Aspirin. Cc tc dng ph ch yu ca cc thuc lm tan huyt khi l chy mu, d ng ( nh Streptokinase lm tt huyt p, lon nhp tim, nhi mu c tim ti pht) v au tht ngc. i vi thuc chng tiu cu, c Aspirin v Ticlopidin u gy nhim c mu nhng gim bch cu trung tnh l mi lo ngi ln nht khi dng Ticlopidin. 4. Bnh ng mch vnh dng ch tnh trng bnh l khi ng mch b hp li ( hoc tc nghn ) tnh trng hp hay tc nghn lng ng mch v l x va ng mch. Khi lng ng mch vnh b hp li n mt mc no th dng mu n nui tim s khng dn n tnh trng thiu mu c tim. Hu ht cc trng hp bnh ng mch vnh l do x va ng mch gy nn. Nguyn nhn bnh l th cha r v vy ngi ta dng khi nim l yu t nguy c ca bnh ng mch vnh: Huyt p cao, ri lon lipid mu ( LDL cao, HDL thp, Triglyceride cao ). Hp lng ng mch vnh s gy ra tnh trng thiu mu c tim, bnh nhn b au ngc, suy tim, ri lon nhp tim v nguy c b nhi mu c tim cp. Khi mng x va ng mch trong lng ng mch vnh v ra th s lm bt tc hon ton ng mch vnh v gy ra thiu mu c tim trm trng cp tnh, hoi t c timcn c gi l nhi mu c tim cp v t l a n t vong rt cao. Chng trnh iu tra ca i hc Harvard vo nm 1989 trn 20,000 Bc s Hoa k, kt lun rng vi 1 vin Aspirin liu thp c th gim bnh tim mch n 44% nh tc dng lm long mu ( tan vn mu trong ng mch ) v vy thuc tr nhc u nh Aspirin 81, Clopidogel hay Plavix (hn hp gia Aspirin v Clopidogel gi rt t, gp nhiu ln) u c s dng cho ngi c nguy c tim mch hay huyt p cao, trc khi can thip bng cch bng cch nng mch vnh qua da hay phu thut bt cu mch vnh (by-pass), t Stent.

Cc chng bnh khng ly lan v vai tr ca dinh dng

- Tim mch v tai bin git 12 triu ngi/nm.

- c lng c 177 triu ngi b Tiu ng tp 2 (Trong 2/3 l ngi mc bnh l cc nc ang pht trin) . - Hn 1 t ngi tha trng lng (bo ph). - Cao huyt p khong 600 triu ngi trn ton th gii, 13% b t vong v 4.4% b tt nguyn 2/3 s ngi b tai bin l do huyt p cao, thng nh hng n tim mch, suy thn v tai bin mch mu no. - M trong mu cao tng nguy him cho bnh suy tim.18% ngi b tai bin v 56% b suy tim , 7.9% ngi b t vong v m trong mu cao. - n t tri cy, thiu rau xanh s lm tng nguy c b ung th, suy tim v tai bin. Ngun : WHO, s liu v cc chng bnh mn tnh v chin lc ton cu (2005).

Natto l g ?
Natto l nhng ht u nnh luc chn c vi Enzim (Bacillus natto) mt mi trng 40C trong vng 14-18 gi ln men thnh nhng ht u c mu nu, nhn nht cao v bn ( cha nhiu Acid Glutamic ), c mi nng nc ( ca nc tiu ) rt kh chu vi ngi khng quen. Theo kinh nghim ca nh sn xut cho bit khi nht cng cao th cht lng Natto cng tt v v cng ngt. L mt mn n dn d rt ph bin nng thn Nht bn, h thng n cm sng vi Natto, nc tng vi rong bin phi kh (Nori) v trng g sng. Ngy nay Natto cn c ch bin trong cc mn n xo nu vi tht, lm sandwich kp natto hay bnh m gi l Natto-burger (!) . Natto l mt c sn thin nhin, khng qua ch bin (nu, xo, hp ) v vy nhng t cht b dng cho sc khe u c gi nguyn vn trong enzym Nattokinase l mt hot cht sn sinh trong qu trnh ln men t nhin c xem l hot cht c hiu qu trong vic ngn nga cc chng bnh tim mch--mt pht hin v cng l th bi nh nghin cu sinh l hc Nht bn ni ting, GS Sumi Hiroyuki vo nm 1980 . T trc n nay, c nhiu thc n t u nnh ln men nh cc loi Tng (miso), Chao.. bng nhng con men nh Aspergillus, Rhozipus hay Actinomucos nhng ch c Natto l ln men t vi khun ( active protease enzymes ) Bacillus Subtilis c trong rm r v c gi ph bin l Bacillus Natto.

Natto l ch ghp ca Nat (np) v To (u) vi ngha l u nnh ln men ngy nay, xut hin Nht vo nm 1068 . u nnh ngoi lm thc n, l loi u dng cng dng c Pht ( nasshonp vo cha ) trong nh cha v a vo bp ch bin thc n cho tng l, ni s . Ngy nay vo ngy lp xun (tt c truyn theo m lch) ti Nht bn, cc cha thng qung ri nhng ht u trc cng chnh cho khch hnh hng n ving, hay cc c ln tui vn gi tc l nm ht u nnh trc ca tr t ( ma qu), rc hn (may mn) vo nh. Pht hin ra Natto C 5 truyn thuyt ch yu c lu truyn cho n ngy nay : 1) Du nhp t Trung Hoa : Vo nm 754 nh s Ganji ca Nht bn sang Trung Hoa hnh o v khi tr v mang theo khong 5.5 tn bnh u nnh ln men (khng p mui) v t pht trin thnh mt mn n trong nh cha di tn Natto. Ngi ta c bit hn 2000 nm trc ngi TQ ch bin ra mn u h ln men c tn l TAN-SHIH (bnh tu hmm mu sng) hay KAN-SHIH (bnh tu h ngt) m ngy nay vn cn lu li qua dng tng bng u en. Qui trnh lm ra Tan-Shih c ghi li trong sch v Nng nghip Trung quc Chi-Min Yao-shu u tin vo nm 535 trong thut li rng u nnh c nu chn, phi trong phng m ri gi trong rm v ln men t nhin thnh Koji, sau ra li bng nc sch, ly xc qun cht bng vi trong nhiu ngy, cui cng phi kh hay sy kh lm thnh bnh. Trong rm hay r c cha loi enzim Bacillus Subtilis v d ln men trong iu kin nhit cao (40C) v to ra cht nhn, mi hi nh k. 2) Thuyt Thi Yayoi Nht bn : Thi i Yayoi (300 - 200 ) l thi k nn nng nghip ca Nht bn c nhng bin chuyn quan trng. Ngi ta pht hin ht u nnh nhng a im khai qut kho c thi i ny mt s a phng ( tnh Akita ng bc, Yamaguchi hay Shizuoka pha Nam ) cho thy ngi Nht bit trng v n u nnh t rt sm. Bn yu t lm thnh Natto xa kia t thi Yayoi hi : u nnh, rm r t vic trng la, vi khun ln men v thi tit nng m vng ng bc Nht bn. S ngu nhin gia vic nu chn u nnh ri qun vo rm r trong iu kin nng m ( ln men) c th c gii thch bng . - Thi Yayoi ngi Nht xy nh c l si gia nh (tate-ana) v c thi quen nu n trn l si (amado) gia nh ri phi trn trn nh thc n d

tha chung quanh bp v nh vy ch qua mt m l nhng ht u c nu chn gi ct trong rm tr thnh Natto . - Nhng ht Natto c mi kh chu ny trc tin l c dng lm thc n cho nga trong chung . - Nhng ht u chn sch s th c em vo nh cha cng dng n Shinto nhng v tnh khi chuyn ch bng rm c qun cht dy bn bng tranh (kamidana) to xc tc ln men cho nhng ht u nnh bn trong v bin chng thnh Natto. Nhng nhng huyn thoiny cng cha c ti liu no chng minhtr ch Natto trong Nat l cng np (hay cng dng) cn To l ht u. - Thuyt Thi t Shotoku tnh Shiga ( vng trung b Nht Bn, pha ng thnh ph Kyoto ). Tng truyn rng thi t Shotoku vo u th k th by i nga qua ngn i Omi v gh li qua m ti lng Warado, vng trng nhiu u nnh. ng ta cho nga n nhng ht u ( nu chn) d tha, gi trong rm v treo cnh cy. Ngy hm sau nhng ht u ln men thnh Natto v khi ng cho thm mui nm th th thy ngon ngt v dn lng bt chc sn xut ra mn Natto c o ny. T i tn lng thnh lng gi bng rm (Warazuto Mura) v thc t l lng ny l ni sn xut Natto cho n nhng nm 1920. GS Ota Teruo cho rng Thi t Shotoku hc cch ln men t mt v s ngi Triu tin, bn thn ca ng ta tn l Keiji, k thut len men u nnh trong khi Thi t theo ng hc o pht. Tt c cc truyn thuyt khc v Natto u ni rng Natto xut pht t cc tnh min Bc Nht Bn. 3) Thuyt Hachiman Taro Yoshiie ( ph bin nht ) Hachiman Taro Yoshiie l tn gi thn mt ca Minamoto Yoshiie, mt Samurai ni ting con ca lnh cha Minamoto no Yoriyashi thi Heian ca Nht bn. Yoshiie l v tng anh hng trong cuc chin ko di 9 nm Zenkunen (1051) v trn chin 3 nm Gosanen (1083) trong nhng cuc dp lon cc s qun min Bc. Nng dn vng ny ng ln v ngho i, chng li su thu, tht ma v nn gi rt v vy triu nh Kyoto vi c tng Yoshiie, cha ng ln min Bc khng ch. Trn ng t Kyoto ln Edo (Vng Tokyo v ph cn) ngon ngho dc theo nhiu tnh ngho (Oshukaido). Tng truyn khi on qun ngng li nu u nnh cho nga n th b tn cng bt ng nh vi v qun u trong gi rm ct cht vo lng nga. Ngy hm sau hay sau na, thy gi u m hn (v thn nhit ca Nga) v bc mi khng khip do ln men nhng n nga n rt ngon. Binh lnh t m nm th th

pht hin y l mn n b dng, mau tiu v nhun trng khng b snh trng hay to bn. Mt giai thoi khc k rng khi tng Yoshiie n thnh ph Iwadeyama Miyagi (tnh vng ng bc) thng trn Zenkunen (Trc chn nm) th tng qun cho rng nh n Natto ca dn lng dng ln m thng trn v t Natto tr thnh c sn ni ting ca lng Iwadeyama t thi k gia Edo. 32 nm sau Yoshiie tht trn Gosannen, b bt ti Sankanbu tnh Akita. Trong thi gian chin u ti y Yoshiie nu u cho nhng nng dn ngho i v vi vng gi vo l tranh, nng dn ngc nhin v my ngy sau u bc mi hng v nhn nht nhng v i nn n ngon lnh v t Natto tr thnh mn n b dng ca ngi Nht bn n ngy nay. Cui cng chin thng tr v Kyoto mang theo k thut ch bin Natto v vy con ng v ca ng c gi l con ng Natto pht xut t lng Yokote tnh Akita min ng bc sang cc tnh Yamagata, Sendai, Fukushima, Haizu,Mito, Urawa (Saitama),Tokyo, Kofuv cui cng l Tanba (gn Kyoto), ni ni u c ph bin k thut sn xut Natto v tr thnh c sn ni ting sau ny Cu chuyn huyn thoi v tng qun Hachiman Taro Yoshiie tr nn mt tc phm truyn khu bt h cho n ngy nay. Ngoi giai thoi va k, chung quanh Natto cn c nhiu giai thoi nh Hong tr thnh nh s Natto khi nh vua Kogen (1331-1333) b ngai vng ln ni i tu v ch bin u nnh thnh Natto (u nnh nu chn gi vo rm ln men) nh vy cc cha vng Yamaguni hay Kyoto cng cho ra i nhng c sn Natto ni ting nh Tanba Natto hay Yamaguni Natto. Vo thi i Muromachi ( 1338-1573 ) ngi Nht bn bit cch ch bin Tng (miso) v cc loi nc tng (shoyu)mt loi nc chm - t ht u nnh hay en nh vy cch lm Natto cng thay i t nhiu bng cch gia v thm tng thay v mui, c bit trong nh n thin hc, cc v s s dng rt nhiu loi tng, u h v Natto trong ba n (Shojin Ryori) nh vy Natto cng tr nn ph bin trong gii Samurai, s si hay tng lp qu tc. T th k th 17 (thi Tokugawa) Natto tr nn ph bin rng khp, Mito (tnh Ibaraki) l ni sn xut ra nhiu loi Natto ni ting lu truyn cho n ngy nay. Ngay Tokyo vo nhng nm 1970, ngi ta cn thy cnh bn do Natto v u h bng xe p trong cc khu ph ngho, tr thnh mn n sng ca gii bnh dn, rt tin li v ch cn natto vi cm nng v nc tng l c th xong ba cm sng hay thm mt t tng (miso) cho vo Natto thnh bt canh nng (natto-jiru) cho ba cm ti.

Gii m nhng b n chung quanh Natto

Nh khoa hc u tin nghin cu v s b n ca Natto l tin s K.Yabe, mt chuyn gia v vi sinh hc cng b nhng kt qu tm ti ca ng v s ln men ca Natto vo nm 1894, ghi li rng Natto, mt loi pho-mai thc vt gii thiu vi cc nc phng ty vn rt quen thuc vi cc loi ph-mai t sa b hay sa d. Trc Abe, cha c mt ai tm hiu nguyn nhn ti sao Natto c th ln men t rm r bc quanh, qu l mt iu k b. Vi kin thc v vi sinh vt, TS Abe cho rng u nnh nu chn chc chn c ln men bng mt loi vi sinh vt no v vi phng php trch ly, Abe tm thy 4 loi vi khun (ba loi thuc h Micrococci v mt loi Bacillus) gip cho u nnh ln men d dng (ng ta pht hin Bacillus subtilis l loi men gip cho u nnh nu chn ln men (nhng khng xc nh l mt loi enzym c trong rm r bc quanh Natto). Nhng khm ph ny v mt khoa hc ca Abe gy c ting vang v nh gii chuyn mn xc nh c tnh cht c bit v dinh dng ca Natto v phng din vi sinh. Qun i Nht bn trong thi chin tranh Nht-Nga ( 1904-1905 ) phi n ngy 3 ba bng Natto vi cm nh vy binh lnh gn gi c sc khe khng b au bng, tiu chy hay to bn trn ng hnh qun. Vo nm 1905 TS Shin Sawamura ( i hc Tokyo ) thnh cng trong vic tch 2 loi vi khun Natto t u nnh nu chn, trong vi khun gy ra mi hng c bit lm ht u ln men (Bacillus natto) cng nh vi khun to cht nhn rt do dai ( Bacillus mesentericus vulgarus ) to v ngt. T , khng nh c loi enzym---qua nhiu kim chng trn cc loi natto khc nhau--Bacillus Natto do TS Sawamura tm thy l chnh xc. Bacillus Natto ng ngha vi Bacillus Subtilis trong thut ng ngy nay. Nhiu nghin cu cho thy ngi ta dng nhiu loi men tng t sn xut Natto nhng tt c u tht bi, sn phm Natto ny khng c mi v do nh Natto sn xut bng loi men t rm r, iu gip cc nh khoa hc Nht bn xc nhn c rng con men to ra Natto phi l mt loi men cc c tnh khc vi loi men Bacillus Subtilis tuy rng cng h. S d cc nh khoa hc Nht Bn ct cng nghin cu v thc phm c o ny v cho rng y l mt thc n gip con ngi sng lu, gi gn c sc khe trong c 4 nh nghin cu n hng ngy natto, sng n 80,4 tui vo nhng nm 1900 l bng chng c th. Nhng kt qu nghin cu sau ca GS Muramatsu Shisuke (trng Nng nghip Morioka) trch ly c 3 loi Bacillus c trong Natto to ra mi v hng v cho Natto nhng ng xc nh nhng enzym Natto ny giu protein v cht tinh bt gip cho tiu ha d dng

cng nh hp thu c dng cht t thc n khc nh vi khun natto c trypsin v diastase (enzyme). Vic tm ti sn xut theo li cng nghip sn phm Natto c nghin cu lin tc cc trng i hc Nht bn (nh GS Hazawa Jun H Hokkaido) ng dng cc loi enzym c tnh nng tng t vi enzym t rm r phc v qun i vin chinh Nht bn Mn chu, Trung quct nm 1919. T , Natto tr thnh thc phm ch yu cho qun i vin chinh trong th chin th hai v ngy cng ph cp n nhn dn. Qua thng k chng ta c th thy t mc tiu th Natto 39.000 tn nm 1958 tng vt ln n 170.000 tn/nm 1982 chng t Natto tr thnh lng thc dinh dng m bnh qun ngi Nht s dng 1,42 kg/nm (v hin nay l khong 2 kgs/nm).

Hiu qu dinh dng ca Natto - thc phm chc nng

Khuynh hng ngy cng tiu th sn phm Natto v tin rng Natto khng nhng l thc n r tin d tiu, nhiu protein v khng gy hi nh cc loi thc phm ch bin cng nghip (n lin) mc d mi hng (do vi khun Pyrazine gy ra) ca Natto vn gy kh chu, cc k kh ngi . Bn thn ngi vit bi ny Nht trn 40 nm nhng cng khng th lm quen vi mi c bit ca Natto mc d vn bit y l mt thc n bnh dn c dinh dng cao. Nhiu anh em Vit nam phi b chy lnh xa khi ngi bn Nht (trong c x) bn cnh m np gi Natto ra n. iu khc thng l nhng ai quen hay chu c th ngy cng nghinmn ny mt cch l lng nh ngi Php ghin ph-mai ln men xanh Roquefort nng mi vy. y cng l im yu m cc nh sn xut thc phm ra sc khc phc bng cch (1)Pha trn vi ht d (2) hun khi, sy kh vi cm la mch (3) thm Calci (4)Natto vi loi rong to giu Vitamin B-12 hay (5) Pha trn Natto v go lcv c nhng pht biu nh gi kh tch cc ca gii chuyn mn vo nhng nm cui v thp k 1970 nh nghin cu ca GS Kameda (H Y khoa Kanazawa) v hiu qu ngn nga nhim c, t bo ung th, kim loi nng ca Natto trn c th chut hay nh tng kt ca GS Ohta thuc vin nghin cu Thc phm quc gia (NB) rng c nhiu chng c qua nghin cu c bn cho thy hiu qu ca Natto nh ngn nga bnh kit l, tiu chy v nhim c ng rut hay gim bogia cc nh chuyn mn mc d cho dn nay vn cn nhiu tranh ci nhng r rng l ngi n Natto khng b y hi, trng bng nh khi n cc loi u khc, c ngha l enzyme natto c kh nng l mt hot cht c ch khng th ph nhn.

Trc khi i vo chi tit dinh dng c bit v kh nng ngn nga cc chng bnh tim mch ca Nattokinase, chng ta hy lt qua nhng c trng tng qut ca u nnh.

c trng ca u nnh
u nnh l loi u c xem l ttnht trong cc loi ng cc nh nhng c tnh dinh dng sau: - Protein ( 35 - 45% ) gm cc loi Acid amin c bn ( Isoleucine, Leucine, Lysin, Methionine, Phenylamin, Tryptophan, Valin) Isoflavones ( cht Genistein ) l mt estrogen thc vt ngn ng mu trong ng mch, chng xp xng, gip cho hot ng ca no b cho Nam ln n di 4 dng: Aglycone, Daizein, Genistein v Glycitein. Mi ngy c th cn 50 mg Isoflavones (tng ng vi ming u ph hay 30 gr u nnh rang) l cht khng b tiu hy trong qu trnh ch bin, nu nng thc n . Isoflavones c l gii nh mt hot cht chng Oxy ha, ngn cn cc gc t do (free radical) tn cng LDL, gip c th gim Cholesterol xu (LDL), tng o thi chng ra ngoi v lm gim nguy c suy tim mch. - Cht bo ( 15 - 20% ) trong acid bo bo ha thp (13%), khng c cholesterol (acid bo khng bo ha 30%). Lng acid bo khng no cn thit nh acid Linoleic 50% v 7% Alpha Linoleic acid l ngun cung cp acid bo chui mch di Omega 3 (pht trin no tr em) quan trng cho c th nh DHA ( Docosa Hexanoic Acid) v EPA (Eicossa Pentaenoic Acid) c hiu qu trong vic tr cc chng bnh v tim mch, ung th v nhiu bnh khc. - Glucose ( 15 - 25% ). - Cht v c, mui khong nh Ca, Fe, Mg, P, K, Na, S (5%). - Nc (8%). - Vitamin: A, B1, B2, D, E, F. - Globulin, cellulose.

Nhng hiu qu tng qut t u nnh

Trong bi Thc phm chc nngC m mi (1) chng ti ni qua v u nnh, mt trong nhng ng cc c Vua Thn Nng ( nm 2838 )

Trung quc xp vo loi dinh dng c bn v gi tr ca u nnh qua kinh nghim hn 4000 nm ca cuc sng con ngi c chng minh tuy nhin mi n nm 1970 th hng lot nghin cu khoa hc v u nnh trong vic ngn nga cc chng bnh trong y khoa mi c tp trung qua nhiu kha cnh. Kh nng phn tch nh tnh cng nh nh lng cc thnh phn ha hc, bnh l v chc nng khc phc ca u nnh dn c sng t khi iu kin phn tch ha l, cn lm sng v lm sng trong k thut nghin cu y khoa v ha sinh c nhng bc pht trin vt bc. Trong ng y, u nnh c v ngt, bi, khng c (lnh tnh) gii nhit, iu ha ng tng, b nguyn kh, thng li 12 kinh mch. Trong tn gio ( Nht bn), u nnh c dng xua t kh v vy nh cha thng tung u nnh vo ngy 1 thng 2 hng nm (tt m lchgi l Xun phn--Setsubun) trc cng vo dp l (mamemaki) nh mt php l lm sch chn thanh tnh. Cc v cao nin thng tung nhng ht u nnh ra khi ca, h to Oni wa sto, Fuku wa uchi ( Qu ma ra ngoi, phc lc vo nh ). Ci thin xng Sn phm i t u nnh nh sa u nnh khng c nhiu hm lng calci nhng Isoflavones c th ngn nga chng long xng hoc xp xng. Nhiu nghin cu cho thy Isoflavones trong u nnh c kh nng nh mt hormon n tnh (estrogen) thc vt c hiu qu duy tr nhng t bo xng thm vng chc. Cc nh nghin cu i n mt kt lun kh chc chn rng Estrogen thc vt (Isoflavones) c tc dng tch cc n xng trong ph n thi k mn kinh, lm cho xng chc hn, trnh b xp v nh vy m gim nguy c gy xng. y l cch iu tr an ton, r tin v c hiu qu nht. Gim cc chng tin mn kinh Thng k cho thy ph n chu b thng hnh nh bc ha, m hi trm ( khi ng ) hn ph n chu u trong thi k mn kinh. Nhng chng tin mn kinh hin r trong thi k hormon n tnh gim bt giai on tin mn kinh. Khi mn kinh c th khng cn sn xut ra hormon n tnh (Estrogen) gy ra mt lot bin i tm sinh l trong c th ngi ph n dn n mt s bin chng nh long xng, tiu ng hay ung th (v hoc t cung). Hormon n tnh gi vai tr iu ha hot ng sinh hc (k c hot ng tnh dc ca n gii) trong c thn nhit v vy nhng Isoflavone ca u nnhtng t nh Estrogen do non so sn sinh cn thit pht trin c quan sinh dc n-c kh nng khng ch cc chng tin mn kinh. V vy, u nnh c xem l phng php tr liu an ton gip ph n vt qua thi k ny thay v dng cc phng php tr liu bng Hormon thay th (Hormone Replacement Therapy)

c nguy c gy ung th cao. Qua kho st ngi ta pht hin rng ngi ph n Nht bn b tc ng ca cc chng tin mn kinh ( 4% phi dng HRT tr liu ) thp hn ph n ngi M ( phi tr liu bng HRT l 30% ), t b nng bng ( bc ha ) nh i sng n ung nhiu sn phm u nnh . Mt nghin cu khc trn 22,000 ngi ph n Nht bn thc hin vo nm 2003 chng minh rng ch n giu Isoflavone c trong Miso (sp tng Nht) hay Natto s gim dn 50% nguy c b ung th v. Gim nguy c suy tim Cc nh khoa hc Nga kho st cht m c trong u nnh lm gim Cholesterol v Triglyceride trong mu t u th k 20. Lames W. Anderson, chuyn gia v ni tit cho bit n 30 gr/ngy u nnh s lm gim 13% LDL (xu) trong khi HDL (tt) khng i nh tc dng ca acid amin, c bit l 2 cht Glycine v Arginine. V vy ngi dn cc nc tiu th nhiu u nnh c t l suy tim thp hn cc nc khc v u nnh ngn nga c cc bnh tim mch do lm gim cht m (Cholesterol)--loi Lipoprotein nng thp hay cn gi l Cholesterol xutrong mu, l nguyn nhn gy nn chng huyt khi, x cng ng mch hay nguy him hn l chng x va ng mch gy nn t vong. Cc Isoflavones ca u nnh gip cho ng mch c n hi, tim co tht nhp nhng v u n hn. Mc d t l t vong v suy tim, xut huyt hay t qu ca ngi Nht thp hn ngi u m nhng thng k cho thy 60% b t vong Nht l do nhi mu v xut huyt no v vy nn n nhiu Natto l iu thng c cc bc s khuyn bnh nhn. Cng ln tui th hin tng b ng mu cng cao khi lng plasmin gim enzym duy nht trong c th c kh nng trc tip tiu hy si fibrin-- lm tan mu vn cc trong ng mch. Ngn nga mt s bnh ung th Nhiu nghin cu cho thy n nhiu sn phm i t u nnh s ngn nga c cc loi bnh ung th do hormon gy ra nh Ung th v (Ph n), ung th tin lit tuyn (nam) hay ung th ng rut. Nht bn ngi n ng n u khun (tu h) 5 ln/tun c t l b ung th tin lit tuyn (prostate cancer) thp hn khong 50% so vi n ng n u khun 1 ln /tun hay t hn v ngi dng sp Miso (canh tng) t b ung th d dy hn nhng ngi khng dng u nnh. Tng t Trung quc ph n dng thc phm u nnh (di 1 ln/ tun ) c t l b ung th phi v ung th v cao gp 2 n 3,5 ln so vi ph n dng hng ngy. Nhng kt qu nghin cu v tc dng ca u nnh v cc chng ung th u i n kt lun t l ca ngi dng thc phm c cha Estrogen thc vt c t l ung th thp hn dn tc hp thu nhiu cht bo cao, nhiu m ng vt v t tiu th cc cht si (fibre).

Theo c tnh ca WHO nm 2006 c 1,5 triu ph n trn th gii b ung th v, ring Hoa k hng nm c thm 270,000 trng hp mi v bnh ung th v c khuynh hng ngy cng tng cao trn th gii. Hn 300 cng trnh nghin cu v Isoflavones trong u nnh i vi bnh ny cho bit cc t bo ung th khng pht trin khi tip xc vi Genistein l mt loi Isoflavone trong u nnh. Ti hi ngh v phng nga bnh ung th Hoa k thng 11/2006 Bc s Larissa Korde thuc Vin Ung th Quc Gia (Hoa K) cho bit ngi n nhiu thc phn lm t u nnh nh Tofu (tu h), ht u nnh, Miso (tng), tng luc (edamame), sa u nnhkhi cn trong tui 5-11 tui s gim 58% nguy c mc bnh ung th v sau so vi nhng ngi n t thc phn u nnh nh Estrogen thc vt (Isoflavones) c trong u nnh tc ng hu hiu, mt kch thch t pht trin cc c quan sinh dc (n) ng thi l hot cht chng oxy- ha hu hiu. Bc s Stephen Barnes thuc i hc Alabama (Hoa k) cho bit u nnh c th khng ch cc loi ung th bao t, rut, phi, gan v mu. Cc nh khoa hc Php cn cho bit cc Isoflavones cn c tc dng chng ung th i trng v ung th ni mc t cung. Ti hi ngh khoa hc v Ung th ngy 27/6/1990 ti Washington, nhiu nh khoa hc ng tnh cho rng 5 cht chng ung th c trong u nnh l: Cht c ch Protease (Protease Inhibitors) ngn nga ung th kt trng (colon), ung th phi, ung th Ty tng v ung th ming, Phytate (ngn nga tim mch, ngn cn hp th cht st vo rut..), Phytosterols (thay cho Cholesterol vo mu, ch c trong cc loi rau, u v vy gip gim lng Cholesterol trong mu v khi c thi ra ngoi trnh c ung th kt trng do mui mt , hoc ung th da. iu ny gii thch ti sao ngi n chay theo o C c Phc lm hay ngi Nht bn--l dn tc tiu th nhiu u nnh tng ng vi 400 mg Phytosterol--c t l ung th kt trng (Colon Cancer) rt thp (trong khi ngi phng ty ch c 40 mg/ngy); Saponin l cht tch cc chng oxy- ha ca cc radical t do lm gim cholesterol trong mu; Phenolic acid gip cho cc DNA khng b t bo ung th v Lecithin ( cp). Nghin cu ca TS Lister Morrison cho bit Lecithin cn lm chm (ngn chn ) s pht trin ca t bo ung th ngoi kh nng lm gia tng tr nh, l cht b nui dng t bo no v h thn kinh c nhiu nh nghin cu nu ln.

u nnh l cht dinh dng tt

Nhng sn phm i t u nnh nh Tu h, tng, chao, sa, natto l nhng thc phm giu protein (m) cung cp nhiu loi acid amin cn thit cho c th. Nhng acid amin ca u nnh kt hp rt tt vi cc loi acid amin ca nhng ng cc khc. u nnh cn l ngun ca Lecithin v Vitamin E l nhng hot cht chng oxy- ha thin nhin ngn chn tc hi ca Cholesterol nng thp (LDL) mt khc u nnh li giu Magnesium gi vai

tr quan trng cho xng, tim mch v chng x va ng mch. Hn th na u nnh cn c tc dng rt tt cho Thn thc hin chc nng ca mnh (ph thi cht b do chuyn ha ca m, ph thi nc, khong cht d tha trong c th, c t trong thc phm). m thc vt c trong u nnh thay th m ng vt (t tht) lm cho Thn lm vic t hn, lng protein trong nc tiu gim, ngn nga nguy c sn thn. Ti hi ngh quc t v dinh dng t chc ti New Zealand (30/4-3/5/2006) GS Masafumi Kitakaze khng nh Natto c tc dng lm gim r rt cc chng M ( Triglyceride v Cholesterols ) trong mu cao qua nghin cu chung ca 4 c quan y t Nht Bn, ku gi cng ng th gii ci thin np sinh hot (Lifestyle) v tiu th Natto thin nhin trc nguy c bo ph do tha dinh dng v cc chng bnh him ngho, nan y ( tiu ng, ung th ) ngy cng tng khp ni trn th gii. Tuy nhin gn y, mt s nh nghin cu ti hi ngh o cho hay Estrogen c trong u nnh c nguy c lm suy yu tinh trng ca nam gii, kh c th gip non so th tinh trong c th ph n (BS Chris Barratt, i hc Birmingham) v tinh trng rt nhy cm i vi Estrogen nhn to trong qu trnh th tinh. Nhng y l kt qu so snh gia Estrogen thin nhin v Estrogen nhn to i t mi trng vi ch s tinh trng ngy cng gim trn c th v vy s khng nh v tc hi ca nhng IsoflavonesEstrogen thc vt trn tinh trng mi dng li mc cnh bo, gii hc thut ch tha nhn Isoflavones c tc dng ngn nga chng ung th tin lit tuyn nam gii. Tuy nhin iu ny khng phi l khng c l khi nhng nh tu hnh (Pht gio) s dng u nnh lm thc n ph bin, xem l mt bin php dit dc c t nghn nm nay, l ngun thc phm ch bin nhiu mn n chay hay gim m hin nay. Ngoi ra cn c kin cnh bo mt tri ca u nnh l cht Hemaglutinin trong u nnh c kh nng lm cho hng cu b vn, gim hp thu dng kh hay tc hi n chc nng ca tuyn gip nu n thng xuyn trong nhiu nm tuy nhin nhng pht biu ny cha c gii chuyn mn tn thnh, cho rng cc phng php ch bin u nnh thnh thc phm mi l nguyn nhn ch yu chng hn nh lng kim cn st khi ngm u nnh, to ra Lysinealine gy ung th trong khi un si (luc), gy trng chng bng, ng thi kh i cc tc nhn tch cc nh Genistein hay Daizein. Bc s Nguyn Vit Tin, Gim c Bnh vin ph sn Trung ng (Vit Nam) khuyn Ph n chun b c thai khng nn n nhiu thc n ch bin t u nnh. Hp cht Genistein trong u nnh c tc dng tiu dit tinh binh trc khi chng kt hp vi trng (non so) da theo kt qu ca mt nghin cu

trng y t cng cng Johns Hopkins (Maryland M) nhng FDA (M) hay WHO vn cha ln ting xc nhn chnh thc nhng thng tin ny.

Pht hin c o ca GS Sumi Hiroyuki

Natto tr thnh mt ti nng hi khi TS Sumi Hiroyuki tung ra nhng kt qa bt ng v hiu qu ca natto trong vic lm tan cc huyt khi trong ng mch--mt trong nhng nguyn nhn suy tim v t vong ca bnh nhn b cc chng x va ng mch vnh hay t qu v nghn hay xut huyt novo nm 1980. Trong ba cm tra ti nh n ca i hc Y khoa Chicago, Sumi ly mt mu Nattomn n quen thuc ca ng--t vo khay thy tinh c cc mu ng th 18 gi sau cc mu ng ny tan r d dng, iu gi rng trong Natto c th c mt (hay nhiu ?)hot cht (fibrinolytic enzyme) c th phn hy huyt khi nh thy phn si Fibrin-- l mt enzym ni sinh hnh si-- c kh nng lm ng mu (t mu) ngn chng xut huyt ni. Sumi bt u lu ti vai tr ca nattokinase v Vitamin K2 c trong Natto chng minh n l hot cht gip cho ngi Nht bn sng lu, lm tng kh nng to ra Plasmin ni sinh gip cho c th trnh c tai bin hay t qu bi huyt khi hay cc chng x va ng mch, suy tim bin chng gy nn.Theo kt qu nghin cu ca 3 c quan y t--i hc bang Oklahoma (M), JCR Pharmaceuticals (Nht Bn) v Trng Y khoa Miyazaki-- phi hp th nghim trn c th ngi (in vivo) bng cch cho n Natto 200 gr/ngy v kim chng c nhng hiu ng k trn, c bit pht hin lng Plasmin ni sinh gim st ngi cao tui khng lm tan huyt khi, vn cc trong ng mch th hiu qu cng r rt. Cc Bc s M thng s dng cc loi thuc cha hot cht lm tan si fibrin nh Urokinase (t nc tiu con ngi), TPA ( tisue plasminogen activators) t t bo ung th gi l Melanoma (sn sinh enzym plasmin) cn Bc s Chu u li dng Streptokinase l loi protein i t vi khun cha tr bnh huyt khi trong thi k bnh mi pht... nhng hiu ng ca cc loi thuc ny rt ngn, ch ko di trong vng 20 pht khng th ko di khi bnh nhn ln cn t qu hay tai bin cp. l cha k nhng phn ng ph gy, xut huyt, d ng, nn ma, lon nhp tim khi dng TPA. Nm 1986, TS Sumi Hiroyuki cng b ton b kt qu nghin cu v tc dng ca Nattokinase sau khi th nghim gn 200 loi thc phm khc nhau so snh, xc nh Nattokinase l mt loi enzym mang kh nng phn hy huyt khi mt cch hu hiu v mnh nht trong cc loi enzym, gp 4 ln Plasmin enzym ni sinh lm tan mu ng--ng thi tuyt i an ton cho c th khi hp th qua ng n ung. Vn l mt nh nghin cu vi sinh hc, Sumi bc sang lnh vc y khoa nghin cu v Enzymes v y l mt lnh vc

pht trin ni tri ca Nht bn. C nhiu loi u (u en, u xanh, ht hng dng) c th ch bin thnh Natto thay cho u nnh nhng ch c Bacillus Natto l hiu qu hn c tuy nhin enzym ny ch xut hin khi c rm r l iu ng lu . Ngi ta trng u nnh t 150 nm trc ti Hoa k nhng khng pht hin ra vi khun ln men tng t v khng c loi vi khun Bacillus Natto tn ti . Mt khc, t nghn xa ngi ta cho rng Natto rt hu hiu trong vic phng chng bnh cm cm, ng c thc n (kit l, tiu chy cp), lm chc xng., tiu dit vi trng gy bnh cng nh gip cho ph n mang thai sinh con khe khon. Da trn nhng bi thuc c truyn ny Sumi tm cch chng minh bng khoa hc cho bit Natto c cha Di-Picolinic Acid c th khng ch vi khun O-157 nh hiu ng dit khun, hn ch s sinh si ca cc vi khun c hi ng thi thc y loi vi khun c li cho sc khe tng trng nh vi khun Lactobacillus c trong Natto hay mt enzym ni ting lm tan vn mu ng trong mch mu nh Nattokinase cp trn. Kt qu cho thy chng mu ng (huyt khi) trong tim v no gy tai bin nh nhi mu c tim hay t qu cao hn c cc chng ung th v vy Natto c xem l thc phm chc nng tch cc c tc dng lu di vo c th con ngi nhm ngn nga cc chng tim mch tch cc v r tin nht, thng qua i sng hng ngy hn l tim chch cc loi thuc tr liu trc tip c nhiu tc dng ph khng mong mun. Ngoi ra vi hm lng vitamin K2 trong Natto ( c hm lng rt cao 870 micro gr/100 gr ) gip cho xng ca ph n mn kinh chc hn, khng b xp do long xng (Osteoporosis) m 60% ph n tui ny u vng phi. Hin nay ngi ta cn khm ph ra tc dng ca Vitamin K2 (Menaquinone 7) gip cho vic sn sinh ra mt loi protein c tn Osteocalcin hot ng nh mt cht keo kt hp vi Calci trong xng trong khi hm lng Vitamin K2 ca c th ngy cng gim theo lo ha. B Y t NB cng nhn tc dng (dc l) chng long xng ca Vitamin K2 v xem Natto l ngun cung cp b sung Vitamin ny cho c th t Nattokinase. Theo phn tch trong 100 g Natto c cha 1,000 Micro gram Menaquinone 7, ngi bnh thng tiu th 1 micro gram/1kg trng lng c th. C ngha l ngi nng 60 kgs cn 60 micro-gram vitamin K2 hay 10 g Natto l cho 1 ngy. Hn th na, trong Natto cn c Isoflavone l mt hp cht c kh nng chng oxy-ha tng t estrogen n gii v FDA Hoa k khuyn co ngi dn nn dng ti thiu 50 mg /ngy ngn nga ung th, ngha l mt gi Natto n trong ngy l va . Bnh ung th tin lit tuyn M cao gp 15 ln Nht cho thy i sng n nhiu Natto vn c li cho cc chng ung th V (ph n) hay Tin lit tuyn (nam) hu hiu.V hiu qu ca hot ng chng oxy-ha th u nnh ln men c sc mnh gp 4 ln u nnh bnh thng nh enzym bacillus c trong Natto, tuy nhin c ch phn ng ny cha c khng nh. Trong 1 gr Natto c khong 1 triu-1 t vi khun Bacillus v thc n ny c b y t Nht bn xem l thc phm c tc dng

cha bnh tiu ha t nhiu nm trc. Hin nay thc n i t Natto ph cp kh rng ri trn nhiu nc ty phng, c bit l Hoa K, h cho rng y l mt trong nhng nguyn nhn gip cho ngi Nht c tui th bnh qun cao nht trn th gii. Tuy nhin nhc im ca Nattokinase l b phn hy trong mi trng 70C v vy vic ch bin bng cch nu chn Natto l iu nn trnh, tt nht l n sng bng cch pha trn vo cm thm x du nh ngi Nht bn thng dng. ngt c trong Natto l nhng Acid Glutamic thin nhin trong cht nhn khi ln men v vy khng nhng gip cho c th hp thu mt lng ng thin nhin m cn gip cho rut tip nhn calci d dng. Trong 100 gr Natto cn c 7 gr cht si v vy y l yu t nhun trng tt, gip cho tiu ha khng b snh hi (trng), tc bng nh khi n cc sn phm u nnh khc. Ngoi ra enzym Protease c trong Natto s gip phn gii cc protein thnh cc loi acid amin nh Amilase bin cc cht tinh bt thnh ng, Lipase phn gii cht bo trung tnh thnh Glycerin v acid bogip cho c th hp th cc dng cht cn thit ngoi hiu qu khc nh gip cho ph n c ln da p, gim cn v cc chng bnh do tui cao nh ni trn nh Lecithin.

Ngn nga chng tim mch bng Natto : an ton v r nht

Gi 1 liu Urokinase, thuc lm tan vn mu rt t tin, khong 1.500 USD/liu v ch hu hiu trong vng 30 pht hay s dng thuc t-PA c hiu qu trong 3-6 gi v c gi ln n 2.200 USD/liu , r nht cng l 200USD/liu nu dng Streptokinase hiu qu trong vng 12 ting trong khi 100 gr Natto ch l 1 USD c cng hiu qu tng ng ko di 8-12 ting ng h v an ton v Natto t c phn ng ph nh Urokinase. Con s thng k mi nht cho bit lng Natto tiu th trn u ngi Nht Bn ngy nay l 2 kgs/nm v cho ti nay cha c pht hin no cnh bo tc dng ph cng nh Natto l ngun gy d ng. S d nh vy l v Vitamin K c trong Natto cn c chc nng lm ng mu trong khi Pyrazine v Nattokinase c tc dng ngc li, ph tan mu vn cc v vy c th chng ta c th chn la s dng cc cht ny tng h cn bng lu thng mu huyt m khng gy ra mt tc dng ph no v gii thch c l do ti sao Natto khng gy ra s chy mu (xut huyt ni) khng kim sot c nh trng hp Aspirin. Nhiu bc s tim mch Nht bn cho bnh nhn s dng Natto, n 2 ln/tun thay v Wafarin trong khi ngn chn xut huyt vng mc v kt qu rt kh quan. GS Sumi Hiroyuki khuyn co l bnh nhn tim mch nn n Natto vo ba cm ti ch nht ngn nga mt cch hiu qu nht cc bnh xut huyt no hay ri lon nhp tim thng c khuynh hng xy ra vo sng th hai. Vi Lecithin v Linoleic acid c trong u nnhhay sn phm ca n l Natto th ng mch c co dn (flexible), mu c lm sch gip cho c th ngn

c chng x va ng mch vnh hay xut huyt no khi HA ln cao thay cho vic s dng cc loi thuc nh Aspirin (d gy xut huyt bao t) hay Plavix. Nhng thnh qu ca TS Sumi Hiroyuki cng c hai v chuyn gia hai khu vc khc nhau phi hp nghin cu, l BS Martin Milner Trung tm Y khoa t nhin Portland, bang Oregon (Hoa k) v TS Kouhei Makise thuc bnh vin Makise Kyoto, cng cng b kt qu qua bi vit trn tp ch chuyn mn kt lun rngl chuyn gia lu nm v tim mch v h hp chng ti nht tr khng nh rng Nattokinase l mt pht hin y phn chn trong vic ngn nga v iu tr cc chng bnh lin quan n tim mch, v chng ti xc nh Nattokinase l mt hot cht thin nhin c th lm tan cc huyt khi hu hiu, khng gy d ng v c an ton cao hn c ti, nhn sm Triu tin hay Bromelain (t qu da) thin nhin thc y sn sinh ra Plasmin trong qu trnh thy phn si Fibrin .

Thay li kt
Theo thng k, thnh ph HCM mi nm c khong 17.500 b t qu do tai bin mch mu no) trong 9.000 ngi b t vong, a s cn li l sng kiu thc vt hay mt kh nng lao ng gy bit bao au kh cho thn quyn. Nc ta li l mt nc c truyn thng s dng u nnh trong n ung t lu i, sn xut cc loi nc tng v nc chm t u nnh ni ting nh Tng lng bn Hng Yn : Anh i anh nh qu nh Nh canh rau mung, nh c dm tng V hn cn nhiu ngi vn cha qun Tng C H ng, xem tng c l gia bn nh nhng nng dn t x ng bc b. Ngy xa tng truyn tng bn c dng tin Vua v ni ting l ngon, hng thm du ngt v nhiu cht dinh dng, c th ch bin ra nhiu loi nc chm n km. Vo nhng nm 1930 - 1940 lng bn c c Thn th Lu kho tay lm tng ly thng hiu C Lm m mn cho tng lng Bn rn rp, hi nhp th trng c nc, cnh tranh vi tng C ( H ng ). c bit khc vi Natto ca Nht bn l tng lng bn ln men t xi (np go ngon nu chn) trong hai ngy vi u nnh rang, nghin thnh bt ri ngm bng nc ma v Cha thiu (xi) m thi (nc ngm u) th lm tng mi ngon. Bn cnh , nhiu loi nc chm nh x du hay tng chm trong cc mn tht nng, tht xo trn vi cc loi rauphong ph v cn bng b dng tht

tuyt diu. Ngoi tng bn, cn c tng Dc M (Lm thao-Vit Tr), tng Nam n (Ngh An) l mt loi nc chm kh c o, dng ht Ng (bp) hay np lm mc c s dng ph bin cc a phng pha bc nh cc loi mm min nam. Tuy nhin ng tic l nhng lng ngh truyn thng ch bin Tng hay nc tng dn d b mai mt v li lm n chp git, tranh dnh ln nhau, khng gn gi tnh cht ngon c o hnh thnh t trm nm nay v ln sng thc phm ch bin n lin nh m, bn v cc mn sp kh chim u th trn th trng trong np sng ngy cng th ha ln t. Hn th na vic nghin cu nhng yu t tch cc cho sc khe t nhng thc phm truyn thng i t u nnh hin nay vn cn b trng, cha thy c nghin cu khoa hc no v mt Ha sinh v bnh l ni v hiu qu tch cc ca cc loi tng nc ta, v vy ngi tiu dng hay nhn dn ni chung vn cn m m, hiu qua li n hay qung co mt cch nh tnh. Hn th na, cc chng bnh hin i nh cc bnh nh bo ph, tiu ng, tiu ha, ng rut, ung th cc loi ngy cng tng cao, ngi tiu dng ngy cng hng v ngun thc phm thin nhin, trong u nnh c xem l ngun m v cht bo thc vt tt nht nh cp trn. Mong rng cc nh nghin cu thc phm, dinh dngca nc ta s tm ti v khm ph t nhng mn n truyn thng ny vi nhng li gii thch tha ng v khoa hc gip ngi dn ci thin cht lng cuc sng mt cch hiu qu, gp phn tch cc khng nhng vo vic lnh mnh ha x hi m cn ng gp vo i sng dinh dng an ton t c sn t ngun thc vt, thy hi sn ca Vit nam. Chc hn nhiu ngi ang ch i cc nh khoa hc nc ta khai ph, vi nhng nhng thnh qu nghin cu c o tng t nh GS Sumi Hiroyuki thc hin 20 nm trc y, ngi bin Natto thnh mt ngun thc phm chc nng c gi tr kinh t v sc khe cao v r tin mc d hnh th v hng v ca Natto khng hp dn nh tng bn ca Hng Yn . Hng lot sn phm Nattokinase di dng vin, con nhng, bt hay ph gia trong thc nc a vo sn xut v rao bn khp ni, m ra mt th trng rng ln trn th gii c hng triu triu ngi ang ng trc nhng chng bnh nan y v him ngho vi chi ph cha bnh, chm sc ngy cng ln cao khng khip. Khng l tng bn ca Vit nam ch m thm nm trong x gc tnh l, cn li trong nhng hi k vn hc, l hoi nim (nostalgy) ca nhng ngi Vit xa x ?