1

LI CM N

Thc t lun cho thy, s thnh cng no cng u gn lin vi nhng s h

tr, gip ca nhng ngi xung quanh d cho s gip l t hay nhiu,
trc tip hay gin tip. Trong sut thi gian t khi bt u lm lun vn n
nay, em nhn c s quan tm, ch bo, gip ca thy c, gia nh v
bn b xung quanh.

Vi tm lng bit n v cng su sc, em xin gi li cm n chn thnh nht t

y lng n qu Thy C ca trng i hc Ty cng dng nhng tri
thc v tm huyt ca mnh c th truyn t cho chng em trong vn kin
thc qu bu sut thi gian hc tp ti trng.

c bit, em xin chn thnh cm n GS. TSKH. .. tn tm ch bo hng

dn em qua tng bui hc , tng bui ni chuyn, tho lun v ti nghin
cu. Nh c nhng li hng dn dy bo , bi lun vn ny ca em hon
thnh mt cch sut sc nht. Mt ln na, em xin gi li cm n chn thnh
n thy.

Bi lun vn c thc hin trong 2 thng. Ban u em cn b ng v vn kin

thc ca em cn hn. Do vy, khng trnh khi nhng thiu st, em rt mong
nhn c kin ng gp ca qu Thy C v cc bn hc cng lp bi lun
c hon thin hn.

Cn Th, ngy 1 thng 5 nm 2017

Sinh vin thc hin

 2

PHNG TH ANH

THCHNG 1. T VN
t lu ngi ta bit c trong thc n bao gm cc cht dinh dng: protit,
gluxit, lipit v mt s mui khong. Nhng sau ngi ta thy mt s bnh
gy ra do thiu mt cht no trong thc n, chnh l vitamin (theo ting
La Tinh: Vita l s sng, vitamin l amin ca s sng).
Vitamin l nhng cht hu c c bn cht ho hc rt khc nhau, m ch cn
mt lng nh trong thc n ca ngi v ng vt bc cao cng m bo
s sinh trng v pht trin bnh thng ca c th. Nhng vi mt lng rt
b nh vy chng khng phi l nhng cht cung cp nng lng. Ngy nay
ngi ra r vai tr xc tc ca vitamin i vi cc qu trnh bin i trong
c th.
Theo y hc, cc loi vitamin rt cn thit cho cc hot ng sng ca bt k c
th no, lm xc tc cho qu trnh sinh ho, gn lin vi vic gii phng nng
lng, tham gia cc phn ng ca t bo. Vic cung cp khng y vitamin
cho c th s nh hng xu khng nhng i vi s lm vic ca h thn kinh
m cn i vi mt lot cc c quan khc bn trong c th. V th cho nn
iu rt quan trng l khu phn n ca con ngi phi c gi tr hon chnh
khng nhng v phng din calo, v phng din cht m m cn v
phng din vitamin na.
i vi vitamin C ni ring cng c vai tr rt quan trng. N c v tr c bit
trong lch s ca hc thuyt v vitamin. Thiu vitamin C c th s b bnh hoi
huyt, nh hng tiu cc n s t v ca c th vi cc bnh nhim trng
khc. C th chng ta hon ton khng th t tng hp c vitamin C m phi
ly t ngun thc n ngoi vo. V vy vic phn tch vitamin C trong thc
phm l iu rt cn thit.
Tuy nhin y l hp cht hu c thuc i tng kh phn tch, hn na trong
mu phn tch tn ti nhiu cht hu c v v c cc dng khc nhau, gy
cn tr cho qu trnh nh lng. Do cn phi la chn phng php phn
tch hu hiu nht.
 3

C th phn tch vitamin C bng cc phng php: sc k giy, cc ph, trc

quang, ho hc Trong phng php cc ph l mt trong nhng phng
php t trng nht, c dng nhiu trong thc t nh lng hng lot.
Phng php cc ph p ng c nhu cu phn tch hp cht v c, hu c
vi hm lng nh, chnh xc. Tuy nhin do iu kin phng th nghim hin
nay cha p ng c nn khng s dng c phng php ny mc d n
c nhng u im r rt.
Khi nh lng vitamin C bng phng php trc quang ngi ta s dng mt
s thuc th v c nh: axit photphovonframic, mui titan (IV), axit
photphomolipdic cc phng php ny thng gp kh khn khi phn tch
hm lng vitamin C trong hoa qu, v dch qu thng c mu v c cha
nhiu thnh phn kh khc gy cn tr cho qu trnh nh lng.
Trong tri cy c cha hm lng ln vitamin v mui khong rt cn thit cho
nhu cu hng ngy ca c th, c bit trong cc loi qu nh: s ri c cha
hm lng vitamin C ng k (48-50mg/100g), trong chanh dy cha
(30mg/100g), trong da (18mg/100g), rt cn thit tng tnh khng cho
c th. lm phong ph thm mt hng nc qu, vic nghin cu ch bin
nc qu hn hp gm chanh dy - da s ri c thc hin nhm s dng
ngun nguyn liu rau qu c quanh nm to ra sn phm nc ung mi giu
vitamin, hng v thm ngon, p ng nhu cu ngy cng cao ca ngi tiu
dng.
 4

CHNG 2. TNG QUAN TI LIU

2.1. GII THIU CHUNG V VITAMIN C
2.1.1. Lch s ca Vitamin C
- Vo th k 15, 16, trong cuc pht kin a l ca cc nc chu u, nhng
nh thm him lun thy thy th ca h phi cht v cn bnh k l vi triu
chng mt mi, au khp, chy mu nu, l bnh Scurvy (hay Scorbut).
- Mi n nm 1774, James Lind, bc s hng hi qu tc Anh, pht hin n
tri cy s phng trnh c bnh scurvy. ng cho rng nhng ngi thy th
i bin ch tip xc nhng mn n kh, mn, t n tri cy dn n cn bnh
trn. Kinh nghim ca Lind cu sng rt nhiu thy th trong nhng chuyn
hnh trnh bng ng bin sau ny.
- Ngi nghin cu k v vitamin C l Albert Szent-Gyrgyi (1893-1986)
gc Hungary v ng c trao gii Nobel y hc nm 1937 v cng lao trn.
Cng vo nm , gii Nobel ha hc c trao cho Walter Norman Haworth,
ngi Anh, tng hp thnh cng vitamin C. Tuy nhin, quy trnh tng hp
vitamin C li c tn l Tadeus Reichstein, ngi cng tng hp thnh cng
vitamin C cng lc vi Haworth (2 ngi tm ra cch tng hp hon ton c
lp). iu ny s lm cho gi thnh vitamin C r hn rt nhiu, v trc y
vitamin ny c chit ra t tri cy bng phng php kh phc tp.
Hin nay, vitamin C khng cn l vi mi ngi. T tri cy cho n nc
ung, t vin thuc cho n ko ngm, u c s hin din ca n.
 5

Hnh 2.1. Thc phm c cha Vitamin C

2.1.2. nh ngha Vitamin C
Vitamin C cn gi l acid ascorbic. N tn ti trong c th chng ta di hai
dng D v L, tham gia vo cc hot ng khc nhau ca c th. Dng D khng
c hot tnh sinh hc. Dng L khi b xy ha ln u chuyn thnh axit dehydro
ascorbic (hi ng mu) vn cn hot tnh sinh hc ca vitamin C. Nu tip tc
xy ha na s thnh diketo golunat (mu vng sm) mt hot tnh sinh hc ca
vitamin C.
2.2. CU TRC HO HC V PHN NG
C6H8O6 P.t.l: 176,1
 6

Hnh 2.2. Cng thc cu to ca Vitamin C

Hnh 2.3. Cng thc cu to ba chiu ca Vitamin C

Acid ascorbic l (R)-5-[(S)-1,2-dihydroxyethyl]-3,4-dihydroxy-5H-furan 2-on,
phi cha t 99,0 n 100,5% C6H8O6.
 7

2.3. TNH CHT

2.3.1. Tnh cht vt l
Vitamin C kt tinh khng mu hoc hi vng, rt d tan trong nc (300g/lt).
Dung dch nc 5% c pH=3. C khi dng dng mui natri d tan trong nc
hn (900g/lt).
2.3.2. Tnh cht ho hc

D trong CTCT khng c nhm COOH nhng vitamin C vn c tnh axit. N

c tnh cht ha hc tng t cc axit thng thng, c kh nng b oxi ha v
b phn hy thnh CO2 v nc 193oC.

Acid ascorbic b oxy ha cho acid dehydroascorbic; y l phn ng oxy ha

kh thun nghch, qua vitamin C tc dng nh mt ng yu t (cofactor),
tham gia vo nhiu phn ng ha sinh trong c th, nh:

Hydroxyl ha;
Amid ha;
Lm d dng s chuyn prolin, lysin sang hydroxyprolin v
hydroxylysin (trong tng hp collagen);
Gip chuyn acid folic thnh acid folinic trong tng hp carnitin;
Tham gia xc tc oxy ha thuc qua microsom (cytochrom P450) gan;
Gip dopamin hydroxyl ho thnh nor-adrenalin;
Gip d hp thu st do kh Fe3+ thnh Fe2+ d dy, ri d hp thu
rut.
m, vitamin C gip tng hp collagen, proteoglycan v cc thnh
phn hu c khc rng, xng, ni m mao mch.
Trong thin nhin, vitamin C c mt cng vitamin P (vitamin C2).
Vitamin P li c tnh chng oxy ha, nn bo v c vitamin C; hn na
vitamin P cn hip ng vi vitamin C lm bn vng thnh mch, tng to
 8

collagen, c ch hyaluronidase v cng vitamin C, vitamin E, -caroten v

selen, tham gia thanh thi gc t do c hi trong c th.
2.4. CHC NNG SINH HC CA VITAMIN C TRONG C TH
2.4.1. Thc y s hnh thnh collagen
Khi thiuvitamin C, qu trnh tng hp collagen gp tr ngi, khin cc vt
thnglu lnh dn n xut huyt nhiu mc khc nhau (v mao mch,
chy mudi da, chy mu li, v mao mch, gy nhiu m xut huyt),
thnh mchyu l cc hin tng thng thy bnh scobat.
2.4.2 Cht kch hot enzyme
Vitamin C c th bo v vitamin A, vitamin E, vcc axit bo thit yu khi b
tiu hu; lm cho st (2) c trong thc n c duy tr trong trng thi hon
nguyn, thc y s hp th st v chuyn dch tn tr st trong c th. Lm
cho can-xi trong thnh rut khng b kt ta, gip ci thin t l hp th can-xi
vo c th. Tham gia phn nghydroxyt ca cholesterol thnh axit cholic, c
hiu qu nht nh trong iu tr thiu hng cu.

2.4.3. Tham gia qu trnh chuyn ha cholesterol

Gip 80%cholesterol chuyn ha thnh sulfat tan trong nc bi tit khi c

th,gim hm lng cholesterol trong mu; loi b cholesterol tch t trong
ng mch; gia tng cc thnh phn c ch ca mu nh lipoprotein, c
nghaquan trng trong phng chng x va ng mch.

2.4.4. Tham gia qu trnh bi tit cht c khi c th

Tip tc -xy ha thnh glutathione (diketo golunat) cng vi cht c trong c

th b bi tit ra ngoi.

2.4.5. Phng chng ung th

Vic gim vitamin C trong ng tiu ha ngn chn s hnh thnh

nitrosamines, c hiu qu ngn nga s xut hin ca cc khi u ng tiu
ha; ngoi ra vitamin C cn tham gia trong tng hp collagen, gip cc t bo
 9

k duy tr cu trc bnh thng, lm gim qu trnh pht trin ca t bo ung

th.

2.4.6. Chng cm lnh

Vitamin C c th ci thin kh nng khng bnh ca cc t bo min dch v

tng cng min dch ca c th v min dch humoral, loi b cc yu t gy
bnh, gi h h hp c bo ton. Khi thiun, biu m t bo khng bnh
kh qun v ph qun b gim xung. Cc th nghim cho thy, ung 1.000 mg
vitamin C mi ngy c th gim 50% nguy c b cm lnh v gim 23% cc
triu chng cm cm.

2.4.7. Bo v da, chng np nhn

Vitamin C l cht kch hot enzyme, c th gia tng s hot ng ca mt s

kim loi, gip da chng li cc gc t do sinh ra bi tia cc tm, trnh s xut
hin ca tn nhang, thc y s trao i cht, gp phn ngn nga lo ha da.

2.5. IU CH

2.6. TC DNG DC L

2.6.1. Dc l v c ch tc dng

- Vitamin C cn cho s to thnh colagen, tu sa m trong c th v tham gia

trong mt s phn ng oxy ha - kh. Vitamin C tham gia trong chuyn ha
phenylalanin, tyrosin, acid folic, norepinephrin, histamin, st, v mt s h
thng enzym chuyn ha thuc, trong s dng carbohydrat, trong tng hp
lipid v protein, trong chc nng min dch, trong khng vi nhim khun,
trong gi gn s ton vn ca mch mu v trong h hp t bo.
- Thiu ht vitamin C dn n bnh scorbut, trong c s sai st tng hp
colagen vi biu hin l khng lnh vt thng, khim khuyt v cu to rng,
v mao mch gy nhiu m xut huyt, m bm mu, chy mu di da v
 10

nim mc (thng l chy mu li). Dng vitamin C lm mt hon ton cc

triu chng thiu ht vitamin C.
2.6.2. Dc ng hc
- Hp th: Vitamin C c hp thu d dng sau khi ung; tuy vy, hp thu l
mt qu trnh tch cc v c th b hn ch sau nhng liu rt ln. Trong nghin
cu trn ngi bnh thng, ch c 50% ca mt liu ung 1,5 g vitamin C
c hp thu. Hp thu vitamin C d dy - rut c th gim ngi a chy
hoc c bnh v d dy - rut. Nng vitamin C bnh thng trong huyt
tng khong 10 - 20 microgam/ml. D tr ton b vitamin C trong c th
c tnh khong 1,5 g vi khong 30 - 45 mg c lun chuyn hng ngy.
Du hiu lm sng ca bnh scorbut thng tr nn r rng sau 3 - 5 thng
thiu ht vitamin C.
- Phn b: Vitamin C phn b rng ri trong cc m c th. Khong 25%
vitamin C trong huyt tng kt hp vi protein.
- Thi tr: Vitamin C oxy - ha thun nghch thnh acid dehydroascorbic. Mt
t vitamin C chuyn ha thnh nhng hp cht khng c hot tnh gm ascorbic
acid - 2 - sulfat v acid oxalic c bi tit trong nc tiu. Lng vitamin C
vt qu nhu cu ca c th cng c nhanh chng o thi ra nc tiu di
dng khng bin i. iu ny thng xy ra khi lng vitamin C nhp hng
ngy vt qu 200 mg.
2.6.3. c im chung
Vitamin C dng tinh th trng, rt d tan trong nc,tan trong ethanol 96 kh
tan trong ru,thc t khng tan trong ether v clorofom, khng tan trong cc
dung mi hu c, tn ti c 100 C trong mi trng trung tnh v acid, b
oxi ha bi Oxi trong khng kh v cng b oxi ha nhanh khi c s hin din
ca Fe v Cu.
2.6.4. C ch tc dng

Acid ascorbic b oxy ha cho acid dehydroascorbic,y l phn ng oxy ha

kh thun nghch, qua vitamin C tc dng nh mt ng yu t (cofactor),
 11

tham gia vo nhiu phn ng ha sinh trong c th, nh: Hydroxyl ha, Amid
ha. Vitamin C tng hp collagen); gip chuyn acid folic thnh acid folinic
trong tng hp carnitin. Vitamin C cng tham gia xc tc oxy ha thuc qua
microsom (cytochrom P450) gan; gip dopamin hydroxyl ho thnh nor-
adrenalin; gip d hp thu st do kh Fe3+ thnh Fe2+ d dy, ri d hp th
rut. m, vitamin C gip tng hp collagen, proteoglycan v cc thnh
phn hu c khc rng, xng, ni m mao mch.

Trong thin nhin, vitamin C c mt cng vitamin P (vitamin C 2). vitamin P li

c tnh chng oxy ha, nn bo v c Vitamin C. Hn na vitamin P cn
hip ng vi vitamin C lm bn vng thnh mch, tng to collagen, c
ch hyaluronidase v cng vitamin C, Vvitamin E, -caroten v selen, tham gia
thanh thi gc t do c hi trong c th.

2.6.5. Nguyn nhn gy thiu vitamin C

C nhiu nguyn nhn lm thiu Vitamin C, nh:

- Ht thuc: mi iu thuc mt 25mg Vitamin C.

- Nghin ru.

- n ung thiu cht dinh dng, c bit nhng ngi ln tui.

- n khng tri cy v rau c.

- Cng thng thn kinh: iu ny lm bn cn dng Vitamin C nhiu hn.

2.6.6. Triu chng thiu vitamin C

Tnh trng thiu vitamin C l ng k. Tuy nhin, thiu vitamin C mc

trm trng v gy triu chng th tng i kh gp, mc d cng c cc
trng hp triu chng khp li l du hiu gi thiu vitamin C. Thiu
vitamin C sau 1-3 thng bt u c biu hin lm sng v tin trin thnh 3 giai
 12

on. Giai on u c au c, au khp chi di v mt mi. Giai on ton

pht c triu chng xut huyt di da v nu ko c iu tr s n giai on
nng hn gy tn thng, suy kit, t vong. Biu hin khp c th gi . au
khp thng hay phi hp vi au c, hay gp l au cc khp ln chi di.
Hi chng xut huyt c th gy trn mu khp, hay t mu trong c. Tn
thng collagen lm suy yu ni mc cc mao mch lm d gy xut huyt
trong khp. Cc tn thng rng ming thng gp nh vim li ph i, xut
huyt gy vim quanh rang, mt rng. Cc du hiu ton th nh mt mi, gy
st, st mc nh v trung bnh. C th gp chy mu kt mc mt, xut
huyt nhiu khi hnh kinh v rong kinh v c vim thn kinh ngoi bin cng
c m t. Cc xt nghim huyt hc cho thy thiu mu, gim bch cu,
gim cholesterol mu. Chn on d dng v c th nh lng vitamin C trong
mu.

2.6.7.

2.6.8. Tc dng ph

Phn ng ph thng khi dng vitamin C: nng, kh chu d dy, bun nn,
tiu chy, co rt d dy.

2.7. MT S CH PHM CA VITAMIN C

Hin ti trn th trng Vit Nam c mt s ch phm vitamin C ca cc cng

ty nc ngoi lu hnh, nhng u l nhng ch phm vitamin C t cht
lng cao, vi cng ngh bo ch hin i, v gi ca vitamin C ngoi bao gi
cng cao hn vitamin C sn xut trong nc rt nhiu.

Ngoi ch phm thuc vi dc cht chnh l vitamin C, trn th trng, cn

nhiu thuc nc ngoi, ngoi dc cht chnh ca n, cn cha vitamin C nh
l dc cht tc dng h tr trong iu tr. V thng tn ti di nhiu dng
 13

bo ch khc nhau, bao gm: Vin nn, vin nang, vin si, dng siro, cm pha
dung dch ung, thuc tim.
Mt khc, cng c rt nhiu c s sn xut trong nc sn xut ch phm
vitamin C di nhiu dng bo ch khc nhau, bao gm: Vin nn thng, vin
nn bao phim, vin ngm, thuc tim. Vi cc hm lng hot cht a dng, t
vin nn 30mg n vin nn 1000mg. Vitamin C dng vin si cng c mt s
c s bt u sn xut, nhng cht lng cha th snh c vi thuc ngoi.
V gi thnh ca vitamin C sn xut trong nc th r hn nhiu so vi vitamin
C ngoi, ph hp vi ti tin v nhu cu iu tr ca a s bnh nhn.

Hnh 2.4. Mt s sn phm dc phm ca Vitamin C

 14

HNH 2.5. Mt s sn phm m phm ca Vitamin C

2.8. P DNG IU TR

2.8.1. Ch nh

Phng v cha bnh scorbut, cc chng chy mu do thiu vitamin C, tng sc

khng trong nhim khun, nhim c, mt mi, thai nghn, thiu mu, d
ng, ngi nghin thuc nghin ru
2.8.2. Chng ch nh
Chng ch nh dng vitamin C liu cao cho ngi b thiu ht glucose - 6
phosphate dehydrogenase (G6PD) (nguy c thiu mu huyt tn) ngi c tin
s si thn, tng oxalate niu v lon chuyn ho oxalate (tang nguy c si
thn), b bnh thalassemia (tang nguy c hp thu st).
2.8.3. Tc dng khng mong mun
 15

Ri lon tiu ho c th xy ra khi dung liu cao vitamin C (t 1 g hang ngy

tr ln). Tng oxalat niu, bun nn, nn, co cng c bng, mt mi, mt ng
hoc bun ng, thiu mu tan mu c th xy ra khi dng vitamin C tim tnh
mch, do khng c dng tim tnh mch vitamin C v khng an ton cho
ngi bnh.
2.8.4. Thn trng khi dung thuc
- Dng vitamin C liu cao ko di c th dn n hin tng nhn thuc, do
khi gim liu s dn n thiu ht vitamin C. Ung liu ln vitamin C trong khi
mang thai dn n bnh scorbut tr s sinh.
- Tng oxalat niu c th xy ra sau khi dng liu cao vitamin C. Vitamin C c
th gy acid ho nc tiu, i khi dn n kt ta urat hoc cystin, hoc si
oxalat, hoc trong ng tit niu.
- Tim tnh mch nhanh vitamin C (s dng khng hp l v khng an ton) c
th dn n xu nht thi hoc chng mt v c th gy ngng tim.
- Thi k mang thai: Vitamin C i qua nhau thai. Cha c cc nghin cu c
trn sc vt v trn ngi mang thai v nu dng vitamin C theo nhu cu bnh
thng hng ngy th cha thy xy ra vn g trn ngi. Tuy nhin, ung
nhng lng ln vitamin C trong khi mang thai c th lm tang nhu cu v
vitamin C v dn n bnh scorbut tr s sinh.
- Thi k cho con b: Vitamin C phn b trong s m. Ngi cho con b dng
vitamin C theo nhu cu bnh thng, cha thy c vn g xy ra i vi tr
s sinh.
2.8.5. Tng tc thuc
- Dng ng thi theo t l trn 200 mg vitamin C vi 30 mg st nguyn t lm
tng hp thu st qua ng d dy - rut; tuy vy, a s ngi bnh u c kh
nng hp thu st ung vo mt cch y m khng phi dng ng thi
vitamin C.
- Dng ng thi vitamin C vi aspirin lm tng bi tit vitamin C v gim bi
tit aspirin trong nc tiu.
 16

- Dng ng thi vitamin C v fluphenazin dn n gim nng fluphenazin

huyt tng. S acid - ha nc tiu sau khi dng vitamin C c th lm thay
i s bi tit ca cc thuc khc.
- Vitamin C liu cao c th ph hy vitamin B12; cn khuyn ngi bnh trnh
ung vitamin C liu cao trong vng mt gi trc hoc sau khi ung vitamin
B12.
- V vitamin C l mt cht kh mnh, nn nh hng n nhiu xt nghim da
trn phn ng oxy ha - kh. S c mt vitamin C trong nc tiu lm tng gi
to lng glucose nu nh lng bng thuc th ng (II) sulfat v gim gi
to lng glucose nu nh lng bng phng php glucose oxydase Vi cc
xt nghim khc, cn phi tham kho ti liu chuyn bit v nh hng ca
vitamin C.
2.8.6. Liu dng v cch dng
2.8.6.1. Cch dng:
Thng ung vitamin C. Khi khng th ung c hoc khi nghi km hp thu,
v ch trong nhng trng hp rt c bit, mi dng ng tim. Khi dng
ng tim, tt nht l nn tim bp mc d thuc c gy au ti ni tim.
2.8.6.2. Liu lng:
Bnh thiu vitamin C (scorbut):
D phng: 25 - 75 mg mi ngy (ngi ln v tr em).
iu tr: Ngi ln: Liu 250 - 500 mg/ngy chia thnh nhiu liu nh, ung t
nht trong 2 tun.
Tr em: 100 - 300 mg/ngy chia thnh nhiu liu nh, ung t nht trong 2 tun.
Phi hp vi desferrioxamin tng thm o thi st (do tng tc dng chelat
- ha ca desferrioxamin) liu vitamin C: 100 - 200 mg/ngy.
Methemoglobin - huyt khi khng c sn xanh methylen: 300 - 600 mg/ngy
chia thnh liu nh.
CHNG 3. PHNG PHP NGHIN CU
17