Etu esi eji ọgwụ ahụ Amitriptyline 25?

Nkọwa nke metụtara 22.09.2014

Aha Latin: Ammitriptyline
Koodu ATX: N06AA09
Arụ Ọrụ: Amitriptyline
Emeputa: Grindeks (Latvia), Nycomed (Denmark), Synthesis (Russia), Ozone (Russia), ALSI Pharma (Russia)

Akara nchekwa na mbadamba Amitriptyline nwere 10 ma ọ bụ 25 mg nke ihe arụ ọrụ n'ụdị nke amitriptyline hydrochloride.

Ihe ndị ọzọ dị na mbadamba nkume bụ microcrystalline cellulose, talc, lactose monohydrate, silicon dioxide, magnesium stearate, stgelatinized starch.

Ihe ndị ọzọ dị na dragees bụ: magnesium stearate, stachite nduku, talc, polyvinylpyrrolidone, lactose monohydrate.

1 ml nke ihe ngwọta nwere 10 mg nke ihe na-arụ ọrụ. Ihe ndi ozo bu: hydrochloric acid (sodium hydroxide), dextrose monohydrate, mmiri maka infusion, sodium chloride, benzetonium chloride.

Pharmacodynamics na pharmacokinetics

Ọgwụ na-ebelata agụụ, na-ewepụ ịta akwa, nwere antiserotonin edinam. Ọgwụ nwere mmetụta anticholinergic dị n'etiti na akụkụ akụkụ. Mmetụta antidepressant rụzuru site na ịba ụba ịta ahụhụ nke serotonin na sistemụ akwara na norepinephrine na synapses. Ogologo oge ọgwụgwọ na-eduga n'ịbelata ọrụ ọrụ nke serotonin na ndị na-anabata beta-adrenergic na ụbụrụ. Amitriptyline na-ebelata ogo ngosipụta nke ịda mba, mkpasu iwenchegbu n'oge ụjọ na nkụda mmụọ. Site na igbochi ndị na-anabata H2-histamine na mgbidi nke afọ (sel sel parietal) enyere ọgwụ mgbochi. Ogwu nwere ike wedata ahu ahuhu, obara n’azu ure. Ọgwụ ahụ adịghị egbochi monoamine oxidase. Mmetụta nke antidepressant na-apụta mgbe izu 3 nke ọgwụgwọ gasịrị.

Oke ihe nke ihe dị n’ime ọbara na-apụta mgbe awa ole na ole gasịrị, ọ na - abụkarị mgbe ọnwa abụọ gachara. Ọ na-amịpụta metabolites na mmamịrị. Ọ na-ejikọ protein nke ọma.

Ihe ngbanwe

Dabere na nkọwapụta ahụ, a naghị eji ọgwụ ahụ eme ihe maka infarction myocardial, anabataghị isi akụrụngwa, yana mmechi mmechinnukwu mmenaanya na psychoactive, analgesic, hypnotics, na nnukwu mmanya ị intoụbiga mmanya. A na - egbochi ọgwụ ị inụ ara, oke mmebi nke ụzọ mgbochi intraventricular, antioventricular conduction. Na pathology nke obi, yana mgbochi nke ụmị ọkpụkpụ. manic-ịda mba psychoses, ụkwara ume ọkụ, ụkwara ume ọkụ, a motorụrụma na-egbu egbu, na-arụ ọrụ moto nke digestive system, ọrịa strok, imeju na akụrụ, ọbara mgbali intraocular, njide na urinary, prostatic hyperplasia, ya na hypotension nke eriri afo, thyrotoxicosis, afọ ime, Akwụkwụ na-adọ Ejiri amitriptyline dozie nlezianya.

Dodoụbiga ya ókè

Nkpughe si sistemu ụjọ: Coma, nzuzu, ura, ujo, ihe nnabata, ataxia, oria aru, choreoathetosishyperreflexia dysarthria, ịkwụsi ike n’olu, ọgba aghara, aghara aghara, ịta ahụhụ, nsogbu uche.

Ngosipụta nke nnyefere nke Amitriptyline na sisitemu obi: mmebi nke usoro intracardiac, arrhythmia, tachycardia, mbelata ọbara mgbali, ujo, obi obaraadịkarịghị - njide obi.

Ọzọkwa kwuru ngbakaoliguria, sweating bara ụba, ọbara mgbali, ọgbụgbọ, mkpụmkpụ ume, nkụda mmụọ nke sistem, cyanosis. Ikekwe nsị ọgwụ.

Iji zere nsonaazụ na-adịghị mma nke ịdoụbiga mmanya ókè, a ga-achọ lavage ihe mberede na nchịkwa nke cholinesterase inhibitors maka ngosipụta anticholinergic siri ike. Ọ na - achọ ijikwa nguzo mmiri-electrolyte, ọkwa ọbara mgbali elu, nyochaa usoro akwara obi, nrụghachị na usoro anticonvulsant, ma ọ bụrụ na ọ dị mkpa. Uresrụ diureis, na egosighi na ịbawanye ọrịa dị mma ma ọ bụrụ na ị amụbiga mmiri ọgwụ ókè.

Mmekorita

Mmetụta antihypertensive, ume iku ume, a na - ahụta mmetụta na - akpata nkụda mmụọ na usoro nkwonkwo ọgwụ nke na - egbochi usoro ụjọ ahụ na - egbochi: usoro izugbe, benzodiazepines, barbiturates, antidepressants na ndị ọzọ. Ọgwụ ahụ na-akwalite ịdị njọ nke mmetụta anticholinergic mgbe ejiri ya amantadine, ọgwụ mgbochi, biperiden, atropine, ọgwụ antiparkinsonian, phenothiazine. Ọgwụ ahụ na-akwalite ọrụ anticoagulant nke indadione, ọgwụ coumarin, anticoagulants na-apụtaghị ìhè. Belata nke oma alfa igbochiihe ndapụta. Fluvoxamine, fluoxetine nwekwuo ịba uru nke ọgwụ n’ọbara. Ihe ọghọm nke ibute ọrịa ọdịdọ na-abawanye, na etinyere anticholinergic na ọgwụ mgbochi na-akwalitekwa yana ijikọtara ya na ọgwụ benzodiazepines, phenothiazines, na ọgwụ anticholinergic. Nnabata n'otu ogemethyldopa, reserpine, betanidine, guanethidine, clonidine na-ebelata ịdị njọ nke mmetụta ha na - adịghị ala ala. Mgbe ị na-ewere cocaine, arrhythmia na-amalite. Delirium na-etolite mgbe ị na-ewere ọgwụ acetaldehydrogenase, disulfiram. Amitriptyline na-eme ka mmetụta ọ dị na sistem gbasie ike phenylephrinenorepinephrine epinephrineisoprenaline. Ihe egwu nke hyperpyrexia na-abawanye site na iji ọgwụ mgbochi, m-anticholinergics.

Ntụziaka pụrụ iche

Tupu ịmalite ọgwụgwọ, achọrọ ọkwa ọbara mgbali. A na-emezi nlekọta nke amitriptyline naanị n'okpuru nlekọta ahụike na ọnọdụ ụlọ ọgwụ. N'oge mbido ọgwụgwọ, izu ike dị mkpa. A choro iju ethanol. Jectionjụ usoro ọgwụgwọ nwere ike ịkpata mwepu ọrịa. Ogwu n’anu ogwu ihe kariri 150 mg ubochi n’eduba n’enweghi ike idozi onyunyo, nke di nkpa itughari uche n’ilegharia ndi oria n’azu oria. Ikekwe mmepe nke hypomanic ma ọ bụ manic na-ekwu na ndị nwere cyclical, nsogbu na-emetụta oge a na-akụda mmụọ. Ọ bụrụ na ọ dị mkpa, a na-amaliteghachi usoro ọgwụgwọ n’obere ntakịrị mgbe ịkwụsị ọnọdụ ndị a. Ekwesịrị ịkpachara anya mgbe a na-agwọ ndị ọrịa na-a medicationsụ ọgwụ thyroid na ọgwụgwọ nke ndị ọrịa nwere thyrotoxicosis n'ihi ihe ọghọm ọ bụla nke ịmalite nsonaazụ obi. Ọgwụ nwere ike ịkpalite mmepe nke mgbochi mkpọnwụ nke ndị agadi, yana imetakwa afọ ntachi. Ọ bụ iwu d ị ịdọ ndị na - enye ọgwụ mgbochi ike banyere ịnwe amitriptyline tupu ịkpụzi ọgwụ mgbochi mpaghara ma ọ bụ nke izugbe. Ogologo oge ọgwụgwọ na-akpalite mmepe caries. O nwere ike ibute riboflavin. Amitriptyline na-abanye n’ime mmiri ara, n’ime ụmụ aka, ọ na-ebute oke ụra. Ọgwụ na-enwe mmetụta na ịnya ụgbọ ala.

A kọwara ọgwụ ahụ na Wikipedia.

Omume ọgwụ

Zọ ọgwụgwọ maka ịda mba. Na-ebelata nchekasị, mkpali mmetụta uche dị ukwuu, mgbaàmà obi mgbawa. Ofkpụrụ nke ime ihe megide ịda mba bụ n'ihi mmụba na ọnụọgụ nke norepinephrine na synapses na / ma ọ bụ serotonin na sistemụ akwara dị ala (ibelata mmịpụta nke mgbanwe ha). A na-ahụta mkpopụta nke ndị a na - eche nchegharị n'ihi mkpụrụedemede nke nejirons ndị ahụ.

Ihe nke antidepressant na - aputa ihe n’agbata izu abuo na ato site na nmalite ochichi.
Amitriptyline nwere ọgwụ mgbochi, M-anticholinergic, antihistamine, antiserotonin, timoleptik, anxiolytic na analgesic, mmetụta antiulcer.

N'oge ana - egbu mgbu oge niile, ọ na - agbada ọbara mgbali elu na okpomoku ahụ.
Na-egbochi egbochi oxidase monoamine.

Sdị Usoro Ọgwụ

Amitriptyline bụ nke ọtụtụ ndị na-emepụta rụpụtara. Maindị ọgwụ dị iche iche - mbadamba, ngwọta maka injection:

ngwọta ntụtụ - ampoules 20 mg / 2 ml, vials 10 mg / ml,
mbadamba 0.025 g
mbadamba shuga dị mkpa 10 mg, 25 mg,
mbadamba, ihe mkpuchi 10 mg, 25 mg, 50 mg, 75 mg,
dragee 25 mg
Mpempe na-ahapụ mkpụrụ ndụ 50 mg.

Nchịkọta nke ọgwụ ahụ, yana ike ya akpọrọ akpọrọ, nwere ike ịdị iche.

Ngwakọta nke ihe ngwọta maka injection:

onye ọrụ - amitriptyline hydrochloride,
ndị na - eme nchọpụta - glucose (dextrose), mmiri maka injection.

Nchikota mbadamba ihe nkiri:

ihe na-arụ ọrụ bụ amitriptyline hydrochloride,
ndị na - ahụkarị - magnesium stearate, talc, povidone, stachi nduku, cellulose microcrystalline, lactose monohydrate.

Ihe mejupụtara shell: propylene glycol, hypromellose, titanium dioxide, talc.
Ngwakọta nke mbadamba:

ike ọrụ - amitriptyline,
ndị na - ahụkarị - lactose, magnesium stearate, microcrystalline cellulose, ssumum croscarmellose, polyethylene glycol 6000, talc, polysorbate 80, colloidal silicon dioxide, hypromellose, titanium dioxide (E 171), carmoisine (E 122).

Ihe mejupụtara capsules na-adịgide adịgide:

ihe na-arụ ọrụ bụ amitriptyline hydrochloride,
ndị na - ahụkarị - stearic acid, spheres shuga, shellac (shellac nke na-emeghị mkpụ), talc, povidone.

Ihe mejuputara nke akpukpo ahihia ahu bu gelatin, iron dye oxide red (E 172), titanium dioxide (E 171).

ụdị obi mgbawa, ọkachasị ihe mgbaàmà ọfụma nke nchekasị, mkpali mmetụta uche, nsogbu ịrahụ ụra: ịlọ ụwa (oge na-aga n'ihu), imeghachi azụ (mgbe ọ nwesịrị uche ụbụrụ), neurotic, ọgwụ, na ị alcoholụbiga mmanya na-egbu, mmebi ụbụrụ organic, gụnyere n'oge nwata.
ọrịa schizophrenic nke ọrụ ụbụrụ, stere mbà n'obi na ndị ọrịa nwere schizophrenia,
ọgba aghara dị iche iche nke ọnọdụ mmetụta uche,
ntị ntị, ọrụ,
nocturnal enuresis (belụsọ ndị ọrịa nwere ụda olu nke oghere ahụ),
bulimia nervosa
ọrịa mgbu na-adịghị ala ala - mgbu nke ndị ọrịa kansa, migraine, ọrịa rheumatic, ihe mgbu na-egbu egbu na ihu, postherpetic neuralgia, neuropathies sitere na usoro dị iche iche (ọrịa shuga, post-traumatic, neuropathy ndị ọzọ na-emetụta),
isi ọwụwa
prophylaxis migraine,
ọnya afọ nke afọ na duodenum.

Ngwakọta ọgwụ ogwu Tricyclic na-aghọrọ ọgwụ nke mbụ maka nkwarụ siri ike.

Ofzọ nchịkwa na usoro onunu ogwu

A na-ewere Amitriptyline n'ọnụ na-enweghị ita ata ozugbo ị risịrị nri iji belata iwe nke mucosa gastric.
Ọgwụ nke mbụ maka ndị okenye bụ 25-50 mg n'oge ụra, mgbe ahụ, usoro onunu ogwu na-abawanye karịa ụbọchị 5-6 ruo 150-200 mg kwa ụbọchị na usoro onyonyo atọ, edepụtara akụkụ kachasị nke dose ahụ n'oge ụra. Ọ bụrụ na mgbe ụbọchị iri na anọ enweghị mmezi, kwa ụbọchị na-abawanye ruo 300 mg.

Ọ bụrụ na ihe ịrịba ama nke ịda mbà n’obi na-apụ n'anya, a na-ebelata ọgwụ ahụ ka ọ bụrụ 50-100 mg kwa ụbọchị ma a na-aga n'ihu usoro ọgwụgwọ ọ dịkarịa ala ọnwa atọ.
N’oge agadi, na-enwe nsogbu adịghị ike, a na-atụ aro ọgwụ nke 30-100 mg kwa ụbọchị maka abalị, mgbe ha rutesịrị ọgwụgwọ ahụ, ha na-agbanye na nke kachasị dị irè nke 25-50 mg kwa ụbọchị.

A na-eji nwayọ were ọgwụ were were 2040 mg mee ya ugboro anọ n’ụbọchị, jiri nwayọ dochie ya. Ogologo oge ọgwụgwọ agaghị ihe karịrị ọnwa 6-8.
Na ehihie na enuresis:

n'ime ụmụaka 6 ruo 10 afọ - 10 ruo 20 mg kwa ụbọchị n'abalị,
n'ime ụmụaka 11-16 afọ - 25-50 mg / ụbọchị.

Asmụaka dịka ọgwụ mgbochi:

site na afọ isii ruo afọ iri na abụọ - 10-30 mg ma ọ bụ 1-5 mg kwa kilogram nke ịdị arọ kwa ụbọchị pere mpe,
ndị na - eto eto - 10 mg ugboro atọ n'ụbọchị, ọ bụrụ na ọ dị mkpa - ruo 100 mg kwa ụbọchị.

Maka mgbochi nke migraine, ya na ihe mgbu neurogenic na-adịghị ala ala, isi ọwụwa na-adịte aka - site na 12.5 - 25 ruo 100 mg kwa ụbọchị. A na-ewere ọgwụ kachasị n'abalị.

Mmetụta akụkụ

Na mgbakwunye na nsonaazụ na usoro neural, amitriptyline mara ọtụtụ mmetụta neurochemical nke na-ekpebi mmetụta ndị ha nwere:

ntụgharị n'ihe metụtara M1-cholinergic ndị na-anabata ihe na-ekpebi mmepe nke ọrịa anticholinergic syndrome - tachycardia, ọnụ akọrọ, ebe obibi na-enye nsogbu, ntachi obi, njigide nke urinary, ọgba aghara (ịtụgharị ma ọ bụ ihe ndọda), mgbochi mkpachi afọ,
ihe mgbochi nke alpha1-adrenergic ndị na-anabata ya na - akpata nsogbu orthostatic mgbasa (ọgbụgba, adịghị ike, mbelata nke mmụọ, ịda mba), reflex tachycardia,
ihe mgbochi nke ndị nnabata H1-histamine - ịgba ọgwụ mgbochi, ibu ibu,
mgbanwe mgbanwe metabolism nke ion na akwara nke ụbụrụ na obi na-ebelata ohere nke ịdị njikere ma na-enye aka na ngosipụta nke akwara obi - a na-emebi imebi nke contractions na mkpali nke myocardium.

Ogo ogo mmetụta ya na-akpatakarị ndị dọkịta iji ọgwụ ndị ọ na-ezughị ezu na-ekwesịghị ekwesị, ma na-ebelatakwa nnabata ndị ọrịa na usoro ọgwụgwọ, nke na-ebelata oke ọgwụgwọ.

N'ihi ihe ize ndụ nke nsí ọjọọ nke tricyclic antidepressants, ndị ọrịa nwere ebumnuche igbu onwe ha na-ahọpụta ha. Ya mere, edepụtara ọgwụ ọgwụ ka onye ọrịa ghara ịnakọta ego zuru ezu maka igbu onwe ya.

Amitriptyline analogues

Nkwadebe nke isi ihe na-arụ ọrụ ya bụ amitriptyles bụ Amizol, Elivel, Saroten retard. Na nkwekorita, analogues nke ogwu a gunyere ogwu nke ndi otu ogwu tricyclic antidepressants: imipramine, clomipramine, desipramine, doxepin, pipofesin, tianeptine. Agbanyeghị, ọrụ ọgwụ ha dịgasị iche.

Na mkpokọta, nsonaazụ nke ịgwọ ọgwụ mgbochi ọ bụla, ọkachasị na iji ogologo oge, na-achọpụta site na mmetụta dị mgbagwoju anya na ọtụtụ sistemụ neurotransmitter na ndị na-anabata ụbụrụ. Ya mere, ụdị dị iche iche nke psychotropic, neurotropic na somatotropic mmetụta nke ọgwụ ọjọọ megide ịda mba na-adabere na nha nke isi na ike nke mmetụta ndị a. Nchịkọta ha jikọtara ọnụ na-enye gị ohere ịhọrọ naanị ezigbo ọgwụ na nke ọ bụla, nke na-ekpebi ihe ịga nke ọma nke ọgwụgwọ.

Ntị! Nkọwapụta nke ọgwụ ahụ bụ ụdị edozi ọzọ na ntinye akwụkwọ ntuziaka maka ọrụ. A na-enye ozi gbasara ọgwụ ahụ maka ebumnuche ọhụụ na-ekwesịghị iji ya dị ka ntuziaka maka ọgwụ onwe.

Mpempe usoro onunu ogwu

Mbadamba ụrọ ekpuchi, 25 mg

Otu mbadamba ihe

ike ihe - amitriptyline hydrochloride na usoro nke amitriptyline 25 mg,

ndị mbụ: lactose monohydrate, microcrystalline cellulose, ssumum croscarmellose, hypromellose, magnesium stearate, colloidal silicon dioxide, polyethylene glycol 6000, titanium dioxide (E 171), talc, polysorbate 80, carmoisin (E 122).

Mbadamba nkume ndị ahụ dị gburugburu, kpuchie onwe ha, site na pink dị ọcha gaa na pink, na-enwe ihu elu na ala ala. Na mmejọ n'okpuru iko na-eme ka ị dị elu ị ga-ahụ isi nke otu akwa na-aga n'ihu gbara ya gburugburu.

Ngwongwo ogwu

Mlọ ọgwụ

Amitriptyline na-anabata nke ọma site na eriri afọ, akwara ịba uru nke plasma kachasị ihe dị ka awa 6 ka nchịkwa onu gachara.

Ihe bioavailability nke amitriptyline bụ 48 ± 11%, 94.8 ± 0.8% jikọtara ya na protein protein. Usoro ndị a anaghị adabere na afọ onye ọrịa.

Ọkara ọkara bụ 16 ± 6 awa, olu nke nkesa bụ 14 ± 2 l / n'arọ. Ihe abụọ a na - abawanye nke ukwuu na afọwanye nke onye ọrịa.

Amitriptyline na-etinyere akwara nke ukwuu na imeju na-abụkarị metabolite - northriptyline. Abolzọ metabolic gụnyere hydroxylation, N-oxidation, na conjugation na glucuronic acid. A na-ewepụ ọgwụ ahụ na mmamịrị, tumadi n'ụdị metabolites, n'ụdị ma ọ bụ conjugated. Nwepu ya bụ 12.5 ± 2.8 ml / min / n'arọ (ọ dabere na afọ onye ọrịa), erughị 2% na mmamịrị.

Mlọ ọgwụ

Amitriptyline bụ ọgwụ mgbochi tricyclic. O kwupụtawo ọgwụ antimuscarinic na ọgwụ ịgba ọgwụ. Mmetụta ọgwụgwọ na-esite na mbelata ọgwụ reyptake (yana nsonaazụ ya, inactivation) nke norepinephrine na serotonin (5HT) site na presynapti enderve nerve endings.

N'agbanyeghi eziokwu na uto ọgwụ antidepressant, dịka iwu, gosipụtara onwe ya ụbọchị iri na mbụ ruo ụbọchị 14-14 nke mbido ọgwụgwọ, enwere ike ịhụ mmeghari ahụ ihe dịka otu elekere gasịchara. Nke a na-egosi na usoro nke ime ihe nwere ike ịgbakwunye njikwa ọgwụ ndị ọzọ nke ọgwụ.

Usoro onunu ogwu na nhazi

Ọgwụ kwesịrị ịmalite site na obere doses, jiri nwayọọ nwayọọ mụbaa ha, jiri nlezianya nyochaa nzaghachi ụlọ ọgwụ na ngosipụta ọ bụla nke ekweghị ibe nọrọ.

Ndị okenye: Usoro ọgwụgwọ akwadoro bụ 75mg kwa ụbọchị, ana-ewere ya na usoro ọgwụgwọ ma ọ bụ dum n'abalị. Dabere na nsonaazụ ụlọ ọgwụ, enwere ike ịbawanye dose ahụ ruo 150 mg / ụbọchị. Ọ bụ ihe amamihe dị na ịbawanye usoro onunu ogwu na njedebe nke ụbọchị ma ọ bụ n'oge akwa ụra.

Ime sedative na-egosipụta onwe ya ngwa ngwa. Mmetụta ọgwụ antidepressant nwere ike ime mgbe ụbọchị 3-4 gachara, maka mmepe zuru oke nke nsonaazụ ahụ, ọ nwere ike iru ụbọchị 30.

Iji belata ohere ịlaghachi azụ, a ga-ewere ọgwụ mmezi nke 50-100 mg na mgbede ma ọ bụ tupu ụra.

Mụaka: A naghị akwado ọgwụ ahụ maka ụmụaka ndị gbara afọ 16.

Ndị ọrịa agadi (karịrị afọ 65): ọgwụ a tụrụ aro nke mbụ bụ 10-25 mg ugboro atọ kwa ụbọchị na mmụba nwayọ ma ọ bụrụ na ọ dị mkpa. Maka ndị ọrịa nke ọgbọ a na-enweghị ike ịnabata ọgwụ ndị dị elu, ọgwụ kwa ụbọchị nke 50 mg nwere ike zuru ezu. Enwere ike ịchọrọ ị dailyụ ọgwụ kwa ụbọchị ịchọrọ n'ọtụtụ usoro, ma ọ bụ otu oge, ọkacha mma na mgbede ma ọ bụ tupu ụra.

E kwesịrị ilo mbadamba ndị ahụ kpam kpam na-enweghị ị andụ mmiri.

Ekwesịrị ị Theụ ọgwụ ahụ na usoro dọkịta nyere ya, ebe ọ bụ na ịkwụsị ịgwọ onwe ya nwere ike ịdị ize ndụ nye ahụike. Agaghị enwe ọganihu nke ọnọdụ onye ọrịa ahụ ruo izu 4 mgbe mmalite ọgwụgwọ.

Nsonaazụ

Dị ka ọgwụ ndị ọzọ, amitriptyline, mbadamba mkpuchi, nwere ike ibute mmeghachi omume ọjọọ na ụfọdụ ndị ọrịa, ọkachasị mgbe edepụtara maka oge izizi. Ọ bụghị mmetụta niile ndị a ka achọpụtara n'oge a na-eji amitriptyline, ụfọdụ n'ime ha mere mgbe ha na-eji ọgwụ ndị ọzọ so na otu amitriptyline.

A na-ekewa mmeghachi omume ọjọọ oge ugboro ole a na-eme: ọtụtụ mgbe (> 1/10), ọtụtụ mgbe (site na> 1/100 ruo 1/1000 ruo 1/10000 ruo