journal of medical council of islamic republic of iran
مجله علمی پژوهشی سازمان نظام پزشکی جمهوری اسلامی ایران
jmciri
Medical Sciences
http://jmciri.ir
1
admin
1562-1073
0
8
7
14
8888
13
fa
jalali
1399
6
1
gregorian
2020
9
1
38
2
online
1
fulltext
fa
بررسی سطح فریتین سرم و ارتباط آن با شدت علایم و طول مدت بستری در بیماران مبتلا به نارسایی قلبی بستری در بیمارستان گنجویان دزفول
Evaluation of Serum Ferritin Levels and its Relation with Severity and Duration of Hospitalization in Heart Failure Patients Admitted in Ganjavian Hospital, Ahvaz, Iran
عمومى
General
پژوهشي
Research
<strong><span style="letter-spacing:-.35pt;">زمینه:</span></strong><span style="letter-spacing:-.35pt;"> بیماری</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">های قلبی عروقی یکی از شایع ترین بیماری های مزمن می باشد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> که علیرغم پیشرفت در روش</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">های د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">رمانی، هنوز یکی از عوامل مهم مرگ و میر د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر جهان بیشمار می</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">رود. مطالعه حاضر با هد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ف تعیین سطح فریتین سرم د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر بیماران مبتلا به نارسایی قلبی بستری د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر بیمارستان انجام گردید.</span><br>
<strong><span style="letter-spacing:-.35pt;">روش کار:</span></strong><span style="letter-spacing:-.35pt;"> این مطالعه مقطعی د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر بیماران مبتلا به نارسایی های قلبی بستری د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر بیمارستان گنجویان شهر د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">زفول انجام شد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">. نمونه گیری بصورت سرشماری از بین همه بیماران به مد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ت سه ماه (از تیرماه لغایت مهرماه 1398) و به تعد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> 100 نفر انجام شد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">. برای تمامی بیماران فریتین، آهن سرم و</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;"> TIBC</span></span><span style="letter-spacing:-.35pt;"> اند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ازه</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">گیری شد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">. فریتین با د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ستگاه الایزا، آهن سرم و </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">TIBC</span></span><span style="letter-spacing:-.35pt;"> با د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ستگاه اتوآنالیزور آزمایش شد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">.</span><br>
<strong><span style="letter-spacing:-.35pt;">یافته</span></strong><strong><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ها:</span></strong><span style="letter-spacing:-.35pt;"> از 100 بیمار مورد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> بررسی 34</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">%</span></span><span style="letter-spacing:-.35pt;"> زن و 66</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">%</span></span><span style="letter-spacing:-.35pt;"> مرد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> بود</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> و میانگین سنی آنان 21/65 سال بود. همچنین 49 نفر کاهش شد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ید</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span> <span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">EF</span></span><span style="letter-spacing:-.35pt;"> و 51 نفر کاهش متوسط د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اشتند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">. نتایج آزمون </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">t</span></span><span style="letter-spacing:-.35pt;"> برای مقایسه</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ی متغیرهای پژوهش بر اساس </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">EF</span></span><span style="letter-spacing:-.35pt;"> نشان د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> برای متغیر سن و فریتین بین د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">و گروه تفاوت معناد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اری وجود</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اشت (05/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">≥p</span></span><span style="letter-spacing:-.35pt;">). اما سایر متغیرها تفاوتی از نظر آماری ند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اشتند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">. نتایج ضریب همبستگی متغیرها نشان د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> سن بیماران با </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">BUN</span></span><span style="letter-spacing:-.35pt;"> و کراتینین (05/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>BUN</span></span><span style="letter-spacing:-.35pt;"> ، (</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-family:Minion Pro,serif;"><span style="font-size:10.0pt;">p</span></span></span><span style="letter-spacing:-.35pt;"> با کراتینین و آهن سرم (001/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>p</span></span><span style="letter-spacing:-.35pt;">)، سد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">یم با آهن سرم (05/0 </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>ESR</span></span> <span style="letter-spacing:-.35pt;">، (</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">p</span></span><span style="letter-spacing:-.35pt;"> با </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">TIBC</span></span><span style="letter-spacing:-.35pt;"> و </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">CRP</span></span><span style="letter-spacing:-.35pt;"> (05/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>p</span></span><span style="letter-spacing:-.35pt;">)، رابطه مثبت معناد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ار د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اشت. همچنین رابطه منفی معنی</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اری بین سد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">یم و پتاسیم سرم(001/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>ESR</span></span><span style="letter-spacing:-.35pt;">، (</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">p</span></span><span style="letter-spacing:-.35pt;"> و آهن سرم(05/0 </span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>TIBC</span></span><span style="letter-spacing:-.35pt;">، (</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-family:Minion Pro,serif;"><span style="font-size:10.0pt;">p</span></span></span><span style="letter-spacing:-.35pt;"> و فریتین (001/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;">>p</span></span><span style="letter-spacing:-.35pt;">) به د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ست آمد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> اما بین سایر متغیرها رابطه معناد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اری وجود</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> ند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اشت (05/0</span><span dir="LTR" style="letter-spacing:-.3pt;"><span style="font-size:10.0pt;"><p</span></span><span style="letter-spacing:-.35pt;">).</span><br>
<strong><span style="letter-spacing:-.35pt;">نتیجه گیری:</span></strong><span style="letter-spacing:-.35pt;"> بین سطح سرمی فریتین با شد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ت علائم و عوارض بیماران رابطه معنی</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اری وجود ند</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">اشت، لذا ﺑﺮای د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر ﻧﻈﺮ ﮔﺮﻓﺘﻦ ﻓﺮﻳﺘﻴﻦ ﺧﻮن ﺑﻪ ﻋﻨﻮان ﻳﻚ رﻳﺴﻚ ﻓﺎﻛﺘﻮر ﻣﺴﺘﻘﻞ د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر اﺑﺘﻼ ﺑﻪ ﺑﻴﻤﺎری</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ﻫﺎی نارسایی ﻗﻠﺒﻰ نیاز ﺑﻪ اﻧﺠﺎم مطالعات د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">یگری می</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">باشد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> ﺗﺎ ﺷﺎﻳﺪ ﺑﺘﻮان ﺑﻪ ﻧﺘﺎﻳﺞ ﻗﻄﻌﻲ ﺗﺮی د</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">ر اﻳﻦ ﻣﻮرد</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;"> رسید</span><span dir="LTR" style="letter-spacing:-.35pt;"><span style="font-family:Calibri,sans-serif;"></span></span><span style="letter-spacing:-.35pt;">.</span>
Background: Cardiovascular diseases are one of the most common chronic illnesses. Despite the advancement in the management of heart failure, it still remains as one of the most important causes of mortality and morbidity. Anemia is a common finding in heart failure patients and decreases both life quality and bodily function in this group of patients. It is also related with high mortality and morbidity. The aim of the present study was to determine the ferritin levels in heart failure patients.<br>
Methods: This cross-sectional study was conducted on heart failure patients admitted in Ganjavian Hospital, Ahvaz, Iran. Sampling was done by census method for three months duration (July-Sept 2019) and finally a total of 100 patients were recruited. Serum ferritin (ELISA), iron level and Total iron binding capacity (TIBC) was measured in all of the patients. Iron and TIBC were measured with Autoanalizer.<br>
Results: Of the 100 patients, 34% were females and 66% were males. Mean age was 65.21 yrs. 49 patients had severe decrease in EF , while 51 had moderate decrease in EF. Based on EF, t-test showed significant statistical difference in regard to age and ferritin between the two groups (p<0.05), while other variables did not show significant difference.<br>
Correlation coefficient of variables in regard to patient's age with BUN and Creatinine (p<0.05), BUN with Creatinine and serum ferritin (p<0.001), sodium and serum iron (p<0.05), and ESR with TIBC and CRP (p<0.05) demonstrated positive correlation. While a negative correlation was observed in cases of serum sodium and potassium (p<0.001), ESR and serum iron (p<0.05), and TIBC and ferritin (p<0.001). No other significant correlation was found among other variables (p>0.05).<br>
Conclusion: Results did not show significant relation between serum ferritin level with disease severity and complications. Thus, further studies are needed to prove the role of f ferritin as an independent risk factor in developing heart failure.
نارسایی قلبی, فریتین, بیماران بستری, بیماریهای قلبی - عروقی
Heart failure, Ferritin
115
120
http://jmciri.ir/browse.php?a_code=A-10-1-2642&slc_lang=fa&sid=1
دکتر ندا
سبزیوند
10031947532846005909
10031947532846005909
Yes
دانشگاه علوم پزشکی و خدمات بهداشتی درمانی دزفول، دزفول، ایران.
منا
جهانپور
10031947532846005910
10031947532846005910
No
دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی دزفول، دزفول، ایران