fa همبستگی بین سطح سرمی ویتامین D3 و شدت بیماری در بیماران مزمن انسدادی ریه پزشکی- داخلی Internal Medicine پژوهشي اصیل Original Research <span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">زمینه و هدف: </span></span></b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">بیماری مزمن انسدادی ریه (</span></span><span dir="LTR" lang="X-NONE" style="border:none windowtext 1.0pt; font-size:11.0pt; padding:0in"><span style="background:white"><span new="" roman="" style="font-family:" times=""><span style="color:black">Chronic Obstructive Pulmonary Disease </span></span></span></span><span dir="LTR" lang="X-NONE" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">,<span style="color:black">COPD</span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">) با علائمی چون تنگی نفس و سرفه همراه است و به‌عنوان چهارمین علت مرگ‌ومیر در سطح جهان شناخته می‌شود.</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">مطالعات محدودی نشان داده‌اند که ویتامین </span></span><span dir="LTR" lang="X-NONE" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">D₃</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""> می‌تواند در کاهش شدت بیماری و پیشگیری از تشدید حملات بیماران </span></span><span dir="LTR" lang="X-NONE" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">COPD</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""> تأثیر مثبتی داشته باشد. </span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">لذا در این مطالعه به بررسی همبستگی سطح سرمی ویتامین </span></span><span dir="LTR" lang="X-NONE" style="font-size:11.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""> و شدت بیماری در بیماران مزمن انسدادی ریه مراجعه‌کننده به کلینیک بیمارستان علی ابن ابیطالب (ع) رفسنجان در سال 95-1396 پرداخته شده است</span></span><span dir="LTR" lang="X-NONE" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">.</span></span><span lang="FA" style="font-family:"B Zar""></span></span></span></span></span><br> <span style="line-height:normal"><b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">مواد و روش‌ها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black"> این مطالعه، یک مطالعه </span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">توصیفی-همبستگی<span style="color:black"> بود و 70 بیمار مبتلا به </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">COPD</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">پس از انجام اسپیرومتری و تأیید </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">COPD</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">وارد مطالعه شدند. در آغاز پژوهش سطح سرمی ویتامین </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">در همه بیماران اندازه‌گیری شد. سپس متغیرهایی چون شدت بیماری با استفاده از نمره اسپیرومتری بر اساس معیار </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">GOLD</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">، شدت تنگی نفس</span></span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">بر اساس معیار </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">MRC</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">و تعداد حملات سنجیده شد.</span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""> داده‌ها با استفاده از نرم‌افزار 20</span></span> <span dir="LTR" new="" roman="" style="font-family:" times="">SPSS </span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">و آزمون ضریب همبستگی اسپیرمن مورد تجزیه‌وتحلیل قرار گرفت</span></span><span dir="LTR" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">.</span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Zar""></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:281.2pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">یافته‌ها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black"> از 70 بیمار مبتلا به </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">COPD</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">، </span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">17 نفر (24</span></span><span lang="FA" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">٫</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">2%) کمبود شدید ویتامین </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">D₃</span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">و 21 نفر (30%) در سطح ناکافی ویتامین </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">D₃</span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">بودند<span style="color:black">.</span></span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">همبستگی متوسط معنی‌داری بین سطح سرمی ویتامین </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">و شدت بیماری بر اساس داده‌های اسپیرومتری وجود داشت (</span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">0</span></span><span lang="FA" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">٫</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">587= </span></span><span dir="LTR" new="" roman="" style="font-family:" times="">r</span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">و 0</span></span><span lang="FA" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">٫</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">000=</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">P</span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">). همچنین ارتباط معکوس معنی‌داری بین سطح سرمی ویتامین </span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">با تعداد حملات (</span></span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">0</span></span><span lang="FA" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">٫</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">000</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">=</span></span><span dir="LTR" new="" roman="" style="font-family:" times="">P</span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">) و شدت تنگی نفس (0</span></span><span lang="FA" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">٫</span></span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">05</span></span><span b="" lang="FA" style="font-family:" zar="">=</span><span dir="LTR" new="" roman="" style="font-family:" times="">P</span><span b="" lang="FA" style="font-family:" zar="">) </span><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">مشاهده شد.</span></span><span dir="LTR" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:center 3.25in right 375.65pt 6.5in"><span style="direction:rtl"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">نتیجه‌گیری:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black"> نتایج مطالعه حاضر نشان داد که کمبود ویتامین </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">در افراد مبتلا به </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">COPD</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">شایع بوده. علاوه بر این با کمبود ویتامین </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar="">شدت بیماری در بیماران افزایش می‌یابد؛ <span style="color:black">بنابراین درمان سطح ناکافی از ویتامین </span></span></span><span dir="LTR" new="" roman="" style="font-family:" times=""><span style="color:black">D₃</span></span> <span lang="FA" style="font-size:12.0pt"><span b="" style="font-family:" zar=""><span style="color:black">می‌تواند به‌طور بالقوه از شدت و تعداد حملات در این بیماران جلوگیری کند</span></span></span><span dir="LTR" style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">.</span></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span new="" roman="" style="font-family:" times="">Background and Aim:</span></b><span new="" roman="" style="font-family:" times=""> Chronic obstructive pulmonary disease (COPD) which is characterized by symptoms such as dyspnea and cough is the fourth leading cause of death worldwide. Limited studies have shown that vitamin D₃ can have a positive impact on reducing the disease severity and preventing exacerbations in the patients with COPD. Therefore, in this study we evaluated the correlation of the serum vitamin D₃ level with the severity of disease in COPD patients <span style="color:#222222">referring to</span><span style="color:#222222"> the </span></span><span new="" roman="" style="font-family:" times=""><span style="color:#222222">clinic of</span></span> <span new="" roman="" style="font-family:" times=""><span style="color:#222222">Ali</span></span><span new="" roman="" style="font-family:" times=""><span style="color:#222222">-</span></span><span new="" roman="" style="font-family:" times=""><span style="color:#222222">Ibn Abi Talib</span></span><span new="" roman="" style="font-family:" times=""><span style="color:#222222"> Hospital</span></span><span new="" roman="" style="font-family:" times=""><span style="color:#222222"> in Rafsanjan </span></span><span new="" roman="" style="font-family:" times=""><span style="color:#222222">in</span></span> <span new="" roman="" style="font-family:" times=""><span style="color:#222222">2015</span></span><span new="" roman="" style="font-family:" times="">-2016.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span new="" roman="" style="font-family:" times="">Materials and Methods:</span></b><span new="" roman="" style="font-family:" times=""> This descriptive-correlational study included 70 patients with COPD. Diagnosis of COPD was confirmed by spirometry. In all patients, serum vitamin D₃ level was measured then variables such as the severity of the disease (from spirometry score in GOLD criteria), the severity of dyspnea according to MRC dyspnea scale and the number of exacerbations were measured. Using software SPSS 20, data were analyzed by Spearman correlation.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span new="" roman="" style="font-family:" times="">Results:</span></b> <span new="" roman="" style="font-family:" times="">Among 70 COPD patients,</span> <span new="" roman="" style="font-family:" times="">17 (24.2%) had</span> <span new="" roman="" style="font-family:" times="">severe </span><span new="" roman="" style="font-family:" times="">vitamin D₃ </span><span new="" roman="" style="font-family:" times="">deficiency and 21 (30%) had insufficient </span><span new="" roman="" style="font-family:" times="">vitamin D₃ level</span><span new="" roman="" style="font-family:" times="">. Significant moderate correlation was observed between the serum</span> <span new="" roman="" style="font-family:" times="">vitamin D₃ level and severity of the disease based on the results of spirometry (r=0.587 and p=0.000). Also, vitamin D₃ level showed significant inverse relationships with the frequency of exacerbations (p = 0.000) and the severity of dyspnea (p = 0.05).</span></span></span></span></span><br> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Conclusion:</span></b> <span style="font-size:11.0pt">The study findings indicated that vitamin D₃ deficiency among COPD patients was prevalent. Moreover, there was a clear association between </span><span style="font-size:11.0pt">vitamin D₃ </span><span style="font-size:11.0pt">deficiency and the severity of COPD.</span><span style="font-size:11.0pt"> Therefore, treatment of vitamin D₃ deficiency can potentially prevent the severity and frequency of exacerbations in these patients.</span><span style="font-size:11.0pt"></span></span></span><br> &nbsp; بیماری مزمن انسدادی ریه, ویتامین D3, شدت بیماری, تعداد حملات Chronic obstructive pulmonary disease, Vitamin D3, Severity of disease, Number of attacks 65 75 http://sjku.muk.ac.ir/browse.php?a_code=A-10-7060-1&slc_lang=fa&sid=1 sahar rezaei nejad سحر رضایی نژاد srezaei_89@yahoo.com 5400319475328460060488 5400319475328460060488 Yes General surgery resident, department of general surgery, shiraz uni. Med. Science دانشگاه علوم پزشکی و خدمات درمانی شیراز، شیراز، ایران. hamid bakhshi aliabad حمید بخشی علی آباد Bakhshi_hamid@yahoo.com 5400319475328460060489 5400319475328460060489 No Continue Medical education center. Rafsanjan university of medical sciences, Rafsanjan, Iran مرکز آموزش مداوم، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران. hosein basirat حسین بصیرت hosein_basirat@yahoo.com 5400319475328460060490 5400319475328460060490 No Rafsanjan university of medical sciences, Rafsanjan, Iran. کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران haniye maleki هانیه ملکی malekihaniye@yahoo.com 5400319475328460060491 5400319475328460060491 No Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. گروه بیوشیمی بالینی، دانشکده پزشکی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران. fatemeh amin فاطمه امین ft.amin@yahoo.com 5400319475328460060492 5400319475328460060492 No Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran مرکز تحقیقات فیزیولوژی_فارماکولوژی، پژوهشکده علوم پایه پزشکی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران. mahdi karimi مهدی کریمی dr.mahdikarimi@yahoo.com 5400319475328460060493 5400319475328460060493 No Department of Internal Medicine, School of Medicine' Rafsanjan University of Medical Sciences, Rafsanjan, Iran بیمارستان علی ابن ابیطالب، دانشگاه علوم پزشکی و خدمات بهداشتی - درمانی رفسنجان، رفسنجان، ایران