Studies in Medical Sciences
مجله مطالعات علوم پزشکی
Studies in Medical Sciences
Medical Sciences
http://umj.umsu.ac.ir
37
journal37
2717-008X
2717-008X
10.61186/umj
fa
jalali
1392
2
1
gregorian
2013
5
1
24
2
online
1
fulltext
fa
ارتباط بین سطح پلاسمائی فیبرینوژن با پیامد در بیماران با تشدید حاد بیماری انسدادی مزمن ریه
THE RELATION BETWEEN PLASMA FIBRINOGEN LEVEL AND DISEASE OUTCOME IN PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
آناتومی
آناتومی
پژوهشي(توصیفی- تحلیلی)
Research
<p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="AR-SA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt">پیش زمینه و هدف: </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">بیماری انسداد مزمن ریوی (</span><font size="2"><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">COPD</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>) به عنوان بیماری سیستمیک با التهاب مزمن در نظر گرفته میشود که حملات تشدید دارد. پیشبینی صحیحتر پیش آگهی میتواند به انتخاب بیماران و تداخلات درمانی لازم کمک کند. <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">فیبرینوژن که یک نشانگر التهاب است هدف این مطالعه ارزیابی ارزش فیبرینوژن برای پیشگویی پیامد در تشدید </span><font size="2"><font face="Times New Roman"><span style="mso-bidi-language: FA" dir="ltr">COPD</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> است. <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">مواد و روشها: </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">در این مطالعه همگروهی</span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt"> </span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">بیمارانی که به علت تشدید حاد </span><font size="2"><font face="Times New Roman"><span dir="ltr">COPD</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> در بخش ریه بستری شده بودند به دو گروه سطح فیبرینوژن پلاسما بالا (400</span><font size="2"><font face="Times New Roman"><span dir="ltr">mg/dL</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> ) و کمتر تقسیم شدند و از نظر طول مدت بستری و پیامد ثبت شد ناشی نیاز به انتقال به </span><font size="2"><font face="Times New Roman"><span dir="ltr">ICU</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>، نیاز به انتوباسیون و ونتیلاسیون مکانیکی و مرگ در بیمارستان به عنوان پیامدهای بد پیگیری شدند ارتباط سطح فیبرینوژن پلاسما با پیامد با استفاده از </span><font size="2"><font face="Times New Roman"><span dir="ltr">t-test</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> سنجیده شد.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">یافتهها: </span></b><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2">.</font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">از 54 بیمار 15 بیمار پیامد بد 39 بیمار پیامد خوب داشتند میانگین فیبرینوژن پلاسمادر بیماران با پیامد خوب </span><font size="2"><font face="Times New Roman"><span dir="ltr">mg/dL</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> 55/96 ± 67/155 و در بیماران با پیامد بد </span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font size="2"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>mg/dL</font></font></span><span dir="rtl"></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> 43/256 ± 36/530 بود (001/0= </span><font size="2"><font face="Times New Roman"><span dir="ltr">P</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>).<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">میانگین طول مدت بستری در بیمارستان در بیماران با سطح فیبرینوژن بالای 400</span><font size="2"><font face="Times New Roman"><span lang="X-NONE" style="mso-ansi-language: X-NONE" dir="ltr">mg/dL</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> برابر با 7/13 روز و در بیماران با سطح فیبرینوژن کمتر از 400</span><font size="2"><font face="Times New Roman"><span lang="X-NONE" style="mso-ansi-language: X-NONE" dir="ltr">mg/dL</span><span dir="rtl"></span></font></font><span lang="X-NONE" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> </span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">برابر2/5 روز بود (001/0 = </span><font size="2"><font face="Times New Roman"><span lang="X-NONE" style="mso-ansi-language: X-NONE" dir="ltr">P</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span>). <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">نتیجه گیری</span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt">: که سطح فیبرینوژن پلاسما در زمان بستری با پیامد نامطلوب در بیماران با تشدید حاد </span><font size="2"><font face="Times New Roman"><span dir="ltr">COPD</span><span dir="rtl"></span></font></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> <span lang="FA"><font face="Nazanin" size="2">ارتباط دارد و میتواند به عنوان نشانگربرای پیش آگهی در بیماران با تشدید </font></span></span><font size="2"><font face="Times New Roman"><span lang="EN-AU" style="mso-ansi-language: EN-AU" dir="ltr">COPD</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><span dir="rtl"></span> به کار رود.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"></span></b></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-bidi-language: FA mso-ansi-font-size: 8.5pt"><p> </p></span></p>
<p class="Abstract" style="MARGIN: 0in 0in 0pt"><span lang="FA" style="FONT-FAMILY: "B Lotus" mso-fareast-language: EN-US" dir="rtl"><p><strong><font size="3"> </font></strong></p></span></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><i><span style="mso-fareast-language: EN-US"><strong>Background & Aims</strong></span></i><span><strong>: </strong>C</span><span style="BORDER-BOTTOM: windowtext 1pt BORDER-LEFT: windowtext 1pt PADDING-BOTTOM: 0in PADDING-LEFT: 0in PADDING-RIGHT: 0in BORDER-TOP: windowtext 1pt BORDER-RIGHT: windowtext 1pt PADDING-TOP: 0in mso-fareast-language: EN-US mso-border-alt: none windowtext 0in">hronic obstructive pulmonary disease (COPD)</span><span style="mso-fareast-language: EN-US"> is considered as a systemic disease by chronic inflammation with exacerbation episodes. <span style="BORDER-BOTTOM: windowtext 1pt BORDER-LEFT: windowtext 1pt PADDING-BOTTOM: 0in PADDING-LEFT: 0in PADDING-RIGHT: 0in BORDER-TOP: windowtext 1pt BORDER-RIGHT: windowtext 1pt PADDING-TOP: 0in mso-border-alt: none windowtext 0in">Fibrinogen</span> is a marker of systemic inflammation.<span dir="rtl"></span><span dir="rtl"><span dir="rtl"></span> </span>The aim of this study was to assess the relation between plasma of fibrinogen level with adverse outcome in COPD patients.<p></p></span></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><b><i><span style="mso-fareast-language: EN-US">Materials & Methods</span></i></b><b><span style="mso-fareast-language: EN-US">:<span dir="rtl"></span><span dir="rtl"><span dir="rtl"></span> </span></span></b><span style="mso-fareast-language: EN-US">In this cohort study<b> </b>patients with acute exacerbation of COPD admitted to pulmonary ward were studied prospectively.<span style="mso-spacerun: yes"> </span>They were divided into two cohort, patients with high plasma fibrinogen (>400 mg/dl) and less than 400 mg/dl on admission day venous blood. The patients were followed for duration of hospitalization and any adverse outcome (death in the hospital, transfer to ICU, intubation and mechanical ventilation). Relation of fibrinogen level with outcome evaluated.</span><span style="mso-fareast-language: EN-US mso-fareast-font-family: Calibri"><p></p></span></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><b><i><span style="mso-fareast-language: EN-US">Results</span></i></b><b><span lang="X-NONE" style="mso-ansi-language: X-NONE mso-no-proof: yes"> : </span></b><span lang="X-NONE" style="mso-ansi-language: X-NONE">Among 54<span dir="rtl"></span><span dir="rtl"><span dir="rtl"></span> </span>patients, 15 had adverse outcome, and 39 good outcomes. Among these two groups</span>, the <span lang="X-NONE" style="mso-ansi-language: X-NONE"><span style="mso-spacerun: yes"> </span>mean plasma fibrinogen was 530±256.43 mg/L and 155.67±96.55</span>,<span lang="X-NONE" style="mso-ansi-language: X-NONE"> respectively (p=0.001). In 14 patients plasma fibrinogen level was >4</span>00 m<span lang="X-NONE" style="mso-ansi-language: X-NONE">g/</span>dl<span lang="X-NONE" style="mso-ansi-language: X-NONE"> and in 40 patients ≤ 4</span>00 m<span lang="X-NONE" style="mso-ansi-language: X-NONE">g/</span>d<span lang="X-NONE" style="mso-ansi-language: X-NONE">l<span style="mso-spacerun: yes"> </span><p></p></span></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-no-proof: yes">The rate of adverse outcome was 85.7%<span style="mso-spacerun: yes"> </span>in 7.5% in those with higher and lower fibrinogen level<span style="mso-spacerun: yes"> </span>(p value=0.001). The m</span><span style="mso-fareast-language: EN-US mso-bidi-font-family: 'Traditional Arabic' mso-bidi-font-size: 13.0pt">ean duration of hospitalization was 13.7±5.27 vs. 5.02± 2.06 days in fibrinogen > 400 mg/dl and<span style="mso-spacerun: yes"> </span>≤ 400 mg/dl group respectively (p value=0.001) <p></p></span></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman"><b><i><span style="mso-fareast-language: EN-US">Conclusion</span></i><span style="mso-no-proof: yes">: </span></b><span lang="X-NONE" style="mso-ansi-language: X-NONE mso-no-proof: yes">Plasma fibrinogen obtained at admission day may assist identification of high-risk patients with acute exacerbation of COPD</span><span style="mso-no-proof: yes">.<p></p></span></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0in 0in 0pt"><font size="3"><font face="Times New Roman">SOURCE: URMIA MED J 2013: 24(2): 103 ISSN: 1027-3727<span lang="EN" style="mso-fareast-language: EN-US mso-ansi-language: EN"><p></p></span></font></font></p>
بیماری انسدادی مزمن ریه (COPD)، فیبرینوژن، پیامد، طول مدت بستری، مرگ و میر
COPD, Fibrinogen, Outcome, Mortality, Duration of Hospitalization
97
103
http://umj.umsu.ac.ir/browse.php?a_code=A-10-582-335&slc_lang=fa&sid=1
Mohammad Hossein
Rahimi-Rad
محمدحسین
رحیمیراد
370031947532846008349
370031947532846008349
No
Urmia University of medical sciences
دانشگاه علوم پزشکی ارومیه
Sepideh
Fathi-Bitaraf
سپیده
فتحی
sepideh_fathibitaraf_md@yahoo.com
370031947532846008350
370031947532846008350
Yes
Urmia University of medical sciences
دانشگاه علوم پزشکی ارومیه
Yousef
Rasmi
یوسف
رسمی
370031947532846008351
370031947532846008351
No
Urmia University of medical sciences
دانشگاه علوم پزشکی ارومیه
Reza
Dinparast
رضا
دین پرست
370031947532846008352
370031947532846008352
No
Urmia University of medical sciences
دانشگاه علوم پزشکی ارومیه