Paramedical Sciences and Military Health
علوم پیراپزشکی و بهداشت نظامی
Paramedical Sciences and Military Health
Medical Sciences
http://jps.ajaums.ac.ir
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بررسی تغییرات سیستم انعقادی در مبتلایان به کووید-19 بستری در بیمارستان طی سال های 1399 و 1400
Coagulation system changes in Covid-19 in Patients during 2020-2021
مقالات کامل
full articles
پژوهشي
Research
<h1><span style="font-size:14px;"><span style="font-family:yekanYW;"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" times=""><b><span lang="AR-SA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">مقدمه:</span></span></span></b> <span lang="FA" style="line-height:150%"><span b="" nazanin="">بیماری کووید-19 علائم بالینی و آزمایشگاهی متعددی ایجاد می ­کند که هر یک از این علائم ممکن است در تشخیص بیماری و یا تعیین سیر بیماری موثر باشد. در این مطالعه تغییرات سیستم انعقادی در افراد مبتلا به کووید-19 بستری در بیمارستان مورد بررسی قرار گرفت.</span></span></span></span></span></span><br>
<br>
<span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" times=""><b><span lang="AR-SA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">مواد و روشها:</span></span></span></b><span lang="AR-SA" style="line-height:150%"><span b="" nazanin=""><span style="color:black"> در یک مطالعه توصیفی/ مقطعی، تعداد 90 بیمار </span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">مبتلا به کووید-19 </span></span></span><span lang="AR-SA" style="line-height:150%"><span b="" nazanin="">بستری در بیمارستان <span style="color:black">انتخاب و از نظر تغییرات سیستم انعقادی (</span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">PT</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">، </span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">PTT</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">، </span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">Plt</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">، </span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">MPV</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">، </span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">D-dimer</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black"> و </span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">FDP</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">) </span></span></span><span lang="AR-SA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">روز اول و هفتم بستری </span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">بررسی و مقایسه شدند. تحلیل داده­ ها با نرم افزار </span></span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">SPSS</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black"> نسخه 26 صورت گرفت</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">. جهت مقایسه </span></span><span lang="AR-SA" style="line-height:150%"><span b="" nazanin="">تغییرات انعقادی </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">روز اول و هفتم بستری به صورت کمی از آزمون ویل-کاکسون و به صورت کیفی رتبه­ ای از آزمون مک­نمار استفاده شد.</span></span></span></span></span></span><br>
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<span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" times=""><b><span lang="AR-SA" style="line-height:150%"><span b="" nazanin="">یافتهها:</span></span></b> <a name="_Hlk150047246"><span lang="FA" style="line-height:150%"><span b="" nazanin="">میانگین سن بیماران</span></span></a><span lang="AR-SA" style="line-height:150%"><span b="" nazanin="">51/61 سال</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">، 53/33 درصد مرد و 46/64 درصد زن بودند. به ترتیب روز اول و هفتم بستری میانگین و انحراف معیار </span></span><span dir="LTR"><span style="line-height:150%">PT</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">: </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">71/69</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">12/1</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">2/39</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">15/00</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> ثانیه (</span></span><span dir="LTR"><span style="line-height:150%">P<0.001</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">)، </span></span><span dir="LTR"><span style="line-height:150%">PTT</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">: </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">5/09</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">33/8</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">11/31</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">43/32</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> ثانیه (</span></span><span dir="LTR"><span style="line-height:150%">P<0.001</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">)، </span></span><span dir="LTR"><span style="line-height:150%">Plt</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">: </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">58/30</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">276/18</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">7/20</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">244/09</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> ×</span></span><span dir="LTR"><span style="background:white"><span style="line-height:150%"><span style="color:black">10<sup>3</sup>/µl</span></span></span></span><span style="line-height:150%"><span b="" nazanin=""> (</span></span><span dir="LTR"><span style="line-height:150%">P<0.001</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">)، </span></span><span dir="LTR"><span style="line-height:150%">MPV</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">: </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">0/84</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">8/2</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">3/83</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">10/58</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> فمتولیتر (</span></span><span dir="LTR"><span style="line-height:150%">P<0.001</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">)، </span></span><span dir="LTR"><span style="line-height:150%"><span style="color:black">D-Dimre</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">: </span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">40/17</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">300/34</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و </span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">194/26</span></span></span><span lang="FA" style="line-height:150%"><span cambria=""><span style="color:black">±</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">493/17</span></span></span> <span lang="FA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">نانوگرم بر میلی­لیتر</span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> (</span></span><span dir="LTR"><span style="line-height:150%">P<0.001</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">) بود. همچنین </span></span><span dir="LTR"><span style="line-height:150%">FDP</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> بالاتر از 5 روز اول و هفتم بستری به ترتیب 6/7 و 70 درصد (</span></span><span dir="LTR"><span style="line-height:150%">P<0.001</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">) بود.</span></span></span></span></span></span><br>
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<span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" times=""><b><span lang="AR-SA" style="line-height:150%"><span b="" nazanin=""><span style="color:black">بحث و نتیجهگیری:</span></span></span></b><span lang="AR-SA" style="line-height:150%"><span b="" nazanin=""><span style="color:black"> سیستم انعقادی بیماران مبتلا به کووید-19 از زمان بستری تا روز هفتم دچار تغییرات قابل توجهی می­ شود. این تغییرات شامل </span></span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">افزایش </span></span><span dir="LTR"><span style="line-height:150%">PT</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">، </span></span><span dir="LTR"><span style="line-height:150%">PTT</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">، </span></span><span dir="LTR"><span style="line-height:150%">MPV</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و </span></span><span dir="LTR"><span style="line-height:150%">D-Dimer</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin="">، </span></span><span dir="LTR"><span style="line-height:150%">FDP</span></span><span lang="FA" style="line-height:150%"><span b="" nazanin=""> و کاهش پلاکت است.</span></span></span></span></span></span></span></span></h1>
<span style="font-size:14px;"><span style="font-family:yekanYW;"> </span></span>
<span style="font-size:12pt"><span style="line-height:200%"><span style="tab-stops:97.9pt"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:200%">Introduction: T</span></span></b><span style="font-size:10.0pt"><span style="line-height:200%">he Covid-19 disease causes many clinical and paraclinical symptoms, each of these symptoms may be effective in diagnosing the disease or determining the trend of the disease. Coagulation system changes in Covid-19 inpatients were evaluated in this study.</span></span><br>
<b><span style="font-size:10.0pt"><span style="line-height:200%">Methods and Materials: </span></span></b><span style="font-size:10.0pt"><span style="line-height:200%">In a descriptive/cross-sectional study, 90 Covid-19 hospitalized patients in Hamedan were selected. Moreover, their coagulation system changes including platelet count (Plt), PT, PTT, FDP, MPV and D-Dimer were investigated on the first and seventh days of admission. Data analysis was performed with SPSS software version 26. Wilcoxon test was used quantitatively and Mc Nemar test was used qualitatively in order to compare the coagulation system changes on the first and seventh days of hospitalization.</span></span><br>
<b><span style="font-size:10.0pt"><span style="line-height:200%">Results: </span></span></b><span style="font-size:10.0pt"><span style="line-height:200%">The mean age of the patients was 51.61 years. 53.33% of these patients were male and 46.64% of them were female. On the first and seventh days of hospitalization, the mean and standard deviation of coagulation system changes were as follow respectively; PT: 12.71±1.69 and 15.00±2.39 seconds (P<0.001), PTT: 33.5±8.09 and 43.11±32.31 seconds (P<0.001), Plt: 276.58±18.30 and 244.09±7.20 × 103/μl (P<0.001), MPV: 8.00±2.84 and 10.58±3.83 femtoliters (P<0.001), D-Dimre: 300.17±34.40 and 493.17±194.26 nanogram per milliliter (P<0.001). FDP≥5 in the seventh day was also higher than the first day of hospitalization (70% Vs 6.7%) respectively (P<0.001).</span></span><br>
<b><span style="font-size:10.0pt"><span style="line-height:200%">Discussion and Conclusion:</span></span></b><span style="font-size:10.0pt"><span style="line-height:200%"> Coagulation system of inpatients with Covid-19 undergoes significant changes from the time of admission to the seventh day. These changes include increased levels of PT, PTT, MPV, FDP and D-Dimer biomarkers and decreased platelet count.</span></span></span></span></span></span></span>
کووید-19, سیستم انعقادی, PT, PTT, D-Dimer
Covid-19, Coagulation System, PT, PTT, D-Dimer
40
48
http://jps.ajaums.ac.ir/browse.php?a_code=A-10-526-3&slc_lang=fa&sid=1
maryam
Moradi
مریم
مرادی
maryam1996.cutegirl@yahoo.com
10031947532846003500
10031947532846003500
No
Faculty of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
دانشکده پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران
Fatemeh
Amiri
فاطمه
امیری
amirif2012@gmail.com
10031947532846003501
10031947532846003501
Yes
Department of Laboratory Sciences, Faculty of Paramedicine, Hamedan University of Medical Sciences, Hamedan, Iran
گروه علوم آزمایشگاهی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران
Narges
Mohammadi parsa
نرگس
محمدی پارسا
nmohamadi646@gmail.com
10031947532846003502
10031947532846003502
No
Clinical Research Development Units, Besat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran
واحد توسعه تحقیقات بالینی بیمارستان بعثت، دانشگاه علوم پزشکی همدان، همدان، ایران