Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
1
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1735-9260
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1401
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2022
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211
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en
بررسی قدرت تشخیصی سی تی اسکن در مقایسه با آزمایش
RT-PCR در تشخیص بیماران کووید - 19
Comparing the Diagnostic Power of Chest CT Scan and RT-PCR in Diagnosis of COVID-19
اپیدمیولوژی
Epidemiology
گزارش کوتاه
Brief Report
<span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">تشخیص درست بیماران مبتلا به کووید-</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">۱۹</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt"> یکی از چالش<span style="color:black"></span>های مراکز درمانی است. آزمایش </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">RT-PCR</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> تست استاندارد و مرجع در تشخیص بیماران مبتلا به کووید-۱۹ می</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">باشد. این مطالعه با هدف تسریع در تشخیص درست بیماران مبتلا به کووید-19، و بررسی قدرت تشخیصی سی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">اسکن با آزمایش </span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">RT-PCR</span></span></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">، </span></span></span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">انجام پذیرفت.<span style="color:#0e101a"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">این مطالعه توصیفی، براساس </span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">صحت</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> تست تشخیصی سی تی اسکن، </span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">بر 569 بیمار مبتلا به کووید-19 <span style="letter-spacing:-.1pt">بستری در بیمارستان گلستان-کرمانشاه انجام شد. </span></span></span></span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">آزمایش </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.1pt">RT-PCR</span></span></span><span style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"> یک آزمایش استاندارد و مرجع در تشخیص کووید-۱۹ در نظر گرفته شد. </span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">اطلاعات مورد نیاز از پرونده</span></span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">ی بیماران با استفاده از چک لیست محقق ساخته استخراج گردید. جهت تجزیه و تحلیل داده</span></span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">ها از </span></span></span></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">نرم</span></span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">افزار </span></span></span></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">STATA</span></span></span></span></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt"> نسخه ۱۴ استفاده شد.</span></span></span></span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">در این مطالعه</span></span></span></span></span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">میانگین سنی بیماران 53/52 سال با انحراف معیار 88/16 سال بود. هم چنین 432 (9/7</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">۵ درصد</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">) نفر از افراد مورد بررسی مرد بودند. </span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">84 درصد افراد با سی</span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تی اسکن و 9/84 درصد با </span></span></span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">RT-PCR</span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> نتیجه آزمایش آن</span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">ها مثبت بود. حساسیت، ویژگی و دقت تست تشخیصی سی</span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span class="fontstyle01" style="font-family:"B Mitra""><span style="color:black"><span style="font-weight:normal"><span style="font-style:normal"><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تی اسکن به ترتیب 7/88، 8/64 و 1/80 درصد گزارش شد. </span></span></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">حساسیت تست تشخیصی سی<span style="color:black"></span>تی اسکن در افراد کم<span style="color:black"></span>تر از 60 سال 9/</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">۸۹</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""> درصد و در افراد بالای 60 سال 8/</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">۸۲</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""> درصد بود. همچنین دقت تست تشخیصی سی<span style="color:black"></span>تی<span style="color:black"></span>اسکن در زنان 7/</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">۸۴</span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">درصد و در مردان 7/7</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">۸</span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">درصد گزارش شد.</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">دقت </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CT</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> در بیماران مبتلا به کووید-۱۹ بالا می</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">باشد. </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CT</span></span> <span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">نمی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تواند بهطور حتمی کووید-۱۹ را تشخیص دهد یا رد کند. با این حال، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">CT</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> می</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تواند به عنوان یک ابزار سریع برای دسته</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">بندی بیماران به گروه</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">های مثبت و منفی مورد استفاده قرار گیرد.</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span>
<span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial","sans-serif""><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%">Proper diagnosis of patients with COVID-19 is one of the challenges in medical centers. RT-PCR is the standard and reference test in diagnosis of patients with COVID-19. This study aimed at accelerating the correct diagnosis of COVID-19 and the diagnostic power of chest CT scan and RT-PCR.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:150%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial","sans-serif"">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">This study was performed in 569 patients with COVID-19 admitted to Golestan-Kermanshah Hospital based on diagnostic chest CT scan. The RT-PCR test was considered as the standard and reference test in diagnosis of COVID-19. Relevant information was extracted from patients' records using a researcher-made checklist. Data analysis was performed in STATA V14.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial","sans-serif"">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">The mean age of patients was 52.53</span></span><span style="font-size:10.0pt"><span style="line-height:150%">±</span></span><span style="font-size:10.0pt"><span style="line-height:150%">16.88 years. Men included 432 (75.9%) patients. In this study, 84% had positive chest CT scan and 84.9% had positive RT-PCR results. Sensitivity, specificity, and accuracy of chest CT scan were 88.7%, 64.8%, and 80.1%, respectively. The sensitivity of chest CT scan was 89.9% in people under 60 years of age and 82.8% in patients over 60 years old. The accuracy of chest CT scan was 84.7% in women and 78.7% in men.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="vertical-align:top"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial","sans-serif"">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> The </span></span><span style="font-size:10.0pt"><span style="line-height:150%">accuracy of chest CT scan is high in patients with COVID-19 while it cannot definitively detect or rule out COVID-19. Nevertheless, it can be used as a quick tool to classify patients into positive and negative groups.</span></span><i><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></i></span></span></span></span>
کووید-19, کرونا ویروس, سیتی اسکن, RT-RT-PCR, حساسیت, ویژگی
COVID-19, Coronavirus, CT scan, RT-PCR, sensitivity, specificity
118
122
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-15362-1&slc_lang=en&sid=1
Alireza
Janbakhsh
علیرضا
جانبخش
janbakhsh.a@gmail.com