Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
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فراوانی استرس هایپرگلایسمی و تاثیر آن بر پیامد بیماری در بیماران کووید19 مراجعهکننده به مرکز آموزشی درمانی امام خمینی(ره) ساری
Frequency of Stress Hyperglycemia and Its Effect on Disease Outcome in COVID-19 Patients Referred to the Imam Khomeini Medical Education Center in Sari
داخلی
Internal medicine
پژوهشي-کامل
Research(Original)
<span style="font-size:12pt"><span style="line-height:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">استرس هایپرگلایسمی یک پاسخ فیزیولوژیک نورو اندوکرین در برابر استرس</span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">های پزشکی است</span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> و</span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">قند </span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">خون بالاتراز </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%"><span style="letter-spacing:-.2pt">mg/dl</span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">200 در شرایط استرسزا مانند سپسیس، </span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">شوک، استروک، تروما، انفارکتوس میوکارد و سوختگی میباشد و</span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">ریسک مورتالیتی و موربیدیتی را در بیماران بد حال افزایش می<span style="color:black"></span>دهد. لذا هدف از مطالعه حاضر بررسی فراوانی استرس </span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">هایپر<a name="_Hlk153128858">گلایسمی </a>و عوامل مرتبط با آن و هم</span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt"></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">چنین ارتباط هایپرگلایسمی با شدت و پیامدهای بالینی بیماران بستری با کووید19 بود.</span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:#0e101a"><span style="letter-spacing:-.2pt"></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:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">در این مطالعه مقطعی تمامی بیماران بالای 18 سال بستری شده با تشخیص کووید19 در مرکز </span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">آموزشی</span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> درمانی امام خمینی ساری در سال 1399 وارد مطالعه شدند. تشخیص بیماری براساس علائم بالینی، نتایج مثبت در آزمایش</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">های </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">CBC</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">CRP</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">،</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">ESR </span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> و تست </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">RT-PCR</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""> و سی</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">تی</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar="">اسکن ریه بود<span style="color:red">.</span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""> داده</span></span><span lang="AR-SA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">های مطالعه با نرمافزار </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">SPSS26</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""> تجزیه و تحلیل شدند.<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:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">در مجموع، 312 نفراز بیماران مبتلا به کووید19 مورد بررسی قرار گرفتند، که 22 نفر (7/1 درصد) دچار استرس هایپرگلایسمی شدند. بیماران استرس هایپرگلایسمی نسبت به افراد نرموگلایسمی میزان مرگ و میر، بستری در </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">ICU</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar="">، ونتیلاسیون تنفسی و مدت زمان بستری در بیمارستان بیشتری داشتند، اما فقط از نظر میزان مرگ و میر بین دو گروه تفاوت معنادار آماری وجود داشت (0/046=</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:97%">P</span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" 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:97%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:97%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">باتوجه به تاثیر هیپرگلیسمی در پیامد بیماری و میزان مرگ و میر در بیماران بد حال و بستری مبتلا به کووید19</span></span></span><span lang="FA" style="line-height:97%"><span b="" style="font-family:" zar=""> نسبت به بیماران با قند خون نرمال، اهمیت تشخیص به موقع و کنترل مناسب قند خون در این بیماران مشخص میشود.</span></span></span></span></span></span></span></span></span>
<span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%">Stress hyperglycemia is a neuroendocrine physiological response to medical stress, hyperglycemic stress increases the risk of mortality and morbidity in ill patients. This study aimed to investigate the frequency of hyperglycemic stress and its related factors, as well as the relationship between hyperglycemia and the severity and clinical outcomes of hospitalized patients with COVID-19.</span></span><span style="font-size:10.0pt"><span style="line-height:150%"></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 new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">This cross-sectional study was conducted in Imam Khomeini Hospital in Sari in 2019. The patients were diagnosed based on clinical symptoms, CBC, CRP, ESR tests, RT-PCR test, and CT scan of the lungs and were hospitalized in the Covid ward. Data analysis was performed using SPSS Software.</span></span><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">312 COVID-19 patients were investigated, and 22 (7.1%) suffered from hyperglycemic stress. Hyperglycemic stress patients had more mortality, hospitalization in ICU, respiratory ventilation, and length of hospital stay compared to the normoglycemic subjects, but only in terms of mortality, there was a statistically significant difference between the two groups (P=0.46)</span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:150%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> Considering the effect of hyperglycemia on the outcome of the disease and the death rate in ill and hospitalized patients compared to patients with normal blood sugar, it shows the importance of timely diagnosis and proper control of blood sugar in these patients.<i><span style="color:black"></span></i></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:135%"><span style="tab-stops:121.45pt"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:8.0pt"><span style="line-height:135%"><span style="color:black"></span></span></span></i></b></span></span></span></span><br>
کووید19, هایپر گلایسمی, شدت بیماری, پیامد بالینی
stress hyperglycemia, COVID-19, hyperglycemia, disease severity, clinical outcome
57
67
http://jmums.mazums.ac.ir/browse.php?a_code=A-11-183-10&slc_lang=fa&sid=1
Maryam
Mosayyebi
مریم
مسیبی
maryam11mosayyebi@yahoo.com