Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
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فراوانی فیبرومیالژیا در کم کاری تیروئید، یک مطالعه مقطعی
Frequency of Fibromyalgia in Hypothyroidism: A Cross-Sectional Study
روماتولوژی
Gynecology and Infertility
پژوهشي-کامل
Research(Original)
<span style="font-size:16px;"><span style="line-height:2;"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span b="" lang="FA" style="font-family:" zar=""><span style="color:black">فیبرومیالژیا یک سندرم است که با درد مزمن اسکلتی عضلانی، حساسیت و سایر علائم فیزیکی مشخص می شود. این </span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">مطالعه با هدف بررسی فراوانی فیبرومیالژیا در بیماران مبتلا به کم کاری تیروئید و رابطه بین علائم فیبرومیالژیا و وضعیت کم کاری تیروئید، انجام پذیرفت.</span></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:#0e101a"></span></span></span></span></span></span><br>
<span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA"><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"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">مطالعه حاضر، یک مطالعه توصیفی از نوع مقطعی است که میزان شیوع و ویژگیهای دموگرافیک فیبرومیالژیا را در بیماران هیپوتیروئیدی مراجعهکننده به درمانگاه</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">های دانشگاهی شهرستان ساری در سال 1401-1402، مورد بررسی قرار داد. روش نمونه</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">گیری به روش نمونهگیری در دسترس بود. نود و یک بیمار مبتلا به کم کاری تیروئید وارد مطالعه شدند. ویژگی</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">های جمعیت شناختی و ویژگیهای بالینی بیماران و آزمایشات تیروئید شامل </span></span></span><span dir="LTR"><span style="color:black">T4</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">، </span></span></span><span dir="LTR"><span style="color:black">TSH</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> و</span></span></span><span dir="LTR">Anti Tpo Ab</span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> ثبت گردید. سپس شرکتکنندگان در خصوص وجود علایم فیبرومیالژیا با استفاده از معیارهای روماتولوژی کالج آمریکایی (2010 و 1990) ارزیابی شدند و برای بیمارانی که به عنوان فیبرومیالژیا طبقه</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">بندی شدند، پرسشنامه </span></span></span><span dir="LTR"><span style="color:black">FIQR</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> تکمیل شد. برای تجزیه و تحلیل دادهها از شاخصهای آمار توصیفی مانند شاخصهای مرکزی و پراکندگی و محاسبه نسبت</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">ها استفاده شد و برای بررسی ارتباط متغیرهای کیفی از آزمون کای دو و مقایسه متغیر کمی در گروه</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">های مختلف از آزمون</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">های </span></span></span><span dir="LTR"><span style="color:black">t</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> و </span></span></span><span dir="LTR"><span style="color:black">ANOVA</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> در نرمافزار </span></span></span><span dir="LTR"><span style="color:black">SPSS-25</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> استفاده گردید.</span></span></span></span></span></span><br>
<span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">میانگین سن و طول مدت کمکاری تیروئید، بهترتیب13/8</span></span></span><span lang="FA"><span cambria="" style="font-family:"><span style="color:black">±</span></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">48/35 و 6/6</span></span></span><span lang="FA"><span cambria="" style="font-family:"><span style="color:black">±</span></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">9/84 سال بود. فراوانی فیبرومیالژیا در بیماران کم کاری تیروئید بر اساس معیارهای </span></span></span><span dir="LTR"><span style="color:black">ACR 2010</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">، 7 نفر (8 درصد) بود. در بیماران دچار کم کاری تیروئید و فیبرومیالژیا 6 نفر (85/7 درصد) </span></span></span><span dir="LTR"><span style="color:black">TPOAb</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> مثبت بودند در حالی که در بیماران دچار کم کاری تیروئید بدون فیبرومیالژیا 29 نفر (34/5 درصد) واجد این آنتی</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">بادی بودند (0/007=</span></span></span><span dir="LTR"><span style="color:black">P</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">).</span></span></span></span></span></span><br>
<span dir="RTL" lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span dir="RTL" lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">به نظر می رسد اهمیت همزمانی </span></span></span><span new="" roman="" style="font-family:" times="">Anti Tpo Ab</span><span dir="RTL" lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"> بیش از اختلال عملکرد تیروئید باشد و پیشنهاد می</span></span></span><span dir="RTL" lang="FA"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span></span><span dir="RTL" lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">شود در بیماران فیبرومیالژیا علاوه بر تست عملکرد تیروئید، این آنتی</span></span></span><span dir="RTL" lang="FA"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"></span></span></span><span dir="RTL" lang="FA"><span b="" style="font-family:" zar=""><span style="color:black">بادی هم بررسی شود.</span></span></span></span></span>
<span style="font-size:16px;"><span style="line-height:2;"><span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></b> <span style="letter-spacing:-.1pt">Fibromyalgia is a syndrome characterized by chronic musculoskeletal</span> pain, tenderness, and other physical symptoms. We determined the frequency of Fibromyalgia in hypothyroid patients and the relationship between FM symptoms and hypothyroid status.<span style="line-height:130%"></span></span><br>
<span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:">Materials and methods:</span></b><b> </b>The current study is a cross-sectional descriptive study investigating the prevalence and demographic characteristics of fibromyalgia in hypothyroid patients referred to University clinic in Sari in 1401-1402. Ninety-one hypothyroid patients were included in the study. The sampling method was convenience sampling. The sociodemographic features and the clinical features of hypothyroid patients were recorded. Thyroid tests included T4, TSH, and Anti Tpo Ab. Patients were examined for Fibromyalgia using American College Rheumatology (ACR) criteria for FM 2010 and 1990. For the patients who were classified as FM, the FIQR questionnaire was completed. To analyze the data, descriptive statistics indicators such as central and dispersion indicators and calculation of ratios were used, and to check the relationship between qualitative variables, chi-square test and quantitative variable comparison in different groups were used by t-tests and ANOVA in SPSS-25 software was used.<span style="line-height:130%"></span></span><br>
<span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:">Results:</span></b><b> </b>The mean age and duration of hypothyroidism were 48.35 ± 13.8 and 9.84± 6.6 years respectively. The frequency of fibromyalgia in hypothyroid patients was 7(8%) patients based on ACR 2010 criteria. In patients with hypothyroidism and fibromyalgia, 6 patients (85.7%) were positive for Anti Tpo Ab, while in patients with hypothyroidism without fibromyalgia, 29 patients (34.5%) had this antibody (P=0.007).<span lang="EN"><span style="line-height:130%"></span></span></span><br>
<span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:">Conclusion:</span></b> It seems that Anti Tpo Ab is more important than thyroid dysfunction, and it is suggested to check this antibody in fibromyalgia patients in addition to thyroid function tests.<i><span style="color:black"></span></i></span></span><br>
<span new="" roman="" style="font-family:" times=""><b><i><span style="color:black"></span></i></b></span></span></span><br>
فیبرومیالژیا, کم کاری تیروئید, Tpo Ab
fibromyalgia, hypothyroidism, Anti Tpo Ab
76
83
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-6574-4&slc_lang=fa&sid=1
Maryam
Mobini
مریم
مبینی
mmobini50@yahoo.com