Avicenna Journal of Clinical Medicine
مجله پزشكي باليني ابن سينا
Avicenna J Clin Med
Medical Sciences
http://sjh.umsha.ac.ir
1
admin
2588-722X
2588-7238
-
10.53208/ajcm
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-
-
fa
jalali
1404
12
1
gregorian
2026
3
1
32
4
online
1
fulltext
fa
ارتباط شاخصهای التهابی مشتق از شمارش کامل خون با شدت بیماری عروق کرونر در جمعیت جوان و میانسال ایرانی
Association of Complete Blood Cell Count-Derived Inflammatory Indices with the Severity of Coronary Artery Disease in a Young and Middle-Aged Iranian Population
قلب و عروق
Cardiovascular Diseases
پژوهشي
Original
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">سابقه و هدف:</span></span></span></span></span></span></b> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بیماری عروق کرونر (</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">Coronary Artery Disease; CAD</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) یکی از علل اصلی مرگومیر جهانی است و التهاب نقش کلیدی در</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">پاتوژنز آن دارد. این مطالعه با هدف تعیین ارتباط شاخصهای التهابی کمهزینه و در دسترس مشتق از شمارش کامل خون (</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CBC</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) با شدت آنژیوگرافیک </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CAD</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">انجام شد.</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="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">مواد و روشها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">: </span></span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در این مطالعۀ مقطعی گذشتهنگر، پروندۀ ۲۳۶ بیمار (۱۸۹ مرد، ۴۷ زن) با میانگین سنی 5.4</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">±</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">47.9 سال بررسی شد که تحت آنژیوگرافی الکتیو قرار گرفته بودند. شدت </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CAD</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">براساس نمرۀ </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">SYNTAX</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تعیین شد. دادههای دموگرافیک، پارامترهای </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CBC</span></span><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">.</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">diff</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(شامل </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">NLR</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">PLR</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) و سطوح </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">ESR</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">جمعآوری و با نرمافزار </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">SPSS</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">نسخۀ ۱۶ و آزمونهای آماری مناسب تحلیل شد.</span></span><span dir="LTR" style="font-size:10.0pt"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">یافتهها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">:</span></span></span></span></span></b><b> </b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در تحلیل کلی، سطوح </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">WBC</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0.046 = </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، نوتروفیل (0.002= </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">NLR</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0.012 = </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">PLR</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0.032 = </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، هماتوکریت (0.020 = </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">ESR</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0.001 ></span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، و </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">(0.004 = </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">همگی ارتباط آماری معناداری با شدت </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CAD</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">داشتند. سطوح </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">WBC</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، نوتروفیل، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">NLR</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">PLR</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، هماتوکریت، </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">ESR</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، و </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ارتباط معناداری با شدت </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">CAD</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">داشتند. این ارتباطها بهویژه در مردان و افراد بالای ۴۵ سال قویتر بود. درمقابل، هیچ‏یک از پارامترها در جمعیت زنان ارتباط معناداری نشان ندادند و لنفوسیت، تعداد پلاکت، و هموگلوبین نیز در کل نمونه فاقد ارتباط معنادار بودند.</span></span></span></span></span></span></span><br>
<b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:-.15pt">نتیجهگیری: </span></span></span></span></span></span></b><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">شاخصهای التهابی ساده و کمهزینۀ مشتق از </span></span></span><span style="font-size:9.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">CBC</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">، بهویژه </span></span></span><span style="font-size:9.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">ESR</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">، نوتروفیل، </span></span></span><span style="font-size:9.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">NLR</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">، و </span></span></span><span style="font-size:9.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">CRP</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">، هم‏بستگی زیادی با شدت بیماری عروق کرونر دارند و میتوانند به‏عنوان ابزارهای غربالگری اولیۀ مفید، برای شناسایی بیماران با ریسک بالا و کمک به اولویتبندی آنان برای انجام آنژیوگرافی به کار روند.</span></span></span>
<span style="font-family:Tahoma;"><span style="font-size:14px;"><span style="unicode-bidi:embed"><span ms="" trebuchet=""><span style="color:black"><b><span style="color:#274cc3"><span style="letter-spacing:.15pt">Background and Objective:</span></span></b> Coronary artery disease (CAD) is a leading cause of death worldwide, and inflammation plays a key role in its pathogenesis. This study aimed to investigate the association of complete blood cell count (CBC)-derived inflammatory indices with the angiographic severity of CAD<span dir="RTL" lang="AR-SA"><span new="" roman="" times="">.</span></span><span style="font-family:Optima"></span></span></span></span><br>
<span style="unicode-bidi:embed"><span ms="" trebuchet=""><span style="color:black"><b><span style="color:#274cc3">Materials and Methods:</span></b> In this retrospective cross-sectional study, the records of 236 patients (189 men, 47 women) with a mean age of 47.9 ± 5.4 years who underwent elective coronary angiography were reviewed. The severity of CAD was determined using the SYNTAX score. Demographic data, CBC.diff parameters (including neutrophil to lymphocyte ratio [NLR] and platelet-to-lymphocyte ratio [PLR]), and levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected and analyzed using SPSS (version 16) and appropriate statistical tests<span dir="RTL" lang="AR-SA"><span new="" roman="" times="">.</span></span><span style="font-family:Optima"></span></span></span></span><br>
<span style="unicode-bidi:embed"><span ms="" trebuchet=""><span style="color:black"><b><span style="color:#274cc3"><span style="letter-spacing:.15pt">Results:</span></span></b> In the overall analysis, levels of white blood cell (<i>P</i> = 0.046), neutrophil (<i>P</i> = 0.002), NLR (<i>P</i> = 0.012), PLR (<i>P</i> = 0.032), hematocrit (<i>P</i> = 0.020), ESR (<i>P</i> < 0.001), and CRP (<i>P</i> = 0.004) all showed a statistically significant association with the severity of CAD. These associations were particularly stronger in men and individuals over 45 years of age. In contrast, none of the parameters showed a significant association in the female population, and lymphocyte count, platelet count, and hemoglobin also showed no significant association in the total sample<span dir="RTL" lang="AR-SA"><span new="" roman="" times="">.</span></span><span style="font-family:Optima"></span></span></span></span><br>
<b><span style="color:#274cc3"><span style="letter-spacing:-.1pt">Conclusion:</span></span></b> <span style="color:black">Simple and cost-effective CBC-derived inflammatory indices, especially ESR, neutrophil count, NLR, and CRP, have a significant correlation with the severity of CAD. They can be used as useful preliminary screening tools to identify high-risk patients and assist in prioritizing them for coronary angiography</span><span dir="RTL" lang="AR-SA"><span new="" roman="" times=""><span style="color:black">.</span></span></span></span></span>
آنژیوگرافی, بیماری عروق کرونر, شمارش کامل خون, نسبت نوتروفیل به لنفوسیت
Angiography, Complete blood count, Coronary artery disease, Neutrophil-to-lymphocyte ratio
202
208
http://sjh.umsha.ac.ir/browse.php?a_code=A-12-3048-1&slc_lang=fa&sid=1
Mohammad Mehdi
Monajjem
محمدمهدی
منجم
m.monajjem97@gmail.com
100319475328460024417
100319475328460024417
Yes
Clinical Research Development Unit of Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran
واحد توسعۀ تحقیقات بالینی مرکز قلب فرشچیان، دانشگاه علوم پزشکی همدان، همدان، ایران
Ali Akbar
Rasuli Nia
علیاکبر
رسولی نیا
aliakbarrn@yahoo.com
100319475328460024418
100319475328460024418
No
Clinical Research Development Unit of Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran
واحد توسعۀ تحقیقات بالینی مرکز قلب فرشچیان، دانشگاه علوم پزشکی همدان، همدان، ایران
Nasrin
Jiryaee
نسرین
جیریایی
n_jiryaee@yahoo.com
100319475328460024419
100319475328460024419
No
Department of Social Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
گروه پزشکی اجتماعی، دانشکدۀ پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران