و
ﻼﺘﺒﻣ
لﺎﺳ
14
ﺮﯾز
نﺎﮐدﻮﮐ
رد
(
IgM&IgG
)
ﯽﯾﺎﯾﺪﯿﻣﻼﮐ
ﺖﻧﻮﻔﻋ
ﯽﻧاواﺮﻓ
ﺪﺻرد
ﻪﺴﯾﺎﻘﻣ
نﺎﮐدﻮﮐ
ﺶﺨﺑ
رد
هﺪﺷ
یﺮﺘﺴﺑ
ﯽﻧﻮﻣﻮﻨﭘ
ﻪﺑ
ﻼﺘﺒﻣﺮﯿﻏ
I
ﺶﺨﺑرﻮﻧ ﻪﻠﯿﻤﺛ ﺮﺘﮐد
*
IIشاﺮﺗﺮﻫاﻮﺟ ﺮﺻﺎﻧ ﺮﺘﮐد
III
زﺎﻤﯾر زﺎﻨﻬﺷ ﺮﺘﮐد
IVﯽﯾﺎﺿر یﺪﻬﻣ ﺮﺘﮐد
Vﯽﯾﺎﺒﻃﺎﺒﻃ ﺖﺧدرذآ
هﺪﯿﮑﭼ داﺮﻓاردﯽﻧﻮﻣﻮﻨﭘوﺖﯿﺸﻧوﺮﺑﻞﻣﺎﻋونﺎﮐدﻮﮐردﯽﻧﺎﺘﺤﺗﯽﺴﻔﻨﺗﺖﻧﻮﻔﻋﻞﻠﻋزاﯽﮑﯾﻪﯿﻧﻮﻣﻮﻨﭘﺎﯾﺪﯿﻣﻼﮐ هﺪـﯾدﻦﯿﻨـﺳمﺎـﻤﺗردنآﻪـﺑﻼـﺘﺑاﻪــﮐﺖﺳاعﺎﻤﺘﺟاردﮏﯿﭙﯿﺗآیﺎﻫﯽﻧﻮﻣﻮﻨﭘزا %10-20 ﻞﻣﺎﻋﺰﯿﻧوﻎﻟﺎﺑ ﻦـﯾاﺖـﺸﮐ .درادﯽﺻﺎـﺼﺘﺧانﺎـﻣردﻪـﺑزﺎــﯿﻧوهﺪﺷﻢﺳآتﻼﻤﺣنﺪﺷلﺎﻌﻓﺐﺒﺳﺖﻧﻮﻔﻋﻦﯾا .دﻮﺷﯽﻣ ﻦـﯾازافﺪـﻫ .ﺪﻨﺘـﺴﻫهﺪـﻨﻨﮐﮏـﻤﮐﺺﯿﺨــﺸﺗیاﺮﺑیژﻮﻟوﺮﺳیﺎﻫشورﻦﯾاﺮﺑﺎﻨﺑﺖﺳاﻞﮑﺸﻣﻢﺴﯿﻧﺎﮔرا ﻪـﺑﻼـﺘﺒﻣلﺎـﺳ 14 ﺮـﯾزنﺎــﮐدﻮﮐردﺎﯾﺪﯿﻣﻼﮐﺖﻧﻮﻔﻋﻪﺑﯽﻠﺒﻗیﻼﺘﺑاودﺎﺣﺖﻧﻮﻔﻋﯽﻧاواﺮﻓﻦﯿﯿﻌﺗﻪﻌﻟﺎﻄﻣ ﺎـﺑﯽﯾﺎـﯾﺪﯿﻣﻼﮐﯽــﻧﻮﻣﻮﻨﭘﺰﯿﻣآﺖﯿﻘﻓﻮﻣنﺎﻣردﺎﺑ .ﺖﺳاهدﻮﺑﺖﻧﻮﻔﻋﻪﺑﻼﺘﺑاﻦﺳﻂﺳﻮﺘﻣﻦﯿﯿﻌﺗوﯽﻧﻮﻣﻮﻨﭘ تﻼـﻤﺣﻪـﮑﻠﺑدﻮـﺷﯽﻣﻪﺘـﺳﺎﮐﯽــﻧﻮﻣﻮﻨﭘدراﻮﻣزوﺮﺑناﺰﯿﻣزاﺎﻬﻨﺗﻪﻧﺎﻫﺪﯿﻟوﺮﮐﺎﻣﺮﯾﺎﺳوﻦﯿﺴﯾﺎﻣوﺮﺘﯾرا 14 ﺮـﯾزکدﻮـﮐ 73 نﻮـﺧﻪـﻧﻮﻤﻧیوریﺪﻫﺎــﺷـدرﻮﻣﻪﻌﻟﺎﻄﻣﻦﯾا .ﺪﺑﺎﯾﯽﻣﺶﻫﺎﮐیﺮﺘﺴﺑدراﻮﻣوﻢﺳآ IgMوIgGﯽﺻﺎـﺼﺘﺧایدﺎـﺑﯽﺘﻧآﯽـﺳرﺮﺑ .ﺪـﺷمﺎـﺠﻧا (ﺪﻫﺎــﺷ 38 وﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣرﺎﻤﯿﺑ 35)لﺎﺳ 3/7±3/87 نﺎــﮐدﻮﮐﻦﺳﻦﯿﮕﻧﺎﯿﻣهﺪﻣآﺖﺳدﻪﺑﺞﯾﺎﺘﻧسﺎﺳاﺮﺑ .ﺖﻓﺮﮔترﻮﺻELISAشورﺎﺑﺎﯾﺪﯿﻣﻼﮐ %48 رد (ﺖــﺒﺜﻣChlamydia IgM)ﯽﯾﺎﯾﺪﯿﻣﻼﮐدﺎﺣﺖﻧﻮﻔﻋ .ﺪﻧدﻮﺑﺮﺘﺧد %51/4 وﺮﺴﭘ %48/6 ودﻮﺑلﺎﺳ 2-3 ﯽﻨـﺳهوﺮـﮔردﯽــﻧاواﺮﻓﻦﯾﺮﺗﺶﯿﺑ .دﻮﺑﺖﺒﺜﻣﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐزا %57 ردونﺎﮐدﻮﮐﻞﮐزا نﺎـﮐدﻮﮐﻞـﮐ %27/4 ردﺎــﯾﺪﯿﻣﻼﮐﻪﺑﺖﺒﺴﻧﯽﻠﺒﻗﯽﻨﻤﯾا .ﺪﺷهﺪﻫﺎﺸﻣلﺎﺳ 3/7 ﯽﻨﺳﻦﯿﮕﻧﺎﯿﻣو (%40)لﺎﺳ دﺎـﺣﺖـﻧﻮﻔﻋﻪـﺑﻼـﺘﺑا .دﻮـﺑ (%50)لﺎـﺳ 5 زاﺮﺗﻻﺎـﺑﻦـﺳﻪــﺑطﻮﺑﺮﻣﯽﻧاواﺮﻓﻦﯾﺮﺗﺶﯿﺑﻪﮐﺖﺷاددﻮﺟو ﯽـﻨﻤﯾاﺎــﻣادﻮﺑﺪﻫﺎﺷهوﺮﮔزاﺶﯿﺑ (P<0/001)یرادﯽﻨﻌﻣرﻮﻃﻪﺑﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣهوﺮﮔردﯽﯾﺎﯾﺪﯿﻣﻼﮐ دﺎــﺣﺖــﻧﻮﻔﻋﻪــﮐﺖــﻔﮔناﻮــﺗﯽﻣﯽــﻠﮐیﺮﯿــﮔﻪــﺠﯿﺘﻧناﻮــﻨﻋﻪــﺑ .ﺖـــﺷاﺪﻧﯽـﺤﺿاوتوﺎـﻔﺗﯽـﻠﺒﻗ ﯽﮕﻟﺎﺳ 3 ﻦﺳردنﺎﮐدﻮﮐزا %50 ردﯽﻧﻮﻣﻮﻨﭘنوﺪﺑﺎﯾﯽﻧﻮﻣﻮﻨﭘﺎﺑ (ﺖﺒﺜﻣChlamydia-IgM)ﯽﯾﺎﯾﺪﯿﻣﻼﮐ ﻪـﺑﺖــﻧﻮﻔﻋبﻮﺧﺦﺳﺎﭘﻪﺑﻪﺟﻮﺗﺎﺑ .ﺪﺷﺪﻫاﻮﺧﺖﺒﺜﻣIgGﻦﯾالﺎﺳ 5 ﻦﺳﻪﺑنﺪﯿﺳرﺎﺗﻪﮐدﻮﺷﯽﻣهﺪﯾد تﻼـﻤﺣزاﻪﮑﻠﺑﺪﺑﺎﯾﯽﻣﺶﻫﺎﮐﯽﻧﻮﻣﻮﻨﭘدراﻮﻣﺎﻬﻨﺗﻪﻧﺖﻧﻮﻔﻋﻦﯾالﺮﺘﻨﮐﺎﺑ،ﻦﯿﺴﯾﺎﻣوﺮﺘﯾراﯽﮐارﻮﺧنﺎﻣرد .ﺪﺷﺪﻫاﻮﺧﻢﮐیرﺎﻤﯿﺑیﺮﺘﺴﺑدراﻮﻣوﻪﺘﻓﺎﯾﻒﯿﻔﺨﺗﻞﻗاﺪﺣﺎﯾهﺪﺷﻪﺘﺳﺎﮐﺪﻌﺘﺴﻣداﺮﻓاردﻢﺳآ ﮏﯿﭙﯿﺗآ ﯽﻧﻮﻣﻮﻨﭘ – 3 ﯽﻧﻮﻣﻮﻨﭘ – 2 ﺎﯾﺪﯿﻣﻼﮐ یدﺎﺑﯽﺘﻧآ – 1 :ﺎﻫهژاوﺪﯿﻠﮐ ﯽﯾﺎﯾﺪﯿﻣﻼﮐ ﯽﻧﻮﻣﻮﻨﭘ – 4 ﺮﺘـﮐد هروﺎـﺸﻣ و شاﺮــﺗﺮﻫاﻮﺟ ﺮﺻﺎﻧ ﺮﺘﮐد ﯽﯾﺎﻤﻨﻫار ﻪﺑ نﺎﮐدﻮﮐ یﺎﻫیرﺎﻤﯿﺑ ﯽﺼﺼﺨﺗ یاﺮﺘﮐد ﻪﺟرد ﺖﻓﺎﯾرد ﺖﻬﺟ ﯽﯾﺎﺿر یﺪﻬﻣ ﺮﺘﮐد ﻪﻣﺎﻧ نﺎﯾﺎﭘ زا ﺖﺳا یاﻪﺻﻼﺧ ﻪﻟﺎﻘﻣ ﻦﯾا .1381-82 لﺎﺳ ،ﯽﯾﺎﺑﺎﺒﻃ ﺖﺧدرذآ و ﺶﺨﺑرﻮﻧ ﻪﻠﯿﻤﺛ ﯽﻧﺎـﻣرد ﯽﺘـﺷاﺪﻬﺑ تﺎـﻣﺪﺧ و ﯽﮑـﺷﺰﭘ مﻮــﻠﻋ هﺎﮕﺸﻧاد ،ﺶﯾﺎﯿﻧ ،نﺎﺧرﺎﺘﺳ نﺎﺑﺎﯿﺧ ،(ص)مﺮﮐا لﻮﺳر تﺮﻀﺣ نﺎﺘﺳرﺎﻤﯿﺑ ،نﺎﮐدﻮﮐ ﯽﻧﻮﻔﻋ یﺎﻫیرﺎﻤﯿﺑ ﺺﺼﺨﺗقﻮﻓ و رﺎﯾدﺎﺘﺳا (I (لﻮﺌﺴﻣ ﻒﻟﻮﻣ*)ناﺮﯾا .ناﺮﯾا ﯽﻧﺎﻣرد ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﺶﯾﺎﯿﻧ ،نﺎﺧرﺎﺘﺳ نﺎﺑﺎﯿﺧ ،(ص)مﺮﮐا لﻮﺳر تﺮﻀﺣ نﺎﺘﺳرﺎﻤﯿﺑ ،نﺎﮐدﻮﮐ رد ﯽﺳﺎﻨﺷﯽﻨﻤﯾا ﺺﺼﺨﺗقﻮﻓ و رﺎﯿﺸﻧاد (II .ناﺮﯾا ﯽﻧﺎﻣرد ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،یژﻮﻟﻮﯿﻣﺪﯿﭘا رﺎﯾدﺎﺘﺳا (III .ناﺮﯾا ﯽﻧﺎﻣرد ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،نﺎﮐدﻮﮐ یﺎﻫیرﺎﻤﯿﺑ رﺎﯿﺘﺳد (IV .ناﺮﯾا ﯽﻧﺎﻣرد ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽﺑﺮﻣ ،ﯽﻫﺎﮕﺸﯾﺎﻣزآ مﻮﻠﻋ ﺪﺷرا سﺎﻨﺷرﺎﮐ (V
ﻪﻣﺪﻘﻣ زاﯽﻧﺎـﺘﺤﺗﯽـﺴﻔﻨﺗﺖـﻧﻮﻔﻋﻞــﻠﻋزاﯽﮑﯾﻪﯿﻧﻮﻣﻮﻨﭘﺎﯾﺪﯿﻣﻼﮐ داﺮـﻓاردﯽـﻧﻮﻣﻮﻨﭘوﺖﯿــﺸﻧوﺮﺑونﺎﮐدﻮﮐردﯽﻧﻮﻣﻮﻨﭘﻪﻠﻤﺟ (3 و2 ،1).دراﺪﻧدﻮﺟوﯽﻧﺎﺴﻧاﺮﯿﻏﻊﺒﻨﻣنآیاﺮﺑوﺪﺷﺎﺑﯽﻣﻎﻟﺎﺑ ،ﺖــﺳاهﺪﺷمﺎﺠﻧاًاﺮﯿﺧاﻪﮐیﺰﮐﺮﻣﺪﻨﭼتﺎﻌﻟﺎﻄﻣسﺎﺳاﺮﺑ زاﯽـﺷﺎﻧﯽـﻧﻮﻣﻮﻨﭘﻪـﺑﻼـﺘﺒﻣﻪــﮐﻪﻟﺎﺳ 3-12 نﺎﮐدﻮﮐزا %14 ﺖـﺸﮐناﺰﯿــﻣوﺪﻨﺘﺷادﺖﺒﺜﻣﯽﯾﺎﯾﺪﯿﻣﻼﮐﺖﺸﮐ،ﺪﻧدﻮﺑعﺎﻤﺘﺟا ردنآعﻮﯿـﺷ(5 و4 ،3) .ﺖـﺳاهدﻮـﺑ %22 ﺎﻤــﺳﻼﭘﻮﮑﯾﺎﻣﺎﺑﺖﺒﺜﻣ هﺪـﺷشراﺰـﮔ %18 لﺎـﺳ 6 زاﺮﺗﻻﺎــﺑو %15 لﺎﺳ 6 ﺮﯾزﻦﺳ ﺎـــﺑهاﺮــــﻤﻫ،ﺖــﻧﻮﻔﻋ،نارﺎــﻤﯿﺑزا %20 ردو(3 و2 ،1)ﺖــﺳا یورﺪـﻨﻫردهﺪـﺷمﺎــﺠﻧاتﺎﻌﻟﺎﻄﻣرد .ﺪﺷﺎﺑﯽﻣﺎﻤﺳﻼﭘﻮﮑﯾﺎﻣ زا %27/4 ،عﺎــﻤﺘﺟازاﯽـــﺷﺎﻧﯽـﻧﻮﻣﻮﻨﭘﻪـﺑﻼـﺘﺒﻣکدﻮـﮐ 67 یاﺮـﺑ %6/4 وﺎﻤـﺳﻼﭘﻮﮑﯾﺎـﻣیاﺮــﺑﺖﺒﺜﻣیژﻮﻟوﺮﺳنﺎﮐدﻮﮐ (5) .ﺪﻨﺘﺷادﺎﯾﺪﯿﻣﻼﮐ 3 ،ﺐــﺗنوﺪــﺑﯽـــﻧﻮﻣﻮﻨﭘﻪـﺑﻼـﺘﺒﻣیاهﺮـﮐنازﺎﺑﺮـﺳرد ازیرﺎﻤﯿﺑﻞﻣﺎﻋﻪﻓﺮﺳهﺎﯿﺳوﺎﻤﺳﻼﭘﻮﮑﯾﺎﻣ،ﺎﯾﺪﯿﻣﻼﮐﻢﺴﯿﻧﺎﮔرا ﻊﯾﺎـﺷﺎـﯾﺪﯿﻣﻼﮐ،ﺪـﻨﻟزﻮﯿﻧردهﺪـﺷمﺎــﺠﻧاﻪﻌﻟﺎﻄﻣرد (6).ﺪﻧدﻮﺑ ﻞﻣﺎـﻋﺎـﯾﺪﯿﻣﻼﮐ،ﻪﻟﺎـﺳ 10 ﯽـﺳرﺮﺑﮏﯾﯽﻃﺪﻧﻼﻨﻓردﺎﻣادﻮﺒﻧ %9 لﺎـﺳ 5-9 ﻦﺳردنآعﻮﯿﺷوﺪﺷﯽﻓﺮﻌﻣﺎﻫﯽﻧﻮﻣﻮﻨﭘﻢﻫد تﺎــﻌﻟﺎﻄﻣرد .ﺪﯾدﺮﮔشراﺰﮔ %31 لﺎﺳ 10 زاﺮﺗﻻﺎﺑﻦﺳردو ﯽـﻧﻮﻣﻮﻨﭘﻪﻧﻻﺎـﺳزوﺮـﺑﻪـﮐﺪـﺷهدادنﺎـﺸﻧﻒــﻠﺘﺨﻣﻊﻣاﻮﺟ ﺎﻤـﺳﻼﭘﻮﮑﯾﺎــﻣدرﻮﻣ 1000 رد 5 ﻞﺑﺎﻘﻣرددرﻮﻣ 2/3 ﺎﯾﺪﯿﻣﻼﮐ وﺎــــﯾﺪﯿﻣﻼﮐﺖــﻧﻮﻔﻋﯽــﻫاﺮﻤﻫنارﺎــﻤﯿﺑزا %41 رد .ﺖــﺳا ﻦﯾاﺮﺑﺎــﻨﺑﺪﯿﺳرتﺎﺒﺛاﻪﺑیژﻮﻟوﺮﺳیﺎﻫشورﺎﺑﺎﻤﺳﻼﭘﻮﮑﯾﺎﻣ ﯽـﻧﻮﻣﻮﻨﭘهﺪــﻨﻨﮐدﺎﺠﯾاﻢﻬﻣﺖﻧﻮﻔﻋﺎﯾﺪﯿﻣﻼﮐ،ﻪﺳرﺪﻣﻦﯿﻨﺳرد زاﯽــﺷﺎﻧﺖـــﺒﺜﻣیژﻮﻟوﺮـﺳ (7-10 و1-4).ﺪـﺷﺎﺑﯽﻣنﺎـﮐدﻮﮐرد ﺮﯿــﻏیﺎﻫﺖﻧﻮﻔﻋهﺪﻨﻫدنﺎﺸﻧﻎﻟﺎﺑداﺮﻓازا %30-45 ردﺖﻧﻮﻔﻋ زا %10-20 ﻞﻣﺎــﻋﺎــﯾﺪﯿﻣﻼﮐ .ﺖــﺳانآﺎــﺑﯽﻨﯿﻟﺎـــﺑﺢـﺿاو وﺎﻫﺖﯿـﺸﻧوﺮﺑ %10 ،عﺎـﻤﺘﺟازاﯽــﺷﺎﻧلﺎﮑﯿﭙﯿﺗآیﺎﻫﯽﻧﻮﻣﻮﻨﭘ ﺮﯿـﮔردارﯽﻨـﺳیﺎــﻫهوﺮﮔمﺎﻤﺗوهدﻮﺑﺎﻫﺖﯾﮋﻧرﺎﻓزا %5-10 ﻞــﻣاﻮﻋﺮﯾﺎــﺳﺎــﺑﺎـــﯾﺪﯿﻣﻼﮐزاﯽـﺷﺎﻧﺖـﻧﻮﻔﻋ (4-8).ﺪـﻨﮐﯽﻣ ﯽﻗاﺮﺘـﻓاﺺﯿﺨـﺸﺗﺎﻤـﺳﻼﭘﻮﮑﯾﺎــﻣهﮋﯾوﻪﺑﯽﺴﻔﻨﺗیازیرﺎﻤﯿﺑ (ﯽﯾﺎﯾﺮﺘﮐﺎﺑﺮﯿﻏ)لﺎﮑﯿﭙﯿﺗآهوﺮﮔردنآزاﯽﺷﺎﻧﯽﻧﻮﻣﻮﻨﭘودراد لﺎـﻌﻓوﻢــﺳآهﺪﻨﻨﮐلﺎﻌﻓﻢﻬﻣﻞﻣﺎﻋﺖﻧﻮﻔﻋﻦﯾا .دﺮﯿﮔﯽﻣراﺮﻗ ﮏﯿﺘﺴﯿﮐوﺮﺒﯿﻓیرﺎﻤﯿﺑﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐردﯽﺴﻔﻨﺗﻢﺋﻼﻋهﺪﻨﻨﮐ لﺎـﺳردﺎـﮑﯾﺮﻣآردهﺪـﺷمﺎـﺠﻧاﻪــﻌﻟﺎﻄﻣرد (9 و8 ،7 ،3 ،2).ﺖﺳا وﺎﯾﺪﯿﻣﻼﮐزاﯽﺷﺎﻧ،ﮏﯿﭙﯿﺗآیﺎﻫﯽﻧﻮﻣﻮﻨﭘدراﻮﻣ %1 ﺰﯿﻧ 1999 (6) .ﺪﺷﺮﮐذﺎﻤﺳﻼﭘﻮﮑﯾﺎﻣ %15 شﻮـﮔﻊﯾﺎـﻣزاﺎـﯾﺪﻣﺖـﯿﺗواﻪــﺑﻼﺘﺒﻣنﺎﮐدﻮﮐردﺎﯾﺪﯿﻣﻼﮐ لﺎــﯾﺮﺘﮐﺎﺑﺖﻧﻮﻔﻋﺎﺑهاﺮﻤﻫﺐﻠﻏاﻪﮐﺖﺳانﺪﺷاﺪﺟﻞﺑﺎﻗﯽﻧﺎﯿﻣ ردلﺎﺳ 1 ﺎﺗﺪﻧاﻮﺗﯽﻣنآﺎﺑﺖﻣﻼﻋنوﺪﺑﯽﺴﻔﻨﺗﺖﻧﻮﻔﻋ .ﺖﺳا (1-4) .ﺪﺑﺎﯾﻪﻣادانﺎﮐدﻮﮐوﻎﻟﺎﺑداﺮﻓا %2-5 ﺮﯾﺎــﺳزاﯽﻨﯿﻟﺎﺑﻢﺋﻼﻋسﺎﺳاﺮﺑﺎﯾﺪﯿﻣﻼﮐﯽﻧﻮﻣﻮﻨﭘﺺﯿﺨﺸﺗ ﺺﯿﺨــﺸﺗیاﺮﺑهارﻦﯾﺮﺗﻖﯿﻗدو (1-4)هدﻮﺑﻞﮑﺸﻣﯽﻧﻮﻣﻮﻨﭘﻞﻠﻋ رﺎﯿـﺴﺑوﻪﺘـﺷادﯽﺻﺎـﺼﺘﺧاﻂـﯿﺤﻣﻪـﺑزﺎــﯿﻧﻪﮐﺖﺳاﺖﺸﮐ ﺖـﺳاﺲﮑﻧرﺎــﻓوزﺎﻧﺖﺸﮐیاﺮﺑﻞﺤﻣﻦﯾﺮﺘﻬﺑ .ﺪﺷﺎﺑﯽﻣﻞﮑﺸﻣ ناﻮــﺗﯽﻣﺰﯿﻧرﻮﻠﭘﻊﯾﺎﻣوژاوﻻرﻻﻮﺋﻮﻟآ،ﻂﻠﺧتﺎﺤﺷﺮﺗزاﺎﻣا (1-4) .دﻮﻤﻧاﺪﺟارﻢﺴﯿﻧﺎﮔرا سﺎﺴﺣﺮﯿﻏاﺰﯿﻟاﺎﯾﺲﻧﺎﺳرﻮﻠﻓﻮﻧﻮﻤﯾاﻂﺳﻮﺗنژﯽﺘﻧآﻦﯿﯿﻌﺗ زاهدﺎﻔﺘـﺳاﺎــﺑیژﻮﻟوﺮﺳیﺎﻫشورﻂﺳﻮﺗﺺﯿﺨﺸﺗوهدﻮﺑ مﺎــﺠﻧاﺲﻧﺎــﺳرﻮﻠﻓﻮﻧﻮﻤﯾاوﺮﮑﯿﻣﺎـــﯾنﺎـﻤﻠﭙﻣﺎﮐندﺮـﮐﺖﺑﺎـﺛ رآﯽــﺳﯽﭘشورزاهدﺎﻔﺘــﺳاﺎـــﺑﺰﯿـﻧًاﺮﯿـﺧاو (2-6).دﻮـﺷﯽﻣ ﺎــﯾﻦﯿﺴﯾﺎﻣوﺮﺘﯾراﺰﯾﻮﺠﺗﺎﺑنﺎﻣرد (11 و10 ،6 ،5).دﺮﯿﮔﯽﻣترﻮﺻ ﻞﻣﺎـﮐﯽﻨﮐﻪـﺸﯾریاﺮـﺑﻪـﺘﻔﻫ 2 زاﺶـﯿﺑتﺪــﻣﻪﺑﻦﯿﻠﮑﯿﺳاﺮﺘﺗ ،ﻦﯿــﺴﯾﺎﻣوﺮﺘﯾزآزاهدﺎﻔﺘـﺳاﺎـﻣادﻮـﺷﯽﻣدﺎﻬﻨـﺸﯿﭘبوﺮـﮑﯿﻣ 5-10)ﺮﺗهﺎﺗﻮﮐتﺪﻣﻪﺑ (ﺪﯾﺪﺟیﺎﻫﺪﯿﻟوﺮﮐﺎﻣ) ﻦﯿﺴﯾﺎﻣوﺮﺘﯾرﻼﮐ ﻪــﺑﻞﻣﺎﮐرﻮﻃﻪﺑﻢﺴﯿﻧﺎﮔراوﺮﮑﯿﻣﻦﯾا .ﺪﺷﺎﺑﯽﻣﺮﺛﻮﻣﺰﯿﻧ (زور ﻦـــﯿﯿﻌﺗﻪـﻌﻟﺎﻄﻣﻦـﯾازافﺪـﻫ (1-4).ﺖـﺳاموﺎـﻘﻣﺎﻫﺪﯿﻣﺎﻔﻟﻮـﺳ ردﺎـﯾﺪﯿﻣﻼﮐﺖـﻧﻮﻔﻋﻪـﺑﯽـﻠﺒﻗیﻼـﺘﺑاودﺎــﺣﺖﻧﻮﻔﻋﯽﻧاواﺮﻓ ﻦـﺳﻂـﺳﻮﺘﻣﻦــﯿﯿﻌﺗﺎﺑ .ﺖﺳاهدﻮﺑﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐ ارﺎـﯾﺪﯿﻣﻼﮐﯽـﻧﻮﻣﻮﻨﭘﯽﻧﺎـﻣردﻂـﺧناﻮـﺗﯽﻣﺖــﻧﻮﻔﻋﻪﺑﻼﺘﺑا ﻪـﺑﺖـﻧﻮﻔﻋﻦـﯾاﻪـﮐﺎـﺟنآزا .دﻮـﻤﻧﺺﺨــﺸﻣﻦﺳﺐﺴﺣﺮﺑ ﻪـﺑاﺪـﺘﺑاردوهدﻮـﺑموﺎـﻘﻣﯽــﺑﺮﺠﺗﯽﮑﯿﺗﻮﯿﺑﯽﺘﻧآیﺎﻫنﺎﻣرد لﺮﺘـﻨﮐ،ﺪﻫدﯽﻣﺦﺳﺎﭘﯽﺑﻮﺧﻪﺑﻦﯿﺴﯾﺎﻣوﺮﺘﯾراﯽﮐارﻮﺧنﺎﻣرد دراﻮــﻣداﺪـﻌﺗﺎﻬـﻨﺗﻪـﻧﺐـﺳﺎﻨﻣﮏـﯿﺗﻮﯿﺑﯽﺘﻧآﺎـﺑﺖـﻧﻮﻔﻋﻦـﯾا ﺐﺒﺳﻪﮑﻠﺑﺪﻫدﯽﻣﺶﻫﺎﮐارنآیﻮﯾرﺮﯿﻏضراﻮﻋوﯽﻧﻮﻣﻮﻨﭘ دراﻮــﻣﺶﻫﺎﮐوﻢﺋﻼﻋنﺪﺷﻒﯿﻔﺧ،ﻢﺳآتﻼﻤﺣزوﺮﺑﺶﻫﺎﮐ .ﺪﺷﺪﻫاﻮﺧﺪﻌﺘﺴﻣداﺮﻓاردیﺮﺘﺴﺑ
ﯽﺳرﺮﺑشور یور 1382 لﺎــﺳﯽـــﻃردیﺪﻫﺎـﺷـدرﻮـﻣﻪـﻌﻟﺎﻄﻣﻦـﯾا ﮏــﺷﺰﭘﻂﺳﻮﺗﯽﻧﻮﻣﻮﻨﭘﺺﯿﺨﺸﺗﺎﺑﻪﮐلﺎﺳ 14 ﺮﯾزنﺎﮐدﻮﮐ یﺮﺘـﺴﺑ (ص)مﺮﮐالﻮﺳرنﺎﺘﺳرﺎﻤﯿﺑنﺎﮐدﻮﮐﺶﺨﺑردﺞﻟﺎﻌﻣ .ﺪﯾدﺮﮔمﺎﺠﻧا،ﺪﻧدﻮﺑهﺪﺷ ﺺــﺼﺨﺘﻣﮏﺷﺰﭘﻂﺳﻮﺗﯽﻧﻮﻣﻮﻨﭘﻪﮐﯽﻧﺎﮐدﻮﮐمﺎﻤﺗیاﺮﺑ ودﻮـﺑهﺪـﺷهدادﺺﯿﺨـﺸﺗﻪـﯾرﻊﻤـﺳوﯽﻨﯿﻟﺎــﺑﻪﻨﯾﺎﻌﻣﺎﺑو نﺪـﺷمﺎــﺠﻧازاﺲﭘﻪﮐﯽﻧارﺎﻤﯿﺑ .ﺪﯾدﺮﮔﻞﯿﻤﮑﺗیاﻪﻣﺎﻧﺶﺳﺮﭘ ﯽـﻧﻮﻣﻮﻨﭘﺺﯿﺨـﺸﺗﺎﻫﯽـﺳرﺮﺑﺮﯾﺎـﺳولﺎــﯾﺮﺘﮐﺎﺑیﺎﻫﺖﺸﮐ بﺎـﺨﺘﻧارﺎـﻤﯿﺑهوﺮـﮔناﻮـﻨﻋﻪــﺑدﻮﺑهﺪﺷﻪﺘﺷاﺬﮔﺎﻫنآیاﺮﺑ .ﺪﻧﺪﺷ یﺎـﻫﺶﺨﺑردیﺮﺘـﺴﺑنارﺎــﻤﯿﺑزاﺰﯿﻧﻢﻟﺎﺳوﺪﻫﺎﺷهوﺮﮔ بﺎـﺨﺘﻧا،ﺪـﻧدﻮﺑنﺎـﺴﮑﯾنارﺎـﻤﯿﺑﺎـﺑﯽﻨــﺳﺮﻈﻧزاﻪﮐﯽﺣاﺮﺟ لﻮـﻤﻌﻣرﻮـﻃﻪﺑﻪﮐﯽﻧﻮﺧهﺪﻧﺎﻣﯽﻗﺎﺑزانارﺎﻤﯿﺑﻦﯾارد .ﺪﻧﺪﺷ نﻮـﺧیﺎـﻫزﺎﮔﺎــﯾﯽﻤﯿﺷﻮﯿﺑیﺎﻫﺶﯾﺎﻣزآونﻮﺧﺖﺸﮐﺖﻬﺟ ژﻮﻔﯾﺮﺘﻧﺎــﺳزاﺲﭘنﻮــﺧ .ﺪــﯾدﺮﮔﯽﻣهدﺎﻔﺘﺳا،ﺪﺷﯽﻣﻪﺘﻓﺮﮔ ﻞـﻘﺘﻨﻣمﺮـﮐالﻮـــﺳرنﺎﺘـﺳرﺎﻤﯿﺑﯽــــﺗﺎﻘﯿﻘﺤﺗهﺎﮕﺸﯾﺎﻣزآﻪﺑ یرادﻪــﮕﻧداﺮـــﮔﯽﺘﻧﺎــﺳﻪــــﺟرد -20 رﺰـــﯾﺮﻓردوهﺪـﺷ نآیوریژﻮﻟوﺮـﺳیﺎـﻫﺶﯾﺎﻣزآﻪـﮐﯽﻧﺎـﻣزﺎـﺗﺪـــﯾدﺮﮔﯽﻣ .دﺮﯿﮔترﻮﺻ یاﺮـــﺑﻪــﮐنﻮــﺧهﺪﻧﺎــﻣﯽﻗﺎﺑزاﺰﯿــﻧﺪﻫﺎــﺷهوﺮــﮔرد رد .ﺪـﯾدﺮﮔهدﺎﻔﺘــﺳا،دﻮﺑهﺪﺷﻪﺘﻓﺮﮔﻞﻤﻋزاﻞﺒﻗیﺎﻫﺶﯾﺎﻣزآ یدﺎــﺑﯽﺘﻧآ،اﺰﯿﻟاشورﻪﺑﺪﻫﺎﺷورﺎﻤﯿﺑهوﺮﮔنﻮﺧیﺎﻫﻪﻧﻮﻤﻧ زاﺪـﻌﺑ .ﺪـﺷیﺮﯿـﮔهزاﺪــﻧا (IgM&IgG)ﺎﯾﺪﯿﻣﻼﮐﯽﺻﺎﺼﺘﺧا ﺖـﻧﻮﻔﻋﻪـﺑﻼـﺘﺑادراﻮــﻣ،یژﻮﻟوﺮﺳیﺎﻫﺶﯾﺎﻣزآنﺪﺷمﺎﺠﻧا راﺰــﻓامﺮﻧزاهدﺎﻔﺘﺳاﺎﺑوﺪﯾدﺮﮔﺺﺨﺸﻣﺎﯾﺪﯿﻣﻼﮐﯽﻠﺒﻗودﺎﺣ ﺖﻬﺟ .ﺖﻓﺮﮔترﻮﺻتﺎﻋﻼﻃایرﺎﻣآﻞﯿﻠﺤﺗوﻪﯾﺰﺠﺗSPSS9 هدﺎﻔﺘــﺳارﺎﯿﻌﻣفاﺮﺤﻧاوﻦﯿﮕﻧﺎﯿﻣﺺﺧﺎﺷزاﯽﻤﮐیﺎﻫﺮﯿﻐﺘﻣ .ﺪﯾدﺮﮔﻪﺴﯾﺎﻘﻣP<0/05 ﺎﺑوﺪﺷ ﺞﯾﺎﺘﻧ ﻪـﺘﻓﺮﯾﺬﭘﯽـﻧﻮﻣﻮﻨﭘﺺﯿﺨــﺸﺗﺎﺑرﺎﻤﯿﺑ 135 ﻪﻌﻟﺎﻄﻣﻦﯾاﯽﻃ 101 رد،ﯽﺼﯿﺨــﺸﺗیﺎﻫﺶﯾﺎﻣزآنﺪﺷمﺎﺠﻧازاﺪﻌﺑﻪﮐﺪﻧﺪﺷ ﺪﻧدﻮﺑیرﺎﻤﯿﺑﻞﻣﺎﻋ (ﯽﯾﺎﯾﺪﯿﻣﻼﮐﺮﯿﻏ)ﯽﻧﻮﻔﻋﻞﻣاﻮﻋﺮﯾﺎﺳرﺎﻤﯿﺑ دراوﻪـﮐهﺪﻧﺎـﻣﯽﻗﺎﺑرﺎــﻤﯿﺑ 35 زا .ﺪﻧﺪﯾدﺮﮔفﺬﺣﻪﻌﻟﺎﻄﻣزاو نﻮـﺧنﺪــﺷﺰﯿﻟﺎﯾندﻮﺑﯽﻓﺎﮐﺎﻧﺖﻠﻋﻪﺑدرﻮﻣ 2 ،ﺪﻧﺪﺷﻪﻌﻟﺎﻄﻣ ﺖﯾﺎـﺿرمﺪـﻋﺖـﻠﻋﻪـﺑﻪـﮐﺪﻨﺘــﺷاددﺪﺠﻣیﺮﯿﮔنﻮﺧﻪﺑزﺎﯿﻧ ﺖﻧﻮﻔﻋﺺﯿﺨﺸﺗﺖﻬﺟﺮﮕﯾدرﺎﻤﯿﺑ 33 یاﺮﺑ .ﺪﺸﻧمﺎﺠﻧاﻦﯾﺪﻟاو کدﻮــﮐ 40 وﺖﻓﺮﮔترﻮﺻﮏﯾژﻮﻟوﺮﺳیﺎﻫﺖﺴﺗﯽﯾﺎﯾﺪﯿﻣﻼﮐ ردوﺪﻧﺪـﺷﻪـﺘﻓﺮﮔﺮـﻈﻧردﺪﻫﺎـﺷهوﺮــﮔناﻮﻨﻋﻪﺑﺰﯿﻧﻢﻟﺎﺳ 1 هرﺎﻤﺷلوﺪﺟ .ﺪﻨﺘﻓﺮﮔراﺮﻗﯽﺳرﺮﺑدرﻮﻣکدﻮﮐ 73 عﻮﻤﺠﻣ نﺎـﮐدﻮﮐردارﻦـﺳﺐـﺴﺣﺮﺑﯽﺒـﺴﻧوﻖــﻠﻄﻣﯽﻧاواﺮﻓﻊﯾزﻮﺗ .ﺪﻫدﯽﻣنﺎﺸﻧﯽﺳرﺮﺑدرﻮﻣ و 14/50 ﻪـــﻨﻣادﺎـﺑلﺎـﺳ 14 ﺎـﺗهﺎـﻣ 5 ﻦـﯿﺑنارﺎـﻤﯿﺑﻦﺳ درﻮـﻣهوﺮـﮔردﻦــﺳﻂﺳﻮﺘﻣودﻮﺑلﺎﺳ 3/7±3/87 ﻦﯿﮕﻧﺎﯿﻣ زا %48/6 وﺪـﻣآﺖـﺳدﻪـﺑلﺎــﺳ 4/6 ﺪﻫﺎﺷهوﺮﮔردو 2/69 .ﺪﻧدﻮﺑﺮﺘﺧد %51/4 وﺮﺴﭘنارﺎﻤﯿﺑ ردﻦﺳﺐﺴﺣﺮﺑﯽﺒﺴﻧوﻖﻠﻄﻣﯽﻧاواﺮﻓﻊﯾزﻮﺗ -1 هرﺎﻤﺷلوﺪﺟ رد (ص)مﺮﮐالﻮﺳرنﺎﺘﺳرﺎﻤﯿﺑنﺎﮐدﻮﮐﺶﺨﺑردهﺪﺷیﺮﺘﺴﺑنﺎﮐدﻮﮐ 1382 لﺎﺳ کدﻮﮐﻦﺳ ﯽﻧاواﺮﻓ ﺪﺻرد لﺎﺳ 1 ﺮﯾز 22 35/5 لﺎﺳ 3 ﺎﺗ 2 19 30/6 لﺎﺳ 5 ﺎﺗ 4 4 6/5 لﺎﺳ 5 زاﺮﺗﻻﺎﺑ 17 27/4 ﻊﻤﺟ 73 100 Missing=11case %48 ردChlamydia-IgMﯽﺻﺎــﺼﺘﺧایژﻮﻟوﺮﺳﺖﺴﺗ Chlamydia-IgMﺖـﺴﺗ .دﻮـﺑﯽــﻔﻨﻣ %52 ردوﺖﺒﺜﻣدراﻮﻣ ﺪﻣآﺖﺳدﻪﺑ %20 ﺪﻫﺎﺷهوﺮﮔردو %57 رﺎﻤﯿﺑهوﺮﮔردﺖﺒﺜﻣ وﯽـﻧﻮﻣﻮﻨﭘﻪـﺑﻼـﺘﺒﻣهوﺮــﮔﻦﯿﺑتوﺎﻔﺗﻦﯾایرﺎﻣآﺮﻈﻧزاﻪﮐ نﺪــﺷﺖـﺒﺜﻣ .(P=0/001)ﺖـﺳاهدﻮـﺑرادﯽـﻨﻌﻣﺪﻫﺎـﺷهوﺮـﮔ هوﺮــﮔرد،ﯽﯾﺎـــﯾﺪﯿﻣﻼﮐدﺎـﺣﺖـﻧﻮﻔﻋردChlamydia-IgM ﻦــﺳرد،%21 لﺎﺳ 1 ﺮﯾزﯽﻨﺳهدوﺪﺤﻣردﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣ زاﺮﺗﻻﺎـﺑﻦــﺳردو %8 لﺎﺳ 5 ﺎﺗ 4 ﻦﺳرد،%40 لﺎﺳ 3 ﺎﺗ 2 توﺎﻔﺗﻒﻠﺘﺨﻣﯽﻨﺳیﺎﻫهوﺮﮔردﺎﻣاﺪﺷهﺪﻫﺎﺸﻣ %26 لﺎﺳ 5 دﺎـﺣﺖــﻧﻮﻔﻋﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐردﻦﺳﻦﯿﮕﻧﺎﯿﻣ .دﻮﺒﻧرادﯽﻨﻌﻣ هوﺮــﮔردولﺎﺳ 3/76 (ﺖﺒﺜﻣChlamydia-IgM)ﯽﯾﺎﯾﺪﯿﻣﻼﮐ
توﺎــﻔﺗﻪـــﻄﺑارﻦـــﯾاردﻪـــﮐدﻮـــــﺑلﺎـﺳ 3/62 ﺪـــﻫﺎﺷ ﺎـﯾﺪﯿﻣﻼﮐﺖـﻧﻮﻔﻋﻪـﺑﯽـﻠﺒﻗیﻼـﺘﺑا .ﺖــﺷاﺪﻧدﻮﺟویرادﯽﻨﻌﻣ ﺮﯾﺎـــﺳردوﺖــﺒﺜﻣدراﻮــﻣ %27/4 رد (Chlamydia-IgM) 2 ﻦﺳرد،%40 لﺎﺳ 1 ﺮﯾزﯽﻨﺳهدوﺪﺤﻣرد .دﻮﺑﯽﻔﻨﻣدراﻮﻣ لﺎــﺳ 5 زاﺮﺗﻻﺎﺑﻦﺳو %5 لﺎﺳ 5 ﺎﺗ 4 ﻦﺳرد،%5 لﺎﺳ 3 ﺎﺗ ﯽـﻨﻤﯾا)Chlamydia-IgGنﺪـﺷﺖــﺒﺜﻣﻦﯿﺑ .ﺪﻧدﻮﺑﺖﺒﺜﻣ %50 یرادﯽـﻨﻌﻣﻪـﻄﺑارﻒــﻠﺘﺨﻣﯽﻨﺳیﺎﻫهوﺮﮔو (ﺖﻧﻮﻔﻋﻪﺑﯽﻠﺒﻗ .(P=0/07)ﺪﺸﻧهﺪﻫﺎﺸﻣ هوﺮـﮔ 2 ﻦـﯿﺑ (ﺖـﺒﺜﻣIgG)ﺎــﯾﺪﯿﻣﻼﮐﺖﻧﻮﻔﻋﻪﺑﯽﻠﺒﻗیﻼﺘﺑا .ﺖـــﺷاﺪﻧیرادﯽـﻨﻌﻣتوﺎـﻔﺗیرﺎـﻣآﺮـﻈﻧزاﺪﻫﺎـﺷورﺎـﻤﯿﺑ ﺖـــﺒﺜﻣChlamydia-IgGهوﺮــﮔ 2 ﻦﯿﺑﯽﻨﺳﻦﯿﮕﻧﺎﯿﻣتوﺎﻔﺗ نﺪـــﺷﺖـﺒﺜﻣﻦـﯿﺑودﻮـﺒﻧرادﯽـﻨﻌﻣیرﺎـﻣآﺮـﻈﻧزاﯽـﻔﻨﻣو دﻮــﺟویرادﯽﻨﻌﻣﻪﻄﺑارنارﺎﻤﯿﺑﺲﻨﺟﺎﺑChlamydia-IgM .ﺖﺷاﺪﻧ ﺚﺤﺑ ﺖــﻧﻮﻔﻋزاﯽﺷﺎﻧیژﻮﻟوﺮﺳنﺪﺷﺖﺒﺜﻣتﺎﻌﻟﺎﻄﻣﺮﯾﺎﺳرد (1-4) .ﺖـﺳاهﺪـﺷﺮـﮐذﻎﻟﺎـﺑداﺮـﻓارد %30-45 ،ﺎــﯾﺪﯿﻣﻼﮐﯽﻠﺒﻗ ﻞــﮐزا %27/4 رد (Chlymidia-IgG)ﯽﯾﺎﯾﺪﯿﻣﻼﮐﯽﻠﺒﻗﺖﻧﻮﻔﻋ ﺮﯾزﻦﺳرد .دﻮﺑﺖﺒﺜﻣ (ﺪﻫﺎﺷودرﻮﻣ)ﺮﺿﺎﺣﻪﻌﻟﺎﻄﻣنﺎﮐدﻮﮐ ﺪـﻧاﻮﺗﯽﻣﻪــﮐﺪﻧدﻮﺑیدﺎﺑﯽﺘﻧآیارادناراﻮﺧﺮﯿﺷ %40 لﺎﺳ 1 ﺮﺗﻻﺎـﺑﻦــﺳردﺎﻣاﺪﺷﺎﺑردﺎﻣزاﺖﻔﺟﻖﯾﺮﻃزالﺎﻘﺘﻧاﺖﻠﻋﻪﺑ ﻪﮐﺪﻧدﻮﺑهﺪﺷﻼﺘﺒﻣﺖﻧﻮﻔﻋﻦﯾاﻪﺑًﻼﺒﻗنﺎﮐدﻮﮐ %50 لﺎﺳ 5 زا (1-3) .ﺖﺳﺎﻫرﻮﺸﮐﺮﯾﺎﺳرﺎﻣآزاﺶﯿﺑ نﺪــﺷﺖــﺒﺜﻣ)ﯽﯾﺎـــﯾﺪﯿﻣﻼﮐدﺎـﺣﺖـﻧﻮﻔﻋﻪـﻌﻟﺎﻄﻣﻦـﯾارد هوﺮــﮔودﺮـــﻫ)نﺎـﮐدﻮﮐﻞـﮐزا %48 رد (Chlymidia-IgM زا %57 رد .ﺖــﺷاددﻮـــﺟوﯽـﺳرﺮﺑدرﻮـﻣ (ﺪﻫﺎـﺷورﺎـﻤﯿﺑ ﻪﺑﻪﮐﺪﺷهﺪﯾدﺎﯾﺪﯿﻣﻼﮐدﺎﺣیﻼﺘﺑا،ﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐ ﻦﯿﮕﻧﺎــﯿﻣ .(P<0/001)دﻮﺑﺪﻫﺎﺷهوﺮﮔزاﺶﯿﺑیرادﯽﻨﻌﻣرﻮﻃ دﺎــــﺣﺖـــﻧﻮﻔﻋﻪـــﺑﻼـــﺘﺒﻣهوﺮـــﮔردنارﺎـــﻤﯿﺑﯽﻨـــﺳ ﺖـﺳدﻪـﺑلﺎـﺳ 3/76 (ﺖــﺒﺜﻣChlymidia-IgM)ﯽﯾﺎﯾﺪﯿﻣﻼﮐ ﺮــﯾزﯽﻨﺳهوﺮﮔردﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐعﻮﻤﺠﻣرد .ﺪﻣآ ارﯽﯾﺎـﯾﺪﯿﻣﻼﮐدﺎـﺣﺖـﻧﻮﻔﻋﻪـﺑﻼــﺘﺑاناﺰﯿﻣﻦﯾﺮﺗﺶﯿﺑلﺎﺳ 3 توﺎــﻔﺗﻒﻠﺘﺨﻣﯽﻨﺳیﺎﻫهوﺮﮔردﻼﺘﺑاناﺰﯿﻣﻪﭼﺮﮔا .ﺪﻨﺘﺷاد ﯽﮕﻟﺎـﺳ 3 دوﺪـﺣردًﻻﺎــﻤﺘﺣاﻪﮐﺖﻔﮔناﻮﺗﯽﻣ،ﺖﺷاﺪﻧﯽﻧاﺪﻨﭼ ﯽﯾﺎــﯾﺪﯿﻣﻼﮐدﺎﺣﺖﻧﻮﻔﻋﻪﺑﻼﺘﺒﻣ (%48 دوﺪﺣ)نﺎﮐدﻮﮐزاﯽﻤﯿﻧ .ﺪﺷﺎﺑﯽﻧﻮﻣﻮﻨﭘﻢﺋﻼﻋزوﺮﺑنوﺪﺑﺎﯾﺎﺑﺪﻧاﻮﺗﯽﻣﻪﮐﺪﻧدﻮﺑهﺪﺷ هﺪـﺷﻼــﺘﺒﻣﺖﻧﻮﻔﻋﻪﺑنﺎﮐدﻮﮐ %50 ،لﺎﺳ 5 ﻦﺳﻪﺑنﺪﯿﺳرﺎﺗ نﺪـﺷﺖــﺒﺜﻣ .ﺪﻧﻮﺷﯽﻣChlymidia-IgMیدﺎﺑﯽﺘﻧآیارادو .ﺪﺷﺎﺑﯽﻣنﺎﺴﮑﯾﺲﻨﺟودﺮﻫردChlymidia-IgM Chlymidia-IgG)ﯽﯾﺎــﯾﺪﯿﻣﻼﮐﺖـــﻧﻮﻔﻋﻪـﺑﯽـﻠﺒﻗیﻼـﺘﺑا ﺖـﺷاددﻮــﺟوﯽﺳرﺮﺑدرﻮﻣنﺎﮐدﻮﮐﻞﮐزا %27/4 رد (ﺖﺒﺜﻣ .ﺖــﺷاﺪﻧدﻮﺟوﯽﺤﺿاوتوﺎﻔﺗﺪﻫﺎﺷورﺎﻤﯿﺑهوﺮﮔ 2 ﻦﯿﺑﺎﻣا لﺎـﺳ 14 ﺮـﯾزنﺎـﮐدﻮﮐ %20 ﻪـﮐدادنﺎــﺸﻧﻪﻌﻟﺎﻄﻣﻦﯾاﺞﯾﺎﺘﻧ دﺎـﺣﺖـﻧﻮﻔﻋﻪـﺑﻼـﺘﺒﻣ،عﺎـﻤﺘﺟازاﯽـﺷﺎﻧﯽـﻧﻮﻣﻮﻨﭘﻪــﺑﻼﺘﺒﻣ ردهﺪـﺷﺮـﮐذناﺰﯿـﻣﺎـﺑﻪــﺴﯾﺎﻘﻣردﻪﮐﺪﻨﺷﺎﺑﯽﻣﯽﯾﺎﯾﺪﯿﻣﻼﮐ ناﺰﯿـﻣ .ﺖـﺳاﺮــﺗﺶﯿﺑ،(لﺎﺳ 3-14)%14 ﯽﻨﻌﯾتﺎﻌﻟﺎﻄﻣﺮﯾﺎﺳ و %15 لﺎـﺳ 6 ﺮـﯾزﻦـﺳردﯽــﻠﺒﻗتﺎﻌﻟﺎﻄﻣردﺖﻧﻮﻔﻋعﻮﯿﺷ (6-11 و1-4) .ﺖﺳاهﺪﺷﺮﮐذ %18 لﺎﺳ 6 زاﺮﺗﻻﺎﺑﻦﺳ ﻪﻟﺎـﺳ 3-5 نﺎـﮐدﻮﮐردﯽـﺘﺣهﺪــﺷﺮﮐذﺐﻟﺎﻄﻣﻪﺑﻪﺟﻮﺗﺎﺑ ﯽﺴﻔﻨﺗﺖﻧﻮﻔﻋاﺮﯾزدﻮﺑﺎﯾﺪﯿﻣﻼﮐﺮﮑﻓﻪﺑﺪﯾﺎﺑﯽﻧﻮﻣﻮﻨﭘﻪﺑﻼﺘﺒﻣ وﻎﻟﺎـﺑداﺮـﻓا %2-5 ردلﺎــﺳ 1 ﺎﺗﺪﻧاﻮﺗﯽﻣنآﺎﺑﺖﻣﻼﻋنوﺪﺑ ﺎﻫیﺮﺘﮐﺎﺑﺎﺑهاﺮﻤﻫﺖﻧﻮﻔﻋﻪﮐﺎﺟنآزا (2-4).ﺪﺑﺎﯾﻪﻣادانﺎﮐدﻮﮐ ﯽـﻧﻮﻣﻮﻨﭘﺦـﺳﺎﭘمﺪـﻋترﻮــﺻرد (1-4).ﺖﺳاهﺪﺷشراﺰﮔﺰﯿﻧ ﺮـﺑﺮـﺛﻮﻣیﺎـﻫﮏﯿﺗﻮﯿﺑﯽﺘﻧآزا،لﻮـﻤﻌﻣیﺎـﻫورادﻪــﺑنﺎﮐدﻮﮐ ﺎـﯾﻦﯿــﺴﯾﺎﻣوﺮﺘﯾراﺪﻨﻧﺎﻣرﺎﻤﯿﺑﻦﺳﺎﺑﺐﺳﺎﻨﻣﺎﯾﺪﯿﻣﻼﮐﺖﻧﻮﻔﻋ ﺎـﯾﻦﯿـﺴﯾﺎﻣوﺮﺘﯾزآﺪﻨﻧﺎـﻣﺪـﯾﺪﺟیﺎــﻫﺪﯿﻟوﺮﮐﺎﻣﺎﯾﻦﯿﻠﮑﯿﺳاﺮﺘﺗ .دﻮﻤﻧهدﺎﻔﺘﺳاناﻮﺗﯽﻣﻦﯿﺴﯾﺎﻣوﺮﺘﯾرﻼﮐ ﻊﺑﺎﻨﻣ 1- Campbell AG, Mcintosh Neil. Forfear textbook of pediatrics. 5th ed. Philadelphia, Newyork: WB saunders, Churchil Livingston; 1998. P. 196, 564, 1431-2.
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Comparative Study of Chlamydia Pneumonia(IgM&IgG) Frequency in
under 14-Year Old Children with Pneumonia and in Unaffected
Children Hospitalized in Pediatric Ward
I II III
*S. Noorbakhsh, MD N. Javaher Tarash, MD Sh. Rimaz, Ph.D.
IV V
M. Rezaei, MD A. Tabatabaei, MSc
Abstract
Chlamydia pneumonia is a common cause of lower respiratory tract infection and causes about 10-20% of community acquired pneumonia. It is seen in any age group and reactivates the asthma, so it needs specific treatment. Chlamydia pneumonia hardly grows in culture; therefore, serologic diagnosis is used. The goal of the present study was to determine the frequency of acute and previous infection of chlamydia pneumonia and the mean age of infection in under 14-year-old children with pneumonia. Successful treatment of these patients with erythromycin and other macrolides not only decreases the rate of pneumonia in children but also dramatically decreases the asthmatic attacks in predisposed children and hospital admission. This case-control study was conducted on 73 children aged under 14 years(35 case and 28 control). For detection of specific IgM & IgG in serum enzyme, linked immunoassay was used. Mean age of children was 3.87±3.7 years (48.6% male; 51.4% female). Acute infection (IgM) was positive in 48% of all children and 57% of children with pneumonia. The highest rate was seen in 2-3 age group (40%) with mean age of 3.7. Previous infection (IgG) detected in 27.4% of all children with highest rate (50%) was in over 5-year-old age group. Acute chlamydia infection (IgM) was significantly higher in case group (P>0.001), but no significant difference in previous infection was seen between case and control groups. In conclusion, acute C. pneumonia infection (IgM) is seen in 50% of the 3-year-old children population either with or without pneumonia. Additionally, treatment with oral erythromycin is a successful way to decrease the rate of pneumonia, asthmatic attacks in predisposed children and hospital admission. All of the children would be seropositive (IgG positive) up to the age of 5.
Key Words: 1) Chlamydia Antibody 2) Pneumonia
3) Atypical Pneumonia 4) Chlamydial Pneumonia
This article is a summary of the thesis by M. Rezaei, MD for the degree of specialty in Pediatrics under supervision of N. Javaher Tarash, MD and consultation with S. Nourbakhsh, MD and A. Tabatabaei, MSc (2002-2003).
I) Assistant Professor of Pediatric Infectious Diseases. Hazrat Rasoul-e-Akram Hospital, Sattarkhan
St., Niayesh Ave., Iran University of Medical Sciences and Health Services. Tehran, Iran. (*Corresponding Author)
II) Associate Professor of Pediatric Immunology. Hazrat Rasoul-e-Akram Hospital. Iran University of
Medical Sciences and Health Services. Tehran, Iran.
III) Assistant Professor of Epidemiology. Iran University of Medical Sciences and Health Services.
Tehran, Iran.
IV) Resident of Pediatrics. Iran University of Medical Sciences and Health Services. Tehran, Iran.
V) MSc in Laboratory Sciences. Instructor. Iran University of Medical Sciences and Health Services.
