ﭘﮋوﻫﺸ ﻲ اﻧﺠﻤﻦ ﻋﻠﻤ ﻲ ﭘﺮﺳﺘﺎر ي ﻳا ﺮان دوره ﭼﻬﺎرم - ﺷﻤﺎره ( 1 ﭘﻴﺎﭘﻲ -)

(1)

(2)

دﺮﺧ و نﺎﺟ ﺪﻧواﺪﺧ مﺎﻧ ﻪﺑ

ﻪﻠﺠﻣ شزﻮﻣآ رﺎﺘﺳﺮﭘ

ي

ﻤﻠﻋ ﻪﻣﺎﻨﻠﺼﻓ ﻲ

- ﺸﻫوﮋﭘ ﻲ ﻤﻠﻋ ﻦﻤﺠﻧا ﻲ

رﺎﺘﺳﺮﭘ ي اﻳ ناﺮ

هرود مرﺎﻬﭼ -

هرﺎﻤﺷ 1 ) ﻲﭘﺎﻴﭘ 11 ( - رﺎﻬﺑ 1394

ﺘﻣا ﺐﺣﺎﺻ• ﻴ

زﺎ ﻤﻠﻋ ﻦﻤﺠﻧا: ﻲ

رﺎﺘﺳﺮﭘ ي اﻳ ناﺮ

ﺪﻣ• ﻳ ﺴﻣ ﺮ ﺆ لو ﺮﺘﻛد : ﻲﻧﺎﺤﻟا ﻪﻤﻃﺎﻓ

ﺑدﺮﺳ• ﻴ ﺮ ﻛد: ﺮﺘ يدﺎﺒﻋ سﺎﺒﻋ

ﺪﻣ• ﻳ ﺮ ﻲﻳاﺮﺟا ﺮﺘﻛد: رذآ ﻞﻃ

رﺎﺸﺘﻧا ﻪﻧاوﺮﭘ هرﺎﻤﺷ• ﻲﻣﻼﺳا دﺎﺷرا ترازو

4823 : / 94 خرﻮﻣ 20 / 2 / 91

هرﺎﻤﺷ• ﻦﻴﺑ دراﺪﻧﺎﺘﺳا ﻲﻠﻠﻤﻟا

2322: - 3812

ﺑ هرﺎﻤﺷ• ﻴ ﻦ ﺮﺸﻧ ﻲﻠﻠﻤﻟا ﻳ

ﻧوﺮﺘﻜﻟا ﻪ ﻴ ﻲﻜ 4428 : - e-ISSN2322

ارﻮﺷ• ي ﻮﻧ ﻳ نﺎﮔﺪﻨﺴ

) ﺎﺒﻔﻟا فوﺮﺣ ﺐﻴﺗﺮﺗ ﻪﺑ

:(

- ﻞﻴﻋﺎﻤﺳا ﺪﻤﺤﻣ ﺮﺘﻛد ﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،ﻲﻨﺑﺪﻨﺑ رﻮﭘ

نﻼﻴﮔ ﻲﻜﺷﺰﭘاﺮﻴﭘ و يرﺎ

- سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد يرﺎﺘﺳﺮﭘ هوﺮﮔ رﺎﻴﺸﻧاد ،ﻲﻧﺎﺤﻟا ﻪﻤﻃﺎﻓ ﺮﺘﻛد

- سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد يرﺎﺘﺳﺮﭘ هوﺮﮔ رﺎﻴﺸﻧاد ،ﻪﺷﻮﻧا ﺮﻴﻨﻣ ﺮﺘﻛد

- ،ﺎﺘﻜﻳ ﺎﺳرﺎﭘ هﺮﻫز ﺮﺘﻛد دﺎﺘﺳا

ناﺮﻬﺗ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد

- هﺪﻜﺸﻧاد رﺎﻴﺸﻧاد ،يوﺮﻴﭘ ﺪﻴﻤﺣ ﺮﺘﻛد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ

ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ناﺮﻳا

- ،ﻲﻏاﺮﭼ ﻲﻠﻋﺪﻤﺤﻣ ﺮﺘﻛد رﺎﻴﺸﻧاد

ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد

ناﺮﻬﺗ

- ،ﻲﻨﻴﺴﺣ ﻲﻠﻋﺪﻤﺤﻣ ﺮﺘﻛد رﺎﻴﺸﻧاد

ﻲﺸﺨﺒﻧاﻮﺗ و ﻲﺘﺴﻳﺰﻬﺑ مﻮﻠﻋ هﺎﮕﺸﻧاد

- ﻖﺣ ﻪﻤﻃﺎﻓ هﺪﻴﺳ ﺮﺘﻛد ،ﻲﻳﻮﻜﺳا ﺖﺳود

دﺎﺘﺳا ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد ﺎﮕﺸﻧاد

ﻲﻜﺷﺰﭘ مﻮﻠﻋ ه ناﺮﻳا

- ﺪﻫﺎﺷ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،يرﺪﻴﺣ ﺎﺿرﺪﻤﺤﻣ ﺮﺘﻛد

- نﺎﻘﻫد ﺪﻴﻫﺎﻧ ﺮﺘﻛد ،يﺮﻴﻧ

دﺎﺘﺳا ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد

ناﺮﻬﺗ

- ،هژر ﺪﻴﻫﺎﻧ ﺮﺘﻛد رﺎﻴﺸﻧاد

ﺪﻫﺎﺷ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد

- ﺪﻣ ﺮﻗﺎﺑﺪﻴﺳ تادﺎﺳ ﺮﺘﻛد ﻲﺸﺨﺒﻧاﻮﺗ و ﻲﺘﺴﻳﺰﻬﺑ مﻮﻠﻋ هﺎﮕﺸﻧاد رﺎﻳدﺎﺘﺳا ،حا

- ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻴﺸﻧاد ،ﻲﻤﻃﺎﻓﺪﻴﺳ ﻪﻤﻴﻌﻧ ﺮﺘﻛد ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد

ناﺮﻳا

- ناﺮﻬﺗ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﺖﻣﻼﺳ يﺎﻘﺗرا و ﺖﺷاﺪﻬﺑ شزﻮﻣآ ياﺮﺘﻛد ،ﻞﻃ رذآ ﺮﺘﻛد

- ،يدﺎﺒﻋ سﺎﺒﻋ ﺮﺘﻛد رﺎﻴﺸﻧاد

مﻮﻠﻋ هﺎﮕﺸﻧاد يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد ﻪﻴﻘﺑ ﻲﻜﺷﺰﭘ

ﷲا

- سﺎﺒﻋ سﺎﺒﻋ ﺮﺘﻛد ،هداز

دﺎﺘﺳا ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد

- ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،نﺎﻳﺪﻧﻮﺛﺎﻴﻏ دازﺮﻬﺷ ﺮﺘﻛد ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد

ناﺮﻬﺗ

- نﺎﻨﻤﺳ ﻲﻜﺷﺰﭘاﺮﻴﭘ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،يﺪﺣﻮﻣﺮﺨﻓ ﻲﻠﻋ ﺮﺘﻛد

- ﺮﺘﻛد ﻲﺸﺨﺒﻧاﻮﺗ و ﻲﺘﺴﻳﺰﻬﺑ مﻮﻠﻋ هﺎﮕﺸﻧاد رﺎﻴﺸﻧاد ،بﺎﻨﻜﺸﺧ ﻲﺣﻼﻓ دﻮﻌﺴﻣ

- ﻢﻇﺎﻛ ناوﺮﻴﺷﻮﻧا ﺮﺘﻛد سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد ﻲﺘﺴﻳز رﺎﻣآ هوﺮﮔ دﺎﺘﺳا ،داﮋﻧ

- سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد يرﺎﺘﺳﺮﭘ هوﺮﮔ رﺎﻴﺸﻧاد ،يﺪﻤﺤﻣ ﻲﺴﻴﻋ ﺮﺘﻛد

- ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،دادﺮﻬﻣ اﺪﻧ ﺮﺘﻛد ﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد

ﻲﻜﺷﺰ ناﺮﻳا

- يوﺎﻧ ﻦﺴﺣ ﺮﺘﻛد سرﺪﻣ ﺖﻴﺑﺮﺗ هﺎﮕﺸﻧاد يرﺎﺘﺳﺮﭘ هوﺮﮔ رﺎﻳدﺎﺘﺳا ،رﻮﭘ

- ناﺮﻬﺗ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد دﺎﺘﺳا ،يدﺎﺑآﺮﺼﻧ ﺖﺨﺒﻜﻴﻧ ﺎﺿﺮﻴﻠﻋ ﺮﺘﻛد

- ﺲﻳو ﻲﺒﺘﺠﻣ ﺮﺘﻛد ناﺮﻬﺗ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،يداﺮﻣ

- هﺪﻴﺠﻣ ﺮﺘﻛد ﺪﻫﺎﺷ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻳدﺎﺘﺳا ،يوﺮﻫ

- ﻲﺘﺸﻬﺑ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد رﺎﻴﺸﻧاد ،ﻲﻳﺎﻤﻐﻳ هﺪﻳﺮﻓ ﺮﺘﻛد

و• ﻳ ﻠﮕﻧا رﺎﺘﺳاﺮ ﻴ

ﺴ ﻲ ﺐﻳﺮﻗ ﺎﺿﺮﻴﻠﻋ :

و• ﻳ ﺳرﺎﻓ رﺎﺘﺳاﺮ ﻲ

: ﺮﺘﻛد ﻲﻧﺎﺤﻟا ﻪﻤﻃﺎﻓ

ﭽﻓوﺮﺣ• ﻴ ﻨ ﻲ ﻪﺤﻔﺻ و ارآ ﻲﻳ ﺣ ﻪﺘﺷﺮﻓ: ﻴ رﺪ ي

ﺮﻃ• ا ﺪﻠﺟ ح ا : ﺮﻐﺻ ﻧارﻮﺳ ﻲ

ﺮﺷﺎﻧ• ﻤﻠﻋ ﻦﻤﺠﻧا: ﻲ

رﺎﺘﺳﺮﭘ ي اﻳ ناﺮ

ﻧﺎﺸﻧ• ﻲ : ناﺮﻬﺗ ﻣ– ﻴ ﺣﻮﺗ ناﺪ ﻴ ﺪ رﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد– ي

ﺎﻣﺎﻣ و ﻲﻳ ناﺮﻬﺗ

ﻛ• ﺘﺴﭘﺪ ﻲ 1419733171: ﺘﺴﭘ قوﺪﻨﺻ ،

ﻲ 398: / 14195 ﻦﻔﻠﺗ ، و ﺑﺎﻤﻧ ﺮ 66592535:

e-mail: [email protected] , Website: http://jne.ir

(3)

و يرﺎﻤﻴﺑ ﻪﺑ ﻂﺒﺗﺮﻣ ﺶﻧاد ﺎﺑ يﺪﻨﻤﻧاﻮﺗ ناﺰﻴﻣ طﺎﺒﺗرا ﻲﺳرﺮﺑ ﺺﺧﺎﺷ

لﺮﺘﻨﻛ يﺎﻫ

عﻮﻧ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ رد ﻚﻴﻟﻮﺑﺎﺘﻣ 2

ﻲﻤﻴﻫاﺮﺑا ﻦﻴﺴﺣ ﻲﻗدﺎﺻ يﺪﻬﻣ ،1

ﻲﻓﺮﺷا لﻮﺳر ،2 3

هﺪﻴﻜﭼ

ﻪﻣﺪﻘﻣ : ﺒﻨﺟ ﺮﺑ نآ هدﺮﺘﺴﮔ ﺮﻴﺛﺄﺗ و ﺖﺑﺎﻳد يرﺎﻤﻴﺑ ﻦﻣﺰﻣ ﻂﻳاﺮﺷ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻪ

ﻫ

ﻲﺘﻨـﺳ دﺮـﻜﻳور ﺮﻴﻴﻐﺗ ،ﻲﮔﺪﻧز ﻒﻠﺘﺨﻣ يﺎ ﻪـﺑ

ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ ﺖﺒﻗاﺮﻣ و شزﻮﻣآ رد يزﺎﺳﺪﻨﻤﻧاﻮﺗ ﻲﻣ

ﻪﻨﻴﻣز ﺐﺳﺎﻨﻣ ﺮﺘﺴﺑ دﺎﺠﻳا ﺎﺑ ﺪﻧاﻮﺗ رد ﻲﻨﻴﻟﺎـﺑ ﺖﻴﻌﺿو و ﻲﺘﺒﻗاﺮﻣدﻮﺧ دﻮﺒﻬﺑ زﺎﺳ

ﺪﺷﺎﺑ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ .

ﻦﻴﻴﻌﺗ فﺪﻫ ﺎﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﺺﺧﺎـﺷ و يرﺎﻤﻴﺑ ﺎﺑ ﻂﺒﺗﺮﻣ ﺶﻧاد ﺎﺑ يﺪﻨﻤﻧاﻮﺗ ناﺰﻴﻣ

رد ﻚـﻴﻟﻮﺑﺎﺘﻣ لﺮـﺘﻨﻛ يﺎـﻫ

عﻮﻧ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ 2

ﺖﻓﺮﻳﺬﭘ ترﻮﺻ .

شور ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا : -

ﻌﻄﻘﻣ ﻲ يورﺮﺑ 156 ﺪﺷ مﺎﺠﻧا ود عﻮﻧ ﺖﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ رﺎﻤﻴﺑ .

روآدﺮﮔ راﺰﺑا ي

ﻞﻣﺎـﺷ تﺎﻋﻼﻃا

يﺪﻨﻤﻧاﻮﺗ ﺶﺠﻨﺳ ﻪﻣﺎﻨﺸﺳﺮﭘ ،ﺶﻧاد ﺶﺠﻨﺳ ﻪﻣﺎﻨﺸﺳﺮﭘ DES-28 )

( تﺎﺸﻳﺎﻣزآ ﺖﺒﺛ ﺖﺴﻴﻟ ﻚﭼ و )

ﻦﻴﺑﻮﻠﮔﻮﻤﻫ ،A1C

ﺪﻨﻗ نﻮﺧ

ﺎﺘﺷﺎﻧ و ﺮﻴﻏ ﺎﺘﺷﺎﻧ ، لوﺮﺘﺴﻠﻛ يﺮﺗ ، ﺪﻳﺮﺴﻴﻠﮔ ﻦﻴﻳﺎﭘ ﻲﻟﺎﮕﭼ و ﻻﺎﺑ ﻲﻟﺎﮕﭼ ﺎﺑ ﻦﻴﺌﺗوﺮﭘﻮﭙﻴﻟ و (

ﺑ دﻮ . هداد ﻞـﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ ﺖﻬﺟ رﺎـﻣآ زا ﺎـﻫ

ﺻﻮﺗ ﻴ ﻔ ﻲ نﻮﻣزآ و ﺮﺿ يرﺎﻣآ يﺎﻫ ﻳ

ﮕﺘﺴﺒﻤﻫ ﺐ ﻲ

ﺪﺷ هدﺎﻔﺘﺳا روﺬﺠﻣ يﺎﻛ و نﻮﺳﺮﻴﭘ .

ﻪﺘﻓﺎﻳ ﺎﻫ : نارﺎﻤﻴﺑ ﻦﺳ ﻦﻴﮕﻧﺎﻴﻣ ﻪﻌﻟﺎﻄﻣ درﻮﻣ

18 /

±6 11 / 48 ﺮﺜﻛا و نآ ﺎﻫ نز 8 / 62

% ﺪﻧدﻮﺑ . ﺪـﻨﻤﻧاﻮﺗ هﺮﻤﻧ ﻦﻴﮕﻧﺎﻴﻣ ﻦﻴﺑ و ي

ﻨﻌﻣ طﺎﺒﺗرا نارﺎﻤﻴﺑ ﺶﻧاد هﺮﻤﻧ ﺎ

ﺖﺷاد دﻮﺟو ﺖﺒﺜﻣ راد )

01 / 0

= .(p رادﺎﻨﻌﻣ يرﺎﻣآ طﺎﺒﺗرا ﻦﻴﻨﭽﻤﻫ

ﺧﺎـﺷ ﻦﻴـﺑ ﺺ

ـﻫ يﺎ ﻦﻴﺑﻮـﻠﮔﻮﻤﻫ

،A1C ﺪﻨﻗ ﺎﺘﺷﺎﻧ نﻮﺧ و

ﺮﻴﻏ ﺎﺘﺷﺎﻧ ، لوﺮﺘﺴﻠﻛ يﺮﺗ ، و ﺪﻳﺮﺴﻴﻠﮔ يﺪﻨﻤﻧاﻮﺗ ﺎﺑHDL

ﺎﺑ ﻲﻟو ﺖﺷاد دﻮﺟو دﻮـﺒﻧ رادﺎﻨﻌﻣ طﺎﺒﺗراLDL

ﻣ زا ﺮﺗﻻﺎﺑ يﺪﻨﻤﻧاﻮﺗ ﺎﺑ نارﺎﻤﻴﺑ و بﻮﻠﻄﻣ ﺮﻳدﺎﻘ

ﺮﺗ ﺧﺎﺷ ﻦﻳا ﺺ ﻫ ﺪﻧدﻮﺑ رادرﻮﺧﺮﺑ ﺎ .

ﻪﺠﻴﺘﻧ يﺮﻴﮔ : ﻪﺘﻓﺎﻳ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ دﻮـﺒﻬﺑ و يﺪـﻨﻤﻧاﻮﺗ ﺶﻳاﺰـﻓا ﺎـﺑ ﺶـﻧاد ﺢﻄـﺳ ءﺎـﻘﺗرا ﻲـﻫاﺮﻤﻫ ﺮـﺑ ﻲـﻨﺒﻣ ﺶﻫوﮋـﭘ يﺎﻫ

ﺧﺎﺷ ﺺ ﻫ ﺮﻈﻧ ﻪﺑ ،ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ رد ﻲﻨﻴﻟﺎﺑ يﺎ ﻲﻣ

زﻮﻣآ ﻖﻳﺮﻃ زا ﺪﺳر ش

ﻫ ،نارﺎـﻤﻴﺑ يﺪـﻨﻤﻧاﻮﺗ و ﺶﻧاد ﺢﻄﺳ ﺶﻳاﺰﻓا و ﺮﻤﺘﺴﻣ يﺎ

ﻲﻣ ﻮﺗ بﻮﻠﻄﻣ يﺎﻫﺪﻣĤﻴﭘ ﻪﺑ نا ﺮﺗ

ﺖﻓﺎﻳ ﺖﺳد نارﺎﻤﻴﺑ ﻦﻳا رد ﻲﮔﺪﻧز زا ي .

هژاو ﺪﻴﻠﻛ ﺎﻫ

: عﻮﻧ ﺖﺑﺎﻳد 2

ﻚﻴﻟﻮﺑﺎﺘﻣ لﺮﺘﻨﻛ ،ﺶﻧاد ،يﺪﻨﻤﻧاﻮﺗ ،

ﺖﻓﺎﻳرد ﺦﻳرﺎﺗ :

8 / 6 / 1393 شﺮﻳﺬﭘ ﺦﻳرﺎﺗ

: 2 / 12 / 1393

1 - ﻴﻫ ﻮﻀﻋ ،رﺎﻳدﺎﺘﺳا ﺄ

اد ﻲﻤﻠﻋ ت ا ،دوﺮﻫﺎﺷ ،دوﺮﻫﺎﺷ ﻲﻳﺎﻣﺎﻣ و يرﺎﺘﺳﺮﭘ هﺪﻜﺸﻧاد ،دوﺮﻫﺎﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧ ﻳ

ناﺮ

2 - ﻛ رﺎﺘﺳﺮﭘ ﺪﺷرا سﺎﻨﺷرﺎ ي

ا ،دوﺮﻫﺎﺷ ،دوﺮﻫﺎﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ، ﻳ

ناﺮ ) لوﺆﺴﻣ هﺪﻨﺴﻳﻮﻧ (

ﻲﻜﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ [email protected]:

3 - ﻛ رﺎﺘﺳﺮﭘ ﺪﺷرا سﺎﻨﺷرﺎ ي

ﺒﻗاﺮﻣ ﺖ ﻫ هﮋﻳو يﺎ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ، ا ،دوﺮﻫﺎﺷ ،دوﺮﻫﺎﺷ

ﻳ ناﺮ هرود يرﺎﺘﺳﺮﭘ شزﻮﻣآ 4

هرﺎﻤﺷ 1 ) ﻲﭘﺎﻴﭘ 11 ( رﺎﻬﺑ 1394

، 30 - 23

(4)

و يرﺎﻤﻴﺑ ﻪﺑ ﻂﺒﺗﺮﻣ ﺶﻧاد ﺎﺑ يﺪﻨﻤﻧاﻮﺗ ناﺰﻴﻣ طﺎﺒﺗرا ﻲﺳرﺮﺑ ﺺﺧﺎﺷ

يﺎﻫ ...

ﻲﻤﻴﻫاﺮﺑا ﻦﻴﺴﺣ و

نارﺎﻜﻤﻫ

شزﻮﻣآ يرﺎﺘﺳﺮﭘ

هرود 4 هرﺎﻤﺷ 1 ) ﻲﭘﺎﻴﭘ 11 ( رﺎﻬﺑ 1394

٢٤

ﻪﻣﺪﻘﻣ

رد ﻲﻣﻮـﻤﻋ ﺖﺷاﺪﻬﺑ هﺪﻤﻋ تﻼﻜﺸﻣ زا ﻲﻜﻳ ﺖﺑﺎﻳد ﺖﺳا ﺮﺻﺎﻌﻣ نﺎﻬﺟ )

1 و 2 ( . ﭘ ﻖﺒﻃ ﻴ ﺶ ﺑﻴ ـﻨ ﻲ ﺎـﻫ ي ﻞـﻤﻋ ﻪـﺑ

لﺎﺳ ﺎﺗ هﺪﻣآ 2025

مﺎﻈﻧ ﺎﻫ ي ارا ﻳ ﻪ ﺎـﺑ ﺖـﺒﻗاﺮﻣ هﺪـﻨﻫد 300

ﻣ ﻴﻠ ﻴ د نﻮ ﻳ ﺘﺑﺎ ﻲ دﻮﺑ ﺪﻨﻫاﻮﺧ ور ﻪﺑ ور نﺎﻬﺟ رد )

3 ( لﺎـﺳ ﺎﺗ و

2030 ﻼﺘﺒﻣ داﺪﻌﺗ ، ﻳ

د ﻪﺑ نﺎ ﻳ ﻪـﺑ نﺎﻬﺟ ﺮﺳﺎﺗﺮﺳ رد ﺖﺑﺎ 366

ﻣ ﻴﻠ ﻴ

ـﺳر ﺪـﻫاﻮﺧ ﺮﻔﻧ نﻮ ﻴ

ﺪ ) 2 ( . ﻖﺑﺎـﻄﻣ شراﺰـﮔ نﺎﻣزﺎـﺳ

ﻧﺎﻬﺟ ﻲ ﺷ ،ﺖﺷاﺪﻬﺑ ﻴ

عﻮ د ﻳ ﺖﺑﺎ رد اﻳ ناﺮ ﺑﻴ ﺶ زا 8 % ﺖﺳا و

اﻳ ناﺮ زا ﻪﻠﻤﺟ ﻛ ﺎﻫرﻮﺸ ﻲﻳ ﺖﺳا ـﻛ ﻪ

ﻞـﻣﺎﻋ ﺖـﺑﺎﻳد نآ رد

ﺑﻴ ﺶ زا 20 % ﻣ و گﺮﻣ زا ﻴ

ﺎﻫﺮ ﻲﻣ ﺪﺷﺎﺑ ) 4 (.

ﻲﮔﺪﻧز ﺖﻴﻔﻴﻛ ،ﻲﺘﺷاﺪﻬﺑ ﻞﻜﺸﻣ ﻚﻳ ناﻮﻨﻋ ﻪﺑ ﺖﺑﺎﻳد ﻦﻣﺰـﻣ و دﺎـﺣ ضراﻮـﻋ ﻪـﺑ ﺮـﺠﻨﻣ و هدﺮـﻛ ﺪﻳﺪﻬﺗ ار نارﺎﻤﻴﺑ

ﻲﻣ ددﺮﮔ .

و گﺮـﻣ و ﻲﻧاﻮﺗﺎـﻧ ﻢﻬﻣ ﺖﻠﻋ ﻚﻳ ﺖﺑﺎﻳد ﻦﻴﻨﭽﻤﻫ ا يرﺎﻴﺴﺑ رد ﺮﻴﻣ بﻮـﺴﺤﻣ ﺎﻫرﻮﺸﻛ ز

ﻲـﻣ دﻮـﺷ ) 5 ( . ﻲـﻜﻳ زا

ﺮﺘﻬﺑ ﻳ شور ﻦ ﺎﻫ ي ،ﺖﺑﺎﻳد ﺐﺳﺎﻨﻣ و ﻖﻓﻮﻣ لﺮﺘﻨﻛ ﻪﺑ ﻲﺑﺎﻴﺘﺳد

ا ﻪــﺑ ﻼﺘــﺒﻣ نارﺎــﻤﻴﺑ يزﺎــﺳﺪﻨﻤﻧاﻮﺗ ــﻳ

ﺑ ﻦ ﻴ رﺎــﻤ ي ﺖــﺳا ) 6 ( .

ﺪﻨﻤﻧاﻮﺗ ي ﻚﻳ سﺎﺴﺣا ﻨﻫذ ﻲ ﺳا ﺖ ﻛ ﻪ ﻲﻜﻳ زا ار ﻛ نﺎ ﻠﺻا ﻲ

ﺎﻘﺗرا ي ﻣﻮﻤﻋ ﺖﺷاﺪﻬﺑ ﻲ

ﻪﻌﻣﺎﺟ ﻣ ﻲ ﺪـﺷﺎﺑ ) 7 ( دﺮـﺒﻫار ﻚـﻳ و

ﺖﻣﻼﺳ يﺎﻘﺗرا رد يدﺮﻜﻠﻤﻋ ﻲﻣ بﻮﺴﺤﻣ

دﻮﺷ ) 8 (.

ﺮــــﻈﻧ زا Craig

Lindsay و يزﺎــــﺳﺪﻨﻤﻧاﻮﺗ

ﻂﻠـﺴﺗ دﻮﺧ ﺖﻴﻌﺿو ﺮﺑ داﺮﻓا نآ ﻖﻳﺮﻃ زا ﻪﻛ ﺖﺳا يﺪﻨﻳآﺮﻓ اﺪــﻴﭘ ﻲــﻣ ﺪــﻨﻨﻛ ) 9 ( . ﺪــﻨﻳآﺮﻓ ﻊــﻗاو رد رﺎــﻤﻴﺑ يزﺎــﺳﺪﻨﻤﻧاﻮﺗ

عﻼﻃا ارا و نارﺎﻤﻴﺑ ﻪﺑ ﻲﻧﺎﺳر ﻳ

يﺎـﻫراﺰﺑا ﺎـﺑ تﺎﻋﻼﻃا ﻦﻳا ﻪ

ا ﺖﻬﺟ نارﺎﻤﻴﺑ رد لﻼﻘﺘﺳا دﺎﺠﻳا و مزﻻ ﻳ

ﺎﻔ ي ﺶـﻘﻧ لﺎـﻌﻓ

ﻢﻴﻤــﺼﺗ رد يﺮــﻴﮔ

ﻲــﻣ نﺎــﺸﻳﺎﻫ ﺪــﺷﺎﺑ

) 10 ( . دﺮــﻜﻳور رد

ياﺮـﺑ ﻢـﻫ ﺖﺳد رد ﺖﺳد ﺺﺼﺨﺘﻣ و رﺎﻤﻴﺑ يزﺎﺳﺪﻨﻤﻧاﻮﺗ

ﻪـﻣﺎﻧﺮﺑ يرﺎـﻤﻴﺑ يﺎﻫﺪﻣĤﻴﭘ ﺶﻫﺎﻛ و لﺮﺘﻨﻛ ماﺪـﻗا و يﺰـﻳر

ﻲــﻣ ﺪــﻨﻳﺎﻤﻧ . ياﺮــﺑ رﺎــﻤﻴﺑ ﻞﻴــﺴﻧﺎﺘﭘ ﻪــﻤﻫ دﺮــﻜﻳور ﻦــﻳا رد

شﺮﺘــﺴﮔ و نآ ﺪــﻧور ﺮــﻴﻴﻐﺗ و يرﺎــﻤﻴﺑ ﺎــﺑ يرﺎﮔزﺎــﺳ ﺴﻣ ﺆ ﺖﻴﻟو درﻮﺧﺮﺑ رد يدﺮﻓ ﺪـﻴﻛﺄﺗ و ﻪـﺟﻮﺗ درﻮـﻣ يرﺎﻤﻴﺑ ﺎﺑ

ﻲﻣ ﺐﺟﻮﻣ ﺮﻣا ﻦﻳا و ﺖﺳا يﺮـﻣا ﻪـﻧ نﺎﻣرد ﺪﻨﻳآﺮﻓ ﻪﻛ دﻮﺷ

هﺪــﻳﺪﭘ ﻪــﺑ ﻪــﻜﻠﺑ ﻲــﻌﻄﻘﻣ دﻮــﺷ ﻞﻳﺪــﺒﺗ ﺮﻤﺘــﺴﻣ يا

) 11 ( .

ﺎـﺑ ﻖﺑﺎـﻄﺗ رد ﻢـﻬﻣ ﺺﺧﺎـﺷ ﻚـﻳ ناﻮﻨﻋ ﻪﺑ يزﺎﺳﺪﻨﻤﻧاﻮﺗ ياﺮـﺑ نارﺎـﻤﻴﺑ ﻪـﺑ ﻪﻛ ﺖﺳا حﺮﻄﻣ ﻲﺘﺑﺎﻳد داﺮﻓا رد يرﺎﻤﻴﺑ دﻮﺧ ﻲﻳﺎﻧاﻮﺗ ﺮﺜﻛاﺪﺣ زا هدﺎﻔﺘﺳا و ﻒﺸﻛ ﺖﻳﺮﻳﺪـﻣ رﻮﻈﻨﻣ ﻪﺑ

ﻚﻤﻛ يرﺎﻤﻴﺑ ﻲﻣ

ﺪﻳﺎﻤﻧ ) 12 (.

داﺮـﻓا ،ﺖـﺳا هداد نﺎـﺸﻧ ﻒـﻠﺘﺨﻣ تﺎـﻘﻴﻘﺤﺗ ﻪﺠﻴﺘﻧ بﻮﻠﻄﻣ ﻲﮔﺪﻧز ﺖﻴﻔﻴﻛ ،ﺪﻨﻤﻧاﻮﺗ ﻲﺘﺑﺎﻳد ﺮﺗ

ي ﻪـﺑﺮﺠﺗ ار ـﻛ هدﺮ )

13 و 14 ( ﻪﻨﻳﺰﻫ و ضراﻮﻋ و ﻞﻤﺤﺘﻣ ار يﺮﺘﻤﻛ ﻲﻧﺎﻣرد يﺎﻫ

ــﻣ ﻲ ﺪﻧﻮــﺷ ) 15 و 16 ( . ﺒﻗاﺮــﻣ ﻴ كرد ترﻮــﺻ رد ﻲﺘــﺷاﺪﻬﺑ ﻦ

ﺪﻨﻳآﺮﻓ ﺮﺑ راﺬﮔﺮﻴﺛﺄﺗ ﻞﻣاﻮﻋ ﺎـﺑ دﻮـﺑ ﺪـﻨﻫاﻮﺧ ردﺎﻗ ،يﺪﻨﻤﻧاﻮﺗ

يرﺎـﻳ ﺖـﺑﺎﻳد ﻪـﺑ ﻼﺘـﺒﻣ داﺮـﻓا ﻪﺑ يﺪﻨﻤﻧاﻮﺗ ﺢﻄﺳ ﺶﻳاﺰﻓا ﺖﺳا ﻲﻟﺎﺣ رد ﻦﻳا و ﺪﻨﻧﺎﺳر ﻛ

ﻪ ﺒﻗاﺮﻣ ﻴ هﮋـﻳو ﻪـﺑ ﻲﺘﺷاﺪﻬﺑ ﻦ

يرﺎﻤﻴﺑ ﻪﺑ ﻼﺘﺒﻣ داﺮﻓا يﺪﻨﻤﻧاﻮﺗ ﺢﻄﺳ ﺶﻳاﺰﻓا رد نارﺎﺘﺳﺮﭘ ﺪﻨﻧاﻮﺗﺎﻧ ﺖﺑﺎﻳد .

ﺮﮕﻳد فﺮﻃ زا رد

ك ﻞـﻣاﻮﻋ ﺛﺄﺗ ﻴ راﺬـﮔﺮ ﺮـﺑ

ﺮﻓ آﻳ ﺪـﻨ ﺪـﻨﻤﻧاﻮﺗ ي

، ﻗاﺮﻣ نﺎـﺒ ﺘـﺷاﺪﻬﺑ ﻲ ار رد ﻬـﺴﺗ ﻴ ﻞ

ﺶﺨﺑﺮﺛا ﺮﺗ ﺪﻨﻤﻧاﻮﺗ ي داﺮﻓا ﻼﺘﺒﻣ ﻪﺑ د ﻳ ﺖﺑﺎ ﻳ رﺎ ي ﻲﻣ ﺪﻧﺎـﺳر

) 6 (.

اﺬﻟ ﺢﻄـﺳ يﺎﻘﺗرا رد يﺪﻨﻤﻧاﻮﺗ ﻢﻬﻣ ﺶﻘﻧ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ مﺪـﻗ ﻦﻴﻟوا ﻪﻛ ﺖﻘﻴﻘﺣ ﻦﻳا و ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ ﻲﮔﺪﻧز ﺖﻴﻔﻴﻛ نآ ﺮـﺑ راﺬـﮔﺮﻴﺛﺄﺗ ﻞـﻣاﻮﻋ ﻲﻳﺎـﺳﺎﻨﺷ يﺪﻨﻤﻧاﻮﺗ ءﺎﻘﺗرا ﺖﻬﺟ ﻲﻣ ﻦﻳا ﻪﺑ ﺖﻳﺎﻨﻋ ﺎﺑ و ﺪﺷﺎﺑ ﻪـﺑ ﻲﻛﺪـﻧا تﺎـﻌﻟﺎﻄﻣ ﻪـﻛ ﻪﺘﻜﻧ

ــﻣ ﻞــﻣاﻮﻋ ﻲــﺳرﺮﺑ ﺆ

آ طﺎــﺒﺗرا و يﺪــﻨﻤﻧاﻮﺗ ﺮــﺑ ﺮﺛ ن

ــﻫ ﺎــﺑ ﺎ

ﺧﺎﺷ ﺺ ﻫ ﺘﺧادﺮﭘ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ ﻲﻨﻴﻟﺎﺑ يﺎ ﻪ

ﺪﻧا ﻪـﻌﻟﺎﻄﻣ ﻦﻳا ،

ﻦﻴﻴﻌﺗ فﺪﻫ ﺎﺑ ﺗ طﺎﺒﺗرا

ﻧاﻮ و يرﺎﻤﻴﺑ ﺎﺑ ﻂﺒﺗﺮﻣ ﺶﻧاد ﺎﺑ يﺪﻨﻤ

ﺺﺧﺎـﺷ

ﻚـﻴﻟﻮﺑﺎﺘﻣ لﺮـﺘﻨﻛ يﺎـﻫ رد يﺪـﻨﻤﻧاﻮﺗ ناﺰـﻴﻣ ﺎـﺑ

عﻮﻧ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ 2

ﺬﭘ ترﻮﺻ ﺖﻓﺮﻳ .

ﻪﻌﻟﺎﻄﻣ شور

ﻠﺤﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا ﻴﻠ

ﻲ - ـﻌﻄﻘﻣ ﻲ ﻪـﺑ ﻼﺘـﺒﻣ نارﺎـﻤﻴﺑ ار

ﻪـﻌﻟﺎﻄﻣ ﻪـﺑ دورو يﺎـﻫرﺎﻴﻌﻣ و هداد ﻞﻴﻜـﺸﺗ ود عﻮﻧ ﺖﺑﺎﻳد زا ﺪﻧدﻮﺑ ترﺎﺒﻋ :

زا ﺮﺗﻻﺎﺑ ﻦﺳ 18

ﻲـﻌﻄﻗ ﺺﻴﺨـﺸﺗ ،لﺎـﺳ

تﺪﻣ ﻪﺑ ﻞﻗاﺪﺣ ود عﻮﻧ ﺖﺑﺎﻳد يرﺎﻤﻴﺑ ﻚـﻳ

ﻞـﻳﺎﻤﺗ و لﺎـﺳ

ﺶﻫوﮋﭘ رد ﺖﻛﺮﺷ ياﺮﺑ رﺎﻤﻴﺑ .

ﺑ ﺖﺑﺎﻳد ﺰﻛﺮﻣ ﻴ

ﺎﺘﺳرﺎﻤ مﺎﻣا ن

ﺴﺣ ﻴ

)ﻦ

ع

ﻪـﺑ ﻲـﺳﺮﺘﺳد ﺖﻟﻮﻬﺳ ﺖﻠﻋ ﻪﺑ دوﺮﻫﺎﺷ نﺎﺘﺳﺮﻬﺷ(

ﺑﻴ ﺪﺷ بﺎﺨﺘﻧا ﺶﻫوﮋﭘ ﻂﻴﺤﻣ ناﻮﻨﻋ ﻪﺑ ،نارﺎﻤ .

رﺎـﻛ ﻪﺑ راﺰﺑا

ﻞﻣﺎـﺷ ﺶﻫوﮋـﭘ ﻦﻳا رد ﻪﺘﻓر ،ﺶـﻧاد ﺶﺠﻨـﺳ ﻪﻣﺎﻨـﺸﺳﺮﭘ

ﺺﺧﺎﺷ ﺖﺒﺛ ﺖﺴﻴﻟ ﻚﭼ و يﺪﻨﻤﻧاﻮﺗ ﻪﻣﺎﻨﺸﺳﺮﭘ ﺎﻫ

ي ﻛ لﺮﺘﻨ

ﻟﻮﺑﺎﺘﻣ ﻚﻴ دﻮﺑ . ﺶﺠﻨﺳ ﻪﻣﺎﻨﺸﺳﺮﭘ

يرﺎـﻤﻴﺑ ﺎـﺑ ﻂﺒﺗﺮﻣ ﺶﻧاد ﻞﻣﺎـﺷ

24 اﺆﺳ ﻨﻳﺰﮔ رﺎﻬﭼ ل ﻪ

يا ﺎﺴﻣ ﺎﺑ طﺎﺒﺗرا رد ﻳ

يرﺎـﻤﻴﺑ ﻢـﻬﻣ ﻞ

زا نآ هﺮﻤﻧ و ﻢﻴﻈﻨﺗ و ﻪﻴﻬﺗ ﺖﺑﺎﻳد 0

ﺎـﺗ 24 و هﺪـﺷ رﻮـﻈﻨﻣ

ﻞﻜـﺷ ﻪـﺑ راﺰـﺑا ﻲﻳﺎﻳﺎﭘ و اﻮﺘﺤﻣ ﻲﻳاور ترﻮﺻ ﻪﺑ نآ ﻲﻳاور ﻲﻳﺎﻣزآزﺎﺑ ) 98 / 0 r= ( مﺎـﺠﻧا نارﺎـﻜﻤﻫ و ﻲﻗدﺎﺻ ﻪﻌﻟﺎﻄﻣ رد

دﻮـﺑ هﺪﺷ ) 17 ( . ﻦﻴـﻨﭽﻤﻫ ﻪﻣﺎﻨـﺸﺳﺮﭘ

ﺶﺠﻨـﺳ يﺪـﻨﻤﻧاﻮﺗ

DES-28) (

ــﺳﻮﺗ هﺎﮕــﺸﻧاد ﺶﻫوﮋــﭘ و شزﻮــﻣآ ﺰــﻛﺮﻣ ﻂ

(5)

يﺎﻫ ...

نارﺎﻜﻤﻫ

٢٥

ﺖﺳا هﺪﺷ دراﺪﻧﺎﺘﺳا و ﻲﺣاﺮﻃ نﺎﮕﻴﺸﻴﻣ نآ ﻲﻳﺎـﻳﺎﭘ و

97 / 0

دﻮـﺑ هﺪـﻣآ ﺖﺳد ﻪﺑ )

18 و 19 ( . تﺎـﻌﻟﺎﻄﻣ ﻦﻴـﻨﭽﻤﻫ و ﻞـﻃ

ﺰﻴﻧ نارﺎﻜﻤﻫ قﻮﻓ راﺰﺑا يﻻﺎﺑ ﻲﻳﺎﻳﺎﭘ

يورﺮﺑ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ

ناﺮﻳا داد نﺎـﺸﻧ ار ه

ﺪـﻧا ) 12 ( . ﻞﻣﺎـﺷ قﻮـﻓ ﻪﻣﺎﻨـﺸﺳﺮﭘ 56

ﻪــﻄﻴﺣ ﻪــﺳ رد لاﺆــﺳ )

ر ﺖﻳﺮﻳﺪــﻣ ﻲﺑﺎــﻳزرا ،ﺖــﺑﺎﻳد ﻲــﻧاو

ﺎـﺑ ﻂﺒﺗﺮـﻣ فاﺪـﻫا ﻦﻴﻴﻌﺗ و ﺮﻴﻴﻐﺗ ياﺮﺑ ﻲﮔدﺎﻣآ و ﻲﺘﻳﺎﺿرﺎﻧ نآ ﻪــﺑ ﻲﺑﺎﻴﺘــﺳد و ﺖــﺑﺎﻳد ﺎــﻫ

( اﺮــﺑ و هﺪــﺷ ﻲــﺣاﺮﻃ ي

شزرا راﺬﮔ ي ﻪﻘﺒﻃ زا نآ ﺪﻨﺑ

ي ﻟ ﻜﻴ ﻪﻘﺒﻃ ﺞﻨﭘ تﺮ ا

ي

ًﻼﻣﺎﻛ زا

ﻖﻓاﻮﻣ ) 5 (

ًﻼﻣﺎﻛ ﺎﺗ ﻒﻟﺎﺨﻣ ) 1 ( ﺪﺷ هدﺎﻔﺘﺳا .

تاﺮﻤﻧ هدوﺪﺤﻣ

زا 28 ﺎﺗ 140 ﺮﺗﻻﺎﺑ هﺮﻤﻧ و هدﻮﺑ ﺮﺘـﺸﻴﺑ يﺪـﻨﻤﻧاﻮﺗ ﻲﻨﻌﻣ ﻪﺑ

ﻲﻣ نارﺎﻤﻴﺑ ﻦﻳا رد ﺪﺷﺎﺑ

. ﺖـﻬﺟ ﺖـﺴﻴﻟ ﻚـﭼ زا ﻦﻴـﻨﭽﻤﻫ

تﺎﺸﻳﺎﻣزآ ﺖﺒﺛ رد ﻪـﻛ ﺪـﺷ هدﺎﻔﺘﺳا ﺶﻫوﮋﭘ ﺖﺤﺗ نارﺎﻤﻴﺑ

ﻦﻴﺑﻮـﻠﮔﻮﻤﻫ ﺺﺧﺎـﺷ ﺮـﺑ هوﻼﻋ ﺎﺘﺳار ﻦﻳا ﻪـﺑ ﻪـﻛA1C

ﻢﻬﻣ ناﻮﻨﻋ حﺮـﻄﻣ ﻲﺘﺑﺎـﻳد نارﺎـﻤﻴﺑ ﻲﻜﻴﻟﻮﺑﺎـﺘﻣ رﺎﻴﻌﻣ ﻦﻳﺮﺗ

ﺖﺳا ) 20 ( ، ﺪﻨﻗ تﺎﺸﻳﺎﻣزآ ﺎﺘﺷﺎﻧ نﻮﺧ

و ﺎﺘﺷﺎﻧﺮﻴﻏ

، لوﺮﺘﺴﻠﻛ ،

يﺮﺗ

ﻦﻴﻳﺎـﭘ ﻲﻟﺎـﮕﭼ و ﻻﺎﺑ ﻲﻟﺎﮕﭼ ﺎﺑ ﻦﻴﺌﺗوﺮﭘﻮﭙﻴﻟ و ﺪﻳﺮﺴﻴﻠﮔ ﺪﻧﺪﺷ ﻲﺳرﺮﺑ و ﺖﺒﺛ ﺰﻴﻧ .

ﺶﻳﺎـﻣزآ ندﻮـﺑ نﺎﺴﻜﻳ رﻮﻈﻨﻣ ﻪﺑ

ﻧﻮﻤﻧ مﺎﻤﺗ ﻪ ـﻫ ﻦﻴـﺴﺣ مﺎـﻣا نﺎﺘـﺳرﺎﻤﻴﺑ هﺎﮕـﺸﻳﺎﻣزآ ،ﺎ

) ع

ﻪـﺑ (

بﺎـﺨﺘﻧا نارﺎـﻤﻴﺑ مﺎـﻤﺗ ﺖـﻬﺟ رﺎﻛ ﻦﻳا مﺎﺠﻧا ﻞﺤﻣ ناﻮﻨﻋ ﺪﻳدﺮﮔ . ﻴﻠﻛ ياﺮﺑ ﺶﻫوﮋﭘ فاﺪﻫا رﺎﻛ عوﺮﺷ زا ﻞﺒﻗ نارﺎﻤﻴﺑ ﻪ

آ زا و ﺢﻴﺿﻮﺗ ن

ﻫ

ﺖﻳﺎـﺿر ﻪـﻌﻟﺎﻄﻣ رد ﺖﻛﺮـﺷ ﺖـﻬﺟ ﺎ ﻪـﻣﺎﻧ

ﺪﺷ ﺬﺧا ﻲﺒﺘﻛ .

هداد ﺎﻫ ي ﻊﻤﺟ روآ ي

مﺮـﻧ ﻂـﺳﻮﺗ هﺪـﺷ راﺰـﻓا

SPSS v.19 ﺻﻮﺗ رﺎﻣآ زا هدﺎﻔﺘﺳا ﺎﺑ و

ﻴ ﻔ ﻲ نﻮﻣزآ و يﺎـﻫ

ﺮـﺿ و روﺬـﺠﻣ يﺎﻛ يرﺎﻣآ ﻳ

ﮕﺘـﺴﺒﻤﻫ ﺐ ﻲ

درﻮـﻣ نﻮـﺳﺮﻴﭘ

ﺰﺠﺗ ﻳ ﻠﺤﺗ و ﻪ ﻴ ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻞ .

ﻪﺘﻓﺎﻳ ﺎﻫ

ﻛﺮﺷ نارﺎﻤﻴﺑ داﺪﻌﺗ ﺖ

ﺮـﺿﺎﺣ ﻪـﻌﻟﺎﻄﻣ رد هﺪـﻨﻨﻛ 156

يﺎﻫﺪـﺣاو يرﺎـﻤﻴﺑ ﺎـﺑ ﻂﺒﺗﺮـﻣ و ﻲﻧاواﺮﻓ ﻊﻳزﻮﺗ ﻪﻛ دﻮﺑ ﺮﻔﻧ هرﺎﻤﺷ لوﺪﺟ رد ﺶﻫوﮋﭘ ﺖﺤﺗ 1

ﺖﺳا هﺪﺷ هداد نﺎﺸﻧ .

سﺎﺳاﺮﺑ يﺎﻫﺪـﺣاو يﺪـﻨﻤﻧاﻮﺗ هﺮـﻤﻧ ﻦﻴﮕﻧﺎﻴﻣ ﺞﻳﺎﺘﻧ

ﺶﻫوﮋــﭘ 84 /

±16 56 / 82 ﺶــﻧاد هﺮــﻤﻧ ﻦﻴﮕﻧﺎــﻴﻣ و نآ

ﺎــﻫ

31 /

±6 74 / 12 ﺪﺷ شراﺰﮔ .

هرﺎﻤﺷ لوﺪﺟ 2

نﺎﺸﻧ ﻲﻣ ﺪـﻫد

ﺎـﺑ ﻂﺒﺗﺮـﻣ ﺶـﻧاد هﺮـﻤﻧ رد ﺖـﺒﺜﻣ و رادﺎﻨﻌﻣ ﻲﮕﺘﺴﺒﻤﻫ ﻪﻛ يﺪـﻨﻤﻧاﻮﺗ هﺮـﻤﻧ ﺎﺑ يرﺎﻤﻴﺑ ﺎـﺑ نارﺎـﻤﻴﺑ و ﺪـﻳدﺮﮔ هﺪﻫﺎـﺸﻣ

ﺪﻧدﻮﺑ رادرﻮﺧﺮﺑ ﺰﻴﻧ يﺮﺗﻻﺎﺑ ﺶﻧاد هﺮﻤﻧ زا ﺮﺗﻻﺎﺑ يﺪﻨﻤﻧاﻮﺗ .

ﺺﺧﺎــﺷ ناﺰــﻴﻣ ﻦﻴــﻨﭽﻤﻫ ﺎــﺑ ﻲﻫﺎﮕــﺸﻳﺎﻣزآ يﺎــﻫ

ﺧﺎـﺷ رد يﺪﻨﻤﻧاﻮﺗ ﺺ

ـﻫ يﺎ ﻦﻴﺑﻮـﻠﮔﻮﻤﻫ ،A1C

ﺪـﻨﻗ نﻮﺧ

ﺎﺘــﺷﺎﻧ ، ﺮﻴﻏ نﻮﺧﺪــﻨﻗ ﺎﺘــﺷﺎﻧ

، لوﺮﺘــﺴﻠﻛ يﺮــﺗ ،

و ﺪﻳﺮــﺴﻴﻠﮔ

ﻮﭙﻴﻟ ﺺﺧﺎـﺷ رد و رادﺎـﻨﻌﻣ طﺎـﺒﺗرا ﻻﺎـﺑ ﻲﻟﺎـﮕﭼ ﺎﺑ ﻦﻴﺌﺗوﺮﭘ شراﺰـﮔ رادﺎـﻨﻌﻣ طﺎـﺒﺗرا مﺪـﻋ ﻦﻴﻳﺎﭘ ﻲﻟﺎﮕﭼ ﺎﺑ ﻦﻴﺌﺗوﺮﭘﻮﭙﻴﻟ

ﺪــﻳدﺮﮔ . ﻲﻣﺎــﻤﺗ ﺮﻳدﺎــﻘﻣ ﺎــﺑ يﺪــﻨﻤﻧاﻮﺗ ناﺰــﻴﻣ ﻦﻴــﻨﭽﻤﻫ

ﺧﺎﺷ ﺺ ﻫ ﺑ ﺎ ﻪ HDL ﺰﺟ ﺖـﺷاد ﻲﻔﻨﻣ ﻲﮕﺘﺴﺒﻤﻫ )

لوﺪـﺟ

هرﺎﻤﺷ 3 .(

لوﺪﺟ 1 -

ﺑ ﻂﺒﺗﺮﻣ و يدﺮﻓ تﺎﺼﺨﺸﻣ ود عﻮﻧ ﺖﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ رد يرﺎﻤﻴﺑ ﺎ

ﻲﺳرﺮﺑ درﻮﻣ ﻲﮔﮋﻳو

داﺪﻌﺗ / ﺪﺻرد

ﻦﺳ ﻦﻴﮕﻧﺎﻴﻣ ) لﺎﺳ ( 18

/

±6 11 / 48

يرﺎﻤﻴﺑ ﺺﻴﺨﺸﺗ نﺎﻣز

35 /

±2 36 / 7

ﺲﻨﺟ دﺮﻣ

نز 58

) 2 / 37 (%

98 ) 8 / 62 (%

ﻲﻧﺪﺑ هدﻮﺗ ﺺﺧﺎﺷ دﺮﻣ

نز 38

/

±4 24 / 27

23 /

±4 12 / 26

ﻞﻫﺄﺗ ﺖﻴﻌﺿو ﻞﻫﺄﺘﻣ

هﺪﺷ تﻮﻓ ﺮﺴﻤﻫ

124 ) 5 / 79 (%

32 ) 5 / 20

% (

تﻼﻴﺼﺤﺗ ﺢﻄﺳ

ﺖﻀﻬﻧ و ﻲﻳاﺪﺘﺑا

ﻲﻳﺎﻤﻨﻫار ﺮﺗﻻﺎﺑ و ﻢﻠﭙﻳد 100

) 1 / 64 (%

38 ) 4 / 24 (%

18 ) 6 / 11 (%

لوﺪﺟ 2 -

عﻮﻧ ﺖﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ رد ﺶﻧاد هﺮﻤﻧ ﺎﺑ يﺪﻨﻤﻧاﻮﺗ طﺎﺒﺗرا 2

ﺮﻴﻐﺘﻣ ﺶﻧاد هﺮﻤﻧ

Mean±SD) (

نﻮﺳﺮﻴﭘ ﻲﮕﺘﺴﺒﻤﻫ ﺐﻳﺮﺿ

/

p-value

يﺪﻨﻤﻧاﻮﺗ 74

/

±12 31 / 46 6

/ 0 r=

01 / 0

= p

(6)

يﺎﻫ ...

نارﺎﻜﻤﻫ

٢٦

لوﺪﺟ 3 -

ﻫ ﻲﮕﺘﺴﺒﻤ ﺺﺧﺎﺷ عﻮﻧ ﺖﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ رد يﺪﻨﻤﻧاﻮﺗ ﺎﺑ ﻲﻫﺎﮕﺸﻳﺎﻣزآ يﺎﻫ 2

ﺮﻴﻐﺘﻣ

ﺺﺧﺎﺷ ﻚﻴﻟﻮﺑﺎﺘﻣ لﺮﺘﻨﻛ يﺎﻫ

يﺪﻨﻤﻧاﻮﺗ

p-value) r (

(%)A1Cﻦﻴﺑﻮﻠﮔﻮﻤﻫ 69

/

±1 06 / 8 001 /

<0 54 / 0 r=-

ﺪﻨﻗ ﺎﺘﺷﺎﻧ نﻮﺧ mg/dl 11

/

±32 41 / 168 001 /

<0 54 / 0 r=-

ﺪﻨﻗ ﺎﺘﺷﺎﻧ ﺮﻴﻏ نﻮﺧ mg/dl

47

/

±50 88 / 265 01 / 0 54 / 0 r=-

لوﺮﺘﺴﻠﻛ mg/dl 11

/

±43 86 / 173 05

/ 0 54 / 0 r=-

يﺮﺗ ﺪﻳﺮﺴﻴﻠﮔ mg/dl 52

/

±64 98 / 195 04 / 0 54 / 0 r=-

ﻮﭙﻴﻟ ﻦﻴﻳﺎﭘ ﻲﻟﺎﮕﭼ ﺎﺑ ﻦﻴﺌﺗوﺮﭘ mg/dl

47

/

±64 33 / 175 21 / 0 54 / 0 r=-

ﻮﭙﻴﻟ ﻻﺎﺑ ﻲﻟﺎﮕﭼ ﺎﺑ ﻦﻴﺌﺗوﺮﭘ mg/dl

91

/

±9 89 / 45 01 / 0 54 / r=0

ﺚﺤﺑ

ـﻨﻌﻣ و ﺖـﺒﺜﻣ ﻲﮕﺘﺴﺒﻤﻫ ﻪﻛ داد نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ رادﺎ

دﻮـﺟو ﺖـﺑﺎﻳد يرﺎـﻤﻴﺑ ﺎـﺑ ﻂﺒﺗﺮﻣ ﺶﻧاد هﺮﻤﻧ و يﺪﻨﻤﻧاﻮﺗ ﻦﻴﺑ رﻮـﻃ ﻪـﺑ ،ﺮﺘـﺸﻴﺑ يﺪـﻨﻤﻧاﻮﺗ ﺎﺑ نارﺎﻤﻴﺑ ﻪﻛ ﻲﻨﻌﻣ ﻦﻳا ﻪﺑ ﺖﺷاد ﺎـﺴﻣ ﻪﺑ ﺖﺒﺴﻧ يﺮﺗﻻﺎﺑ ﺶﻧاد زا يرادﺎﻨﻌﻣ ﻳ

ﺖـﺑﺎﻳد يرﺎـﻤﻴﺑ ﻞ

رادرﻮﺧﺮﺑ ﺪﻧدﻮﺑ Minet . شراﺰـﮔ دﻮﺧ ﻖﻴﻘﺤﺗ رد نارﺎﻜﻤﻫ و

ﺪﻨﻤﻧاﻮﺗ ﻲﻧﺎﻣز ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ ﺪﻧدﺮﻛ ﻲـﻣ

ﺪﻧﻮـﺷ تﺎـﻋﻼﻃا ﻪـﻛ

ﻪـﻧﺎﻫﺎﮔآ ﻢﻴﻤـﺼﺗ ذﺎﺨﺗا رﻮﻈﻨﻣ ﻪﺑ ار دﻮﺧ يرﺎﻤﻴﺑ درﻮﻣ رد مزﻻ ياﺮـﺑ ﺐـﺳﺎﻨﻣ ﻂﻳاﺮـﺷ ،دﻮـﺧ ﺮﺑ ﻲﺒﺳﺎﻨﻣ لﺮﺘﻨﻛ ،ﺪﻨﻳﺎﻤﻧ ﺐﺴﻛ ﻦـﻳا يﺪﻨﻣدﻮـﺳ ﻲﺑﺎﻴﺷزرا ياﺮﺑ مزﻻ برﺎﺠﺗ و ﻢﻴﻤﺼﺗ ياﺮﺟا ﺪﻨﺷﺎﺑ ﻪﺘﺷاد ار تﺎﻤﻴﻤﺼﺗ )

21 ( . و يرﺎﻤﻴﺑ هرﺎﺑرد نارﺎﻤﻴﺑ ﺶﻧاد

ﺑ ﺖﻴﻤﻫا نآ لﺮﺘﻨﻛ ﻪ

ﻲﻳاﺰﺳ دراد ﺮﺛا يرﺎـﻤﻴﺑ لﺮﺘﻨﻛ ﺮﺑ و راﺬـﮔ

ﺖﺳا ) 22 ( . يزﺎـﺳﺪﻨﻤﻧاﻮﺗ يﺪـﻴﻠﻛ ءاﺰـﺟا زا ﻲﻜﻳ ،ﺶﻧاد دﻮﺟو

ﺶﻳاﺰـﻓا ،نارﺎـﻤﻴﺑ يزﺎـﺳﺪﻨﻤﻧاﻮﺗ دﻮـﺒﻬﺑ يﺎﺘـﺳار رد ﻪﻛ ﺖﺳا ﺖﻛرﺎﺸﻣ آ ﻞﻣﺎﻌﺗ و رﺎﻤﻴﺑ يﺮﻳﺬﭘ ن

ﻫ ﺖـﺳا يروﺮـﺿ ﺎ )

23 ( . ﺮـﺑ

رﺎـﻤﻴﺑ ﻪـﻛ ﻲﻧﺎـﻣز ﺖـﺳا هداد نﺎـﺸﻧ ﻲﻤﻠﻋ ﺪﻫاﻮﺷ سﺎﺳا ﻦﻳا يرﺎﻤﻴﺑ نﺎﻣرد ﺪﻨﻳآﺮﻓ ﺮﻴﮔرد دﻮﺧ

ﻲﻣ ﺒﺴﻧ ﻪﺑ ددﺮﮔ ﻪـﻛ ﻲﻧﺎﻣز ﺖ

ﺮﻴﻏ دﻮﺧ نﺎﻣرد ﺮﻣا رد ﺖـﺳد ﻪـﺑ يﺮـﺘﻬﺑ ﺞﻳﺎـﺘﻧ ،ﺖـﺳا لﺎـﻌﻓ

ﻲﻣ دروآ ) 24 (.

ﻪﻌﻟﺎﻄﻣ Mosnier-Pudar نﺎﺸﻧ نارﺎﻜﻤﻫ و

شزﻮﻣآ ﻖﻳﺮﻃ زا ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ ﺶﻧاد ﺢﻄﺳ ندﺮﺑ ﻻﺎﺑ ﻪﻛ داد آ ﻪﺑ ن ﻫ ﺚﻋﺎﺑ ﺎ ﻲﻣ ﺐـﺴﻛ ﺎﺑ نارﺎﻤﻴﺑ ﻪﻛ دﻮﺷ ﺶـﻧاد

رد ﺮﺘـﺸﻴﺑ

،دﻮﺧ يرﺎﻤﻴﺑ تﺪﺷ درﻮﻣ ﻴﺻﻮﺗ ﻪﺑ

ﻪ ﻫ ارا يﺎ ﻳ لﺮﺘﻨﻛ ياﺮﺑ هﺪﺷ ﻪ

ﻪﻧﻻﺎﻌﻓ و هدﻮﻤﻧ يﺮﺘﺸﻴﺑ ﻪﺟﻮﺗ يرﺎﻤﻴﺑ ﺖﻳﺮﻳﺪﻣ و ﺮﺗ

ﺖﻳﺮﻳﺪﻣ رد

ﺮﻴﮔرد دﻮﺧ يرﺎﻤﻴﺑ ﻲﻣ

ﺪﻧﻮﺷ ) 25 ( . ﻞﻃ ﻪﻌﻟﺎﻄﻣ ﻪﺠﻴﺘﻧ ﻦﻴﻨﭽﻤﻫ

ﺎﺑ نارﺎﻤﻴﺑ داد نﺎﺸﻧ نارﺎﻜﻤﻫ و ياراد و ﺮﺗﻻﺎـﺑ ﻲﻫﺎـﮔآ ﺢﻄﺳ

ذﺎـﺨﺗا ﺮﺘـﺸﻴﺑ ار ﻲﺘﻳﺮﻳﺪﻣدﻮﺧ يﺎﻫرﺎﺘﻓر ،يرﺎﻤﻴﺑ زا ﺮﺘﻬﺑ كرد ﺪﻨﺘﺷاد يﺮﺘﻬﺑ ﺖﺑﺎﻳد لﺮﺘﻨﻛ نآ ﻪﺠﻴﺘﻧ رد و هدﻮﻤﻧ )

26 (.

ﺮــﺜﻛا ﺮﻳدﺎــﻘﻣ ،ﺪــﺷ هداد نﺎــﺸﻧ ﺮــﺿﺎﺣ ﺶﻫوﮋــﭘ رد ﺺﺧﺎﺷ

ﻦﻴﺑﻮـﻠﮔﻮﻤﻫ ناﺰـﻴﻣ ﻪﻠﻤﺟ زا ﻚﻴﻟﻮﺑﺎﺘﻣ لﺮﺘﻨﻛ يﺎﻫ رادﺎــﻨﻌﻣ طﺎــﺒﺗرا يﺪــﻨﻤﻧاﻮﺗ ﺎــﺑ ﻲﺘﺑﺎــﻳد نارﺎــﻤﻴﺑ ردA1C

ﺖﺷاد . ﻟﺎﻄﻣ رد Shiu ﻪﻌ

ﻫ و نارﺎـﻜﻤ ﻦﻴـﺑ ﻲـﻄﺧ طﺎـﺒﺗرا

ــﻳد نارﺎــﻤﻴﺑ يزﺎــﺳﺪﻨﻤﻧاﻮﺗ لﺮــﺘﻨﻛ ﺖﻴﻌــﺿو دﻮــﺒﻬﺑ و ﻲﺘﺑﺎ

ﺖــﺷاﺪﻧ دﻮــﺟو ﻲﻜﻴﻟﻮﺑﺎــﺘﻣ )

15 ( و ﻞــﻃ ﻖــﻴﻘﺤﺗ رد ﺎــﻣا

شراﺰـﮔ ﺮـﻴﻐﺘﻣ ود ﻦﻳا ﻦﻴﺑ ﻢﻴﻘﺘﺴﻣ ﻲﻄﺧ طﺎﺒﺗرا نارﺎﻜﻤﻫ ﺪــﺷ ) 27 ( . ﺎﺘــﺳار ﻦﻴــﻤﻫ رد ﻲﻋﺎﺠــﺷ ﻪــﻌﻟﺎﻄﻣ رد

و هداز

ناﺰـﻴﻣ ﻲﺘﺑﺎـﻳد نارﺎـﻤﻴﺑ يﺪـﻨﻤﻧاﻮﺗ ﺶﻳاﺰﻓا ﺎﺑ ﺰﻴﻧ نارﺎﻜﻤﻫ ﻦﻴﺑﻮﻠﮔﻮﻤﻫ آA1C

ن ﻫ ﺶﻫﺎﻛ ﺎ ﻲﻣ ﺖﻓﺎﻳ ) 28 (.

د ﻦﻴـﻤﻫ ر

ﺎﺘﺳار ﺖـﺒﺜﻣ ﺮﻴﺛﺄـﺗ ،دﻮـﺧ ﻪـﻌﻟﺎﻄﻣ رد نارﺎـﻜﻤﻫ و ﻲﻗدﺎـﺻ

ﻣﺎﻧﺮﺑ ﻪ ﻫ لﺮﺘﻨﻛ ﺖﻴﻌﺿو ﺮﺑ يزﺎﺳﺪﻨﻤﻧاﻮﺗ يﻮﮕﻟا ﺮﺑ ﻲﻨﺘﺒﻣ يﺎ

عﻮﻧ ﺖﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ ﻲﻜﻴﻟﻮﺑﺎﺘﻣ 2

ﺑ ار ﻪ نﺎـﺸﻧ ﻲﺑﻮﺧ

داد ه ﺪﻧا ) 17 ( . ﻦﻴﻨﭽﻤﻫ ﻪﻌﻟﺎﻄﻣ رد ﺣ

ﻴ رﺪ ي و ﻤﻫ ﻜ ﺮﻴﺛﺄـﺗ نارﺎ

ﺖﺒﺜﻣ اﺮﺟا ي ﻪﻣﺎﻧﺮﺑ زﺎﺳﺪﻨﻤﻧاﻮﺗ ي دﻮﺒﻬﺑ رد و ﻲﮔﺪﻧز ﺖﻴﻔﻴﻛ

رد ﻲﻜﻴﻟﻮﺑﺎﺘﻣ لﺮﺘﻨﻛ نﺎﻧاﻮﺟﻮﻧ

ﺖﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ ﺪـﺷ هﺪﻫﺎﺸﻣ

) 29 .(

ﻪﻌﻟﺎﻄﻣ Pibernik-Okanovic ﺰـﻴﻧ نارﺎﻜﻤﻫ و

تﻼﺧاﺪـﻣ ياﺮـﺟا ﺎـﺑ ار ﻲﻜﻴﻟﻮﺑﺎـﺘﻣ لﺮـﺘﻨﻛ ﺖﻴﻌﺿو دﻮﺒﻬﺑ ﺪــﻧدﺮﻛ شراﺰــﮔ يزﺎــﺳﺪﻨﻤﻧاﻮﺗ ﺮــﺑ ﻲــﻨﺘﺒﻣ ﻲــﻧاور )

30 .(

رد

ﻖﻴﻘﺤﺗ Goldhaber-Fiebert نﺎـﺸﻧ ﺰـﻴﻧ نارﺎﻜﻤﻫ و

هداد زا ﺪـﻌﺑ ﺖـﺑﺎﻳد ﻪـﺑ ﻼﺘـﺒﻣ نارﺎـﻤﻴﺑ ﺶـﻧاد ﺶﻳاﺰﻓا ﺪﺷ

يراﺰــﮔﺮﺑ 11 و ﻪــﻳﺬﻐﺗ درﻮــﻣ رد ﻲــﮕﺘﻔﻫ شزﻮــﻣآ سﻼــﻛ

ﻲﻳﺎﻫﺪـﻣĤﻴﭘ و هﺪﺷ نارﺎﻤﻴﺑ ﻦﻳا دﺮﻜﻠﻤﻋ دﻮﺒﻬﺑ ﺚﻋﺎﺑ شزرو ﻮﺧﺪﻨﻗ ﺮﺘﻬﺑ لﺮﺘﻨﻛ و نزو ﺶﻫﺎﻛ نﻮﭽﻤﻫ آ رد ار ن

ن ﻫ ﻪـﺑ ﺎ

ﺖﺷاد هاﺮﻤﻫ )

31 ( ﻪﻛ نﺎـﺸﻧ قﻮـﻓ تﺎﻘﻴﻘﺤﺗ ﺞﻳﺎﺘﻧ عﻮﻤﺠﻣ

ﻲﻣ ﺮﺑ ياﺮﺟا ﺎﺑ ﺪﻫد ﻣﺎﻧ

ﻪ ﻫ ،ﻲﺘﺑﺎـﻳد نارﺎـﻤﻴﺑ رد يﺪﻨﻤﻧاﻮﺗ يﺎ

بﻮﻠﻄﻣ يﺎﻫﺪﻣĤﻴﭘ ﺮﺗ

ﺧﺎﺷ زا ي ﺺ ﻫ ار ﻲﻨﻴﻟﺎﺑ يﺎ ﻲﻣ

رد ناﻮﺗ

آ ن ﻫ دﻮﺑ ﺪﻫﺎﺷ ﺎ .

نارﺎــﻤﻴﺑ دﺮــﻛ ﺺﺨــﺸﻣ ﺮــﺿﺎﺣ ﻪــﻌﻟﺎﻄﻣ ﺞﻳﺎــﺘﻧ ﺎــﺑ

ﺶﻧاد زا ﺮﺗﻻﺎﺑ يﺪﻨﻤﻧاﻮﺗ دﻮـﺧ يرﺎـﻤﻴﺑ ﻪـﺑ ﺖﺒﺴﻧ يﺮﺘﺸﻴﺑ

ﺧﺎﺷ و ﺪﻧرادرﻮﺧﺮﺑ ﺺ

ﻫ ﻚﻴﻟﻮﺑﺎﺘﻣ لﺮﺘﻨﻛ يﺎ نآ

ﺎﻫ ﺮﻳدﺎـﻘﻣ زا

(7)

يﺎﻫ ...

نارﺎﻜﻤﻫ

٢٧

بﻮــﻠﻄﻣ ﺮــﺗ ي ﺖــﺳا رادرﻮــﺧﺮﺑ .

ﻪــﺑ ﻲﺘﻨــﺳ دﺮــﻜﻳور ﺮــﻴﻴﻐﺗ

ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ ﺖﺒﻗاﺮﻣ و شزﻮﻣآ رد يزﺎﺳﺪﻨﻤﻧاﻮﺗ ﻲﻣ

ﺪـﻧاﻮﺗ

ﻪـﻨﻴﻣز ،ﺐـﺳﺎﻨﻣ ﺮﺘـﺴﺑ دﺎﺠﻳا ﺎﺑ

دﻮـﺧ دﻮـﺒﻬﺑ زﺎـﺳ و ﻲﺘﺒﻗاﺮﻣ

ﺪﺷﺎﺑ ﻲﺘﺑﺎﻳد نارﺎﻤﻴﺑ رد ﻲﺘﻣﻼﺳ ﺖﻴﻌﺿو )

14 (.

ناﻮـﻨﻋ ﻪـﺑ ﺖـﺑﺎﻳد ﻪﺑ ﻼﺘﺒﻣ نارﺎﻤﻴﺑ يزﺎﺳﺪﻨﻤﻧاﻮﺗ ﺮﻴﻴﻐﺗ يﺎﺘﺳار رد ﺮﺛﺆﻣ ﻪﻣﺎﻧﺮﺑ ﻚﻳ ﺖﺑﺎﻳد ﺖﺒﻗاﺮﻣ رد رﺎﺘﻓر

رﺎﻤﺷ ﻪﺑ ﻲﻣ ﺪﻳآ ) 32 .(

و ﻞـﻃ ﻪﻌﻟﺎﻄﻣ ﻪﺠﻴﺘﻧ ﺎﺘﺳار ﻦﻳا رد

ﺮـﺑ ﻲﻨﺘﺒﻣ ﻲﺷزﻮﻣآ تﻼﺧاﺪﻣ دﺮﻛ ﺺﺨﺸﻣ ﺰﻴﻧ نارﺎﻜﻤﻫ ءﺎــﻘﺗرا ﻞﻴـﺴﻧﺎﺘﭘ ،ﻲﺘﺑﺎــﻳد نارﺎـﻤﻴﺑ يزﺎــﺳﺪﻨﻤﻧاﻮﺗ ناﺰـﻴﻣ اراد ار يرﺎـﻤﻴﺑ ﺮﺛﺆـﻣ لﺮـﺘﻨﻛ رد ﻲﺘﻳﺮﻳﺪﻣدﻮﺧ يﺎﻫرﺎﺘﻓر ﺪﻨﺘﺴﻫ ) 12 ( ﻪﺟﻮﺗ و يزﺎـﺳﺪﻨﻤﻧاﻮﺗ ﺪـﻨﻧﺎﻣ ﻲﻤﻴﻫﺎـﻔﻣ ﻪـﺑ

نارﺎــﻤﻴﺑ ﻦــﻳا رد تﻼﺧاﺪــﻣ ﺞﻳﺎــﺘﻧ دﻮــﺒﻬﺑ رد رﺎــﻤﻴﺑ بﺎﻨﺘﺟا ﺖﺳا ﺮﻳﺬﭘﺎﻧ )

28 ( . هدﺎﻣآ ﻖﻳﺮﻃ زا ماﺪﻗا ﻦﻳا ،يزﺎﺳ

عﻼــﻃا

ﻧﺎــﺳرﺪﻨﭼ ﻊﺑﺎــﻨﻣ زا هدﺎﻔﺘــﺳا ﺎــﺑ ﻲﻧﺎــﺳر ﻪ

يا و

ﻣﺎﻧﺮﺑ رد ﺎﻘﺗرا و تﺎﻋﻼﻃا يژﻮﻟﻮﻨﻜﺗ ﻪ

ـﻫ ﻲﺘﻳﺮﻳﺪـﻣدﻮﺧ يﺎ

ﺮﺴﻴﻣ ﺖﺑﺎﻳد ﻲـﻣ

ددﺮـﮔ ) 24 ( . د فﺮـﻃ زا دﺎـﺠﻳا ﺎـﺑ ﺮـﮕﻳ

رﺎﺸﻣ ﻚﻳ ،ﮓﻨﻫﺎﻤﻫ و ﺐﺳﺎﻨﻣ طﺎﺒﺗرا ﻛ

ﻲﺿار ﺖ رد هﺪﻨﻨﻛ

دﺎﺠﻳا ﻦﻴﻓﺮﻃ ﻲﻣ

ﺺﺧﺎـﺷ دﻮﺒﻬﺑ نآ ﻪﺠﻴﺘﻧ ﻪﻛ دﻮﺷ يﺎـﻫ

ﺢﻄـﺳ يﺎـﻘﺗرا و يﺪـﻣآرﺎﻛدﻮﺧ ﺶﻳاﺰـﻓا ،ﺖـﺑﺎﻳد لﺮﺘﻨﻛ ﺖﻳﺎﺿر

ﻲـﻣ ﻪـﺒﻧﺎﺟ ود يﺪﻨﻣ ﺪـﺷﺎﺑ

) 11 ( . ﺮـﻴﻴﻐﺗ ﻦﻳاﺮﺑﺎـﻨﺑ

ﻣﺎﻧﺮﺑ دﺮﻜﻳور ﻪ

ﻫ و يزﺎـﺳﺪﻨﻤﻧاﻮﺗ ﺖﻤـﺳ ﻪـﺑ ﻲـﺘﺒﻗاﺮﻣ يﺎ

ﮔرد ﺶﻳاﺰﻓا ﺖﻳﺮﻳﺪـﻣ رد نارﺎـﻤﻴﺑ ﺖﻛرﺎـﺸﻣ و ندﻮﻤﻧ ﺮﻴ

،دﻮﺧ يرﺎﻤﻴﺑ ﻲﻣ

ﺎﺑ ﺪﻧاﻮﺗ

ﺧﺎـﺷ دﻮـﺒﻬﺑ ﺺ

و ﻲﻨﻴﻟﺎـﺑ يﺎـﻫ

ﺪﺷﺎﺑ هاﺮﻤﻫ ﻲﺘﻣﻼﺳ ﺖﻴﻌﺿو .

ﻳدوﺪﺤﻣ زا

ﺖ ﻫ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ يﺎ ﻲﻣ

ﻢـﺠﺣ ﻪـﺑ ناﻮـﺗ

ﻦـﻳا ﻞـﻴﻟد ﻪـﺑ يﺮﻴﮔﻮﺳ لﺎﻤﺘﺣا و دوﺪﺤﻣ ﻪﻧﻮﻤﻧ ﺎـﻬﻨﺗ ﻪـﻛ

،ﺪـﻨﺘﻓﺮﮔ راﺮﻗ ﻪﻌﻟﺎﻄﻣ ﺖﺤﺗ ﺖﺑﺎﻳد ﺰﻛﺮﻣ ﻪﺑ ﻲﻋﺎﺟرا نارﺎﻤﻴﺑ رﺎــﺷا هدﺮﺘــﺴﮔ تﺎــﻘﻴﻘﺤﺗ مﺎــﺠﻧا ﻪــﻛ دﻮــﻤﻧ ه ﺮــﺗ

يورﺮــﺑ

ﻴﻌﻤﺟ ﺖ ـﻫ ﺨﻣ يﺎ ﺘ دﺎﻬﻨـﺸﻴﭘ ﺮﺘـﺸﻴﺑ ﻪـﻧﻮﻤﻧ ﻢـﺠﺣ ﺎـﺑ و ﻒـﻠ

ﻲﻣ ددﺮﮔ .

ﻪﺠﻴﺘﻧ يﺮﻴﮔ

ﺮﻈﻧ ﻪﺑ ﻲﻣ ﺪﻨﻤﻧاﻮﺗ ﺪﺳر ندﻮﻤﻧ

ﺑﻴ نارﺎـﻤ ﻼﺘـﺒﻣ ﻪـﺑ

ﺑﻴ رﺎﻤ ي ﻫ ﺎ ي ﻦﻣﺰـﻣ زا ﻪـﻠﻤﺟ د ﻳ ﺖـﺑﺎ زا ﺮﻃ ـﻳ ﻖ نﺪـﻧﺎﺠﻨﮔ

تﺎﻣاﺪـﻗا ـﺷزﻮﻣآ ﻲ ـﻨﺘﺒﻣ ﻲ ﺮـﺑ ﻳور ـﻜ دﺮ زﺎـﺳﺪﻨﻤﻧاﻮﺗ ي

، رد

ﻣﺎﻧﺮﺑ ﻪ ـﻫ ﺎ ي ـﺘﺒﻗاﺮﻣ ﻲ ﻖـﻳﺮﻃ زا اﺰـﻓا

ﻳ ﺶ ﻫﺎـﮔآ ﻲ و دﻮـﺒﻬﺑ

ﻲﻨﻴﻟﺎـﺑ يﺎﻫﺪـﻣĤﻴﭘ و

ـﻨﭽﻤﻫ ﻴ ﻦ ﮔاﺮﻓ ـﻴ ﺮ ندﻮـﻤﻧ سﺎـﺴﺣا

ﺴﻣ ﺆ ﻟو ﻴ ﺖ ﺬﭘ ﻳ ﺮ ي ﺑﻴ نارﺎﻤ رد درﻮﻣ ﺑﻴ رﺎـﻤ ي

،دﻮـﺧ ﻪـﺑ رﻮـﻃ

ﺮﺛﺆﻣ ي ﺚﻋﺎﺑ دﻮﺒﻬﺑ ﻌﺿو ﻴ ﺖ اﻳ ﻦ ﺑﻴ نارﺎﻤ ﺪﺷ ﺪﻫاﻮﺧ .

ﻲﻧادرﺪﻗ و ﺮﻜﺸﺗ

هرﺎﻤـﺷ ﻪـﺑ بﻮـﺼﻣ حﺮـﻃ زا ﻲـﺸﺨﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ 1901 ﮕﺸﻧاد ﻲﺸﻫوﮋﭘ ﺖﻧوﺎﻌﻣ دﻮﺑ دوﺮﻫﺎﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎ

ﻦﻳﺪﺑ ﻪﻛ ﻪﻠﻴﺳو ﻦﻴﻘﻘﺤﻣ ﻦﻳا يﻮﻨﻌﻣ و ﻲﻟﺎﻣ ﺖﻳﺎﻤﺣ ﺖﻧوﺎﻌﻣ

رد ﻞﻏﺎـﺷ مﺮـﺘﺤﻣ نارﺎﺘﺳﺮﭘ ﻪﻧﺎﻤﻴﻤﺻ يرﺎﻜﻤﻫ ﻦﻴﻨﭽﻤﻫ و ﻦﻴﺴﺣ مﺎﻣا نﺎﺘﺳرﺎﻤﻴﺑ ﺖﺑﺎﻳد ﺪﺣاو )

ع ( و نوﺪﺑ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ

نﺎﻜﻣا ﻲﻤﻠﻋ ﺖﻴﻟﺎﻌﻓ ﻦﻳا ﻪﻣادا نﺎﺸﻳرﺎﻜﻤﻫ جرا ار دﻮـﺒﻧ ﺮﻳﺬﭘ

ﻲﻣ ﺪﻨﻬﻧ .

ﻊﺑﺎﻨﻣ

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يﺎﻫ ...

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The relationship between empowerment with knowledge related to disease and indicators of metabolic control in type

2 diabetic patients

Ebrahimi¹ H (Ph.D) - Sadeghi² M (MSc.) - Ashrafi³ R (MSc.).

Abstract

Introduction: Due to the chronic condition of diabetes and widespread impact on various aspects of life, changing the traditional approach to empowering education and care patients with diabetes may improve levels of self-care and clinical status of them. The purpose of this study was the finding the relationship between empowerment with knowledge related to disease and indicators of metabolic controls in type 2 diabetic patients.

Method: This analytical-descriptive study was conducted on 156 patients with type 2 diabetes in 2013. The data collection tool was a questionnaire to assess knowledge, empowerment assessment questionnaire (DES-28) and test record forms (hemoglobin A1C, fasting and non-fasting blood glucose, cholesterol, triglycerides and high-density and low-density lipoprotein). Data were analyzed using descriptive statistics and Pearson correlation coefficient.

Results: Mean age of the patients was 48.11±6.18 and most of them were female (62.8%). There was a significant relationship between the mean score for empowerment and knowledge of patients. Also a significant relationship was found between hemoglobin A1C, fasting and non-fasting blood glucose, cholesterol, triglycerides and HDL with empowerment. But, there was not a significant relationship with LDL and patients with higher empowerment.

Conclusion: Continuous training and increasing the knowledge and Empowerment of patients can may result in a favorable outcome of life in these patients.

Key words: Type 2 diabetes, empowerment, knowledge, metabolic control

Received: 30 August 2014 Accepted: 21 February 2015

1 - Ph.D, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran 2 - Corresponding author: MSc., School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran

e-mail: [email protected]

3 - MSc., School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran

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