ﻦﻴﺑ طﺎﺒﺗرا ﻲﻣﺮﺳ حﻮﻄﺳ
ﻦﻴﻧﻮﭘوﺮﺗ و I
ﻻﺎﺑ ﺖﻴﺳﺎﺴﺣ ﺎﺑ CRP
نارﺎﻤﻴﺑ رد ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ
ﻲﺘﻋارز ﻲﻠﻌﺳﺎﺒﻋ ﻲﻔﻳﺮﺷ ﻪﻧازﺮﻓ ،1
1رﻮﭘ
، ﻲﺒﺟر هﺰﺋﺎﻓ
2ﻞﮔ ﺪﻧزرﻮﭘ كرﻮﻫ ،
،3
ﻒﻴﺳ ﺪﻴﺳ يﻮﺳﻮﻣ يدﻼﺑ ﻪﻟا
4
هﺪﻴﻜﭼ
ﻪﻨﻴﻣز فﺪﻫ و يﻻﺎﺑ حﻮﻄﺳ ﻲﻫاﺮﻤﻫ: ﻦﻴﻧﻮﭘوﺮﺗ وCRP
، ﻴﻣ و گﺮﻣ ناﺰﻴﻣ يﺰﻴﻟﺎﻳد نارﺎﻤﻴﺑ رد ار ﺮ
ﺪﻳﺪﺸﺗ ﻲﻣ ﺮﻫ و ﺪﻨﻛ ود
، ﻞﻣاﻮﻋ
ياﺮﺑ ﺮﻄﺧ ﻞﻘﺘﺴﻣ ﻚﻴﻣروا ﻲﺗﺎﭘﻮﻴﻣﻮﻳدرﺎﻛ
ﻲﻣ ﺪﻨﺷﺎﺑ . رد ﻦﻳا ﻪﻌﻟﺎﻄﻣ
، ﻦﻴﻧﻮﭘوﺮﺗ ﺢﻄﺳ ﻦﻴﺑ طﺎﺒﺗرا ﻲﻣﺮﺳ حﻮﻄﺳ وI
ﺎﺑCRP
ﺖﻴﺳﺎﺴﺣ
ﻻﺎﺑ )
hs-CRP
( ﺪﻳدﺮﮔ ﻲﺳرﺮﺑ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد .
شور ﻖﻴﻘﺤﺗ
،ﻲﻌﻄﻘﻣ ﺶﻫوﮋﭘ ﻦﻳا رد : 52
ﺎﺑ رﺎﻤﻴﺑ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ ﺪﻧﺪﺷ ﻪﻌﻟﺎﻄﻣ دراو
. ﻦﻴﻧﻮﭘوﺮﺗ حﻮﻄﺳ و I
hs-CRP
رد ﺎﻬﻧآ مﺮﺳ
هزاﺪﻧا ﺪﺷ يﺮﻴﮔ . ﻲﺳرﺮﺑ درﻮﻣ ﻪﻳﺎﭘ تﺎﻋﻼﻃا ﺮﻳﺎﺳ
، ﺪﻧدﻮﺑ يرﺎﻤﻴﺑ تﺪﻣ لﻮﻃ و ﻦﺳ ﻞﻣﺎﺷ .
زا نﻮﻣزآ ﻦﻣﺮﻴﭙﺳا ﻲﮕﺘﺴﺒﻤﻫ
، ياﺮﺑ ﻲﺳرﺮﺑ
ﻦﻴﻧﻮﭘوﺮﺗ ﻦﻴﺑ طﺎﺒﺗرا وI
hs-CRP
ﺪﺷ هدﺎﻔﺘﺳا .
ﻪﺘﻓﺎﻳ ﺎﻫ رد: ،ﻪﻌﻟﺎﻄﻣ ﻦﻳا 52
ﻤﻴﺑ رﺎ ) 27 و دﺮﻣ 25 نز ( ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ ﺎﺑ 4
/ 13 98± / 42 ﺪﻧﺪﺷ ﻲﺳرﺮﺑ لﺎﺳ .
ﻦﻴﮕﻧﺎﻴﻣ
hs-CRP
نارﺎﻤﻴﺑ رد
هﺪﺷﺪﻧﻮﻴﭘ روادﺎﻛ هﺪﻨﻫد زا )
تﻮﻓ دﺮﻓ هﺪﺷ ( ﻲﻨﻌﻣ رﻮﻃ ﻪﺑ زا ﺮﺗﻻﺎﺑ يراد
دﻮﺑ هﺪﻧز هﺪﻨﻫد
، ﻧﻮﭘوﺮﺗ ﻦﻴﮕﻧﺎﻴﻣ ﻲﻟو مﺮﺳ ﻦﻴ
ود رد توﺎﻔﺗ هوﺮﮔ
ﻲﻨﻌﻣ داﺪﻧ نﺎﺸﻧ يراد .
ﻦﻴﺑ ﺢﻄﺳ ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ مﺮﺳ
Hs-CRP
ﻲﻨﻌﻣ طﺎﺒﺗرا ﺪﺸﻧ هﺪﻫﺎﺸﻣ يراد
. ﻲﻨﻌﻣ طﺎﺒﺗرا يراد
ﻄﺳ ﻦﻴﺑ ﻮ ح ﻧﻮﭘوﺮﺗ ﻦﻴ
ﺎﺑ مﺮﺳ
hs-CRP
رد نارﺎﻤﻴﺑ ﻞﻛ ) 04 / 0 ،r=-
60 / 0
= ( P
و روادﺎﻛ هﺪﻨﻫد زا هﺪﺷﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ و ﺪﺸﻧ هﺪﻫﺎﺸﻣ هﺪﻧز
.
ﻪﺠﻴﺘﻧ يﺮﻴﮔ ﺎﺑ: طﺎﺒﺗرا مﺪﻋ ﻪﺑ ﻪﺟﻮﺗ ﻦﻴﺑ
ﺢﻄﺳ ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ مﺮﺳ
Hs-CRP
ﻴﻠﻛ ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد
،ﻪ ﻲﻣ ﺮﻈﻧ ﻪﺑ بﺎﻬﺘﻟا ﺪﺳر
، دﺎﺠﻳا رد
ﺪﺷﺎﺑ ﻪﺘﺷاﺪﻧ ﺶﻘﻧ نارﺎﻤﻴﺑ ﻦﻳا درﺎﻛﻮﻴﻣ ﺐﻴﺳآ .
هژاو يﺪﻴﻠﻛ يﺎﻫ ﻦﻴﻧﻮﭘوﺮﺗ:
مﺮﺳ
، ﺎﺑCRP
ﻻﺎﺑ ﺖﻴﺳﺎﺴﺣ ،
ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ ﻪﻠﺠﻣ .
1392
؛ 20 ) 3 :(
312 - 316 .
ﺖﻓﺎﻳرد : 27 / 06 / 1391 شﺮﻳﺬﭘ : 29 / 03 / 1392
رﺎﻳدﺎﺘﺳا1
هوﺮﮔ ، ﻲﻠﺧاد
، ﻘﺤﺗ ﺰﻛﺮﻣ ﻴ تﺎﻘ ﭘ ضراﻮﻋ ﻴ ﺪﻧﻮ ﻠﻛ ﻴ
،ﻪ ﺑﻴ نﺎﺘﺳرﺎﻤ ،ﺎﺿر مﺎﻣا ﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲ
ﺪﻬﺸﻣ ناﺮﻳا ،ﺪﻬﺸﻣ ، .
ﻣﻮﻤﻋ ﻚﺷﺰﭘ2
ﻲ
، ﻘﺤﺗ ﺰﻛﺮﻣ ﻴ تﺎﻘ ﭘ ضراﻮﻋ ﻴ ﺪﻧﻮ ﻠﻛ ﻴ
،ﻪ ﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲ
ﺪﻬﺸﻣ ناﺮﻳا ،ﺪﻬﺸﻣ ، .
رﺎﻳدﺎﺘﺳا3
، هوﺮﮔ ﺐﻠﻗ
، هﺪﻜﺸﻧاد ﻲﻜﺷﺰﭘ ، هﺎﮕﺸﻧاد ﻜﺷﺰﭘ مﻮﻠﻋ ﻲ
،ﺪﻬﺸﻣ ﺎﺿر مﺎﻣا نﺎﺘﺳرﺎﻤﻴﺑ ناﺮﻳا ،ﺪﻬﺸﻣ ،
.
،لوﺆﺴﻣ هﺪﻨﺴﻳﻮﻧ4
ﺸﻧاد ﻴ رﺎ
،
،ﻲﻠﺧاد هوﺮﮔ
،ﻪﻴﻠﻛ ﻦﻣﺰﻣ ﻲﻳﺎﺳرﺎﻧ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد
ﻲ زاﻮﻫا رﻮﭘﺎﺷ يﺪﻨﺟ ناﺮﻳا ،زاﻮﻫا ،
.
دآ سر : زاﻮﻫا - ﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲ
ﺪﻨﺟ ي زاﻮﻫا رﻮﭘﺎﺷ - ﻜﺷﺰﭘ هﺪﻜﺸﻧاد ﻲ
- ﻠﺧاد هوﺮﮔ ﻲ .
ﻦﻔﻠﺗ : 09163068063
ﺮﺑﺎﻤﻧ : 8598818 - 0511 ﻲﻜﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ :
و
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ ﻪﻠﺠﻣ
هرود 20 هرﺎﻤﺷ ، 3
، ﺰﻴﻳﺎﭘ 1392
ﻣﺪﻘﻣ ﻪ ﻦﻴﻧﻮﭘوﺮﺗ
،I ﻢﻴﻈﻨﺗ ﻦﻴﺌﺗوﺮﭘ ﻪﻛ ﺖﺳا ﻲﻧﻼﻀﻋ هﺪﻨﻨﻛ
نآ ﺶﻳاﺰﻓا
، نﺎﺸﻧ ﺐﻴﺳآ هﺪﻨﻫد ﻪﺑ
ﺖﺳا ﻲﺒﻠﻗ ﺖﻓﺎﺑ
؛ ﻦﻳا ﺎﺑ
رد ،دﻮﺟو 8
ﻲﻟا 9
% زا يﻮﻴﻠﻛ ﻪﺘﻓﺮﺸﻴﭘ ﻲﻳﺎﺳرﺎﻧ ﺎﺑ نارﺎﻤﻴﺑ
ﻦﻴﻧﻮﭘوﺮﺗ ﺶﻳاﺰﻓا ،درﺎﻛﻮﻴﻣ ﺐﻴﺳآ نوﺪﺑ ﻲﻣ هﺪﻫﺎﺸﻣ I
دﻮﺷ .
ﻦﻴﻧﻮﭘوﺮﺗ
،I ﻲﺻﺎﺼﺘﺧا ﻞﻣﺎﻋ ﻦﻴﻧﻮﭘوﺮﺗ ﻪﺑ ﺖﺒﺴﻧ يﺮﺗ
و T
CK-MB ﺶﻴﭘ ياﺮﺑ
رد درﺎﻛﻮﻴﻣ ﺐﻴﺳآ عﻮﻗو لﺎﻤﺘﺣا ﻲﻨﻴﺑ
ﻲﻣ ﻪﻴﻠﻛ ﻲﻳﺎﺳرﺎﻧ ﺎﺑ نارﺎﻤﻴﺑ ﺪﺷﺎﺑ
. ﺰﻴﻟﺎﻳدﻮﻤﻫ
، رد يزرﺎﺑ ﺮﻴﻴﻐﺗ
ﻦﻴﻧﻮﭘوﺮﺗ ﻲﻣﺮﺳ ﺢﻄﺳ ﻲﻤﻧ دﺎﺠﻳا I
ﺪﻨﻛ . ﻦﻴﻧﻮﭘوﺮﺗ ﺶﻳاﺰﻓا
،
ﻲﺒﻠﻗ ﺮﻴﻣ و گﺮﻣ ﺮﻄﺧ ﺪﻳﺪﺸﺗ ﺎﺑ هاﺮﻤﻫ -
نارﺎﻤﻴﺑ رد ﻲﻗوﺮﻋ
ﺖﺳا ﻚﻴﻣروا )
1 .(
،CRP ﺶﻴﭘ ﻞﻣﺎﻋ ﻲﻨﻴﺑ
ﻢﻬﻣ هﺪﻨﻨﻛ و گﺮﻣ
ًﺎﻳﻮﻗ ﻪﻛ ﺖﺳا يﺰﻴﻟﺎﻳد نارﺎﻤﻴﺑ رد ﺮﻴﻣ ﺮﻄﺧ ﺶﻳاﺰﻓا ﺎﺑ هاﺮﻤﻫ
ﻲﺒﻠﻗ يرﺎﻤﻴﺑ -
ﻲﻣ ﻲﻗوﺮﻋ ﺪﺷﺎﺑ
) 2 .(
يﻻﺎﺑ حﻮﻄﺳ ﻲﻫاﺮﻤﻫ
ﻦﻴﻧﻮﭘوﺮﺗ وCRP
، ﺪﻳﺪﺸﺗ ﺐﺒﺳ نارﺎﻤﻴﺑ رد ﺮﻴﻣ و گﺮﻣ ناﺰﻴﻣ
ﻲﻣ يﺰﻴﻟﺎﻳد ﻞﻣاﻮﻋ ﻦﻳا يودﺮﻫ و دﻮﺷ
، ﻪﺑ رﻮﻃ ﻞﻘﺘﺴﻣ
، ﺮﻄﺧ
ﻲﻣ ﺶﻳاﺰﻓا ار ﻚﻴﻣروا ﻲﺗﺎﭘﻮﻴﻣﻮﻳدرﺎﻛ ﺪﻨﻫد
) 3 .(
،ﻪﻴﺿﺮﻓ ﻦﻳا
يﺎﻫﺮﮕﻧﺎﺸﻧ ﺎﺑ ﻦﻴﻧﻮﭘوﺮﺗ حﻮﻄﺳ ﻦﻴﺑ ﻲﻄﺧ طﺎﺒﺗرا ﻚﻳ دﻮﺟو ﻲﺑﺎﻬﺘﻟا وCRP
ﻦﻴﻛﻮﻟﺮﺘﻨﻳا ﺎﻳ 6
ﻲﻣ ﺖﻳﻮﻘﺗ ار ﺪﻨﻛ
) 3 .(
ﻪﻴﻠﻛ ﻪﺘﻓﺮﺸﻴﭘ ﻲﻳﺎﺳرﺎﻧ ﺎﺑ نارﺎﻤﻴﺑ زا يرﺎﻴﺴﺑ رد
، حﻮﻄﺳ
ﺖﺳا هﺪﺷ شراﺰﮔ ﻦﻴﻧﻮﭘوﺮﺗ يﻻﺎﺑ
، نوﺪﺑ ﻧآ ﻪﻜ زا يﺪﻫاﻮﺷ
درﺎﻛﻮﻴﻣ دﺎﺣ ﻲﻤﻜﺴﻳا ﺪﺷﺎﺑ ﻪﺘﺷاد دﻮﺟو
) 4 (.
دﻮﺟو طﺎﺒﺗرا ﻦﻳا
،
ار لﺎﻴﻠﺗوﺪﻧا دﺮﻜﻠﻤﻋ لﻼﺘﺧا و بﺎﻬﺘﻟا ﻲﻟﺎﻤﺘﺣا ﺶﻘﻧ ناﻮﻨﻋ ﻪﺑ
ﻢﺴﻴﻧﺎﻜﻣ يﺪﻴﻠﻛ يﺎﻫ آ
ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد درﺎﻛﻮﻴﻣ ﺐﻴﺳ
ﻲﻣ حﺮﻄﻣ ﺪﻨﻛ
. ﻲﻣ عﻮﺿﻮﻣ ﻦﻳا ﻪﻴﺿﺮﻓ ﻦﻳا ﺮﮕﻧﺎﻳﺎﻤﻧ ﺪﻧاﻮﺗ
ﺪﺷﺎﺑ
ﻦﻴﻧﻮﭘوﺮﺗ حﻮﻄﺳ ﻪﻛ
، و ﻲﻨﻴﻟﺎﺑ ﺖﺤﺗ بﺎﻬﺘﻟا ﺖﻌﺳو زا ﻲﺑﺎﺗزﺎﺑ
ﻴﻠﺗوﺪﻧا يدﺮﻜﻠﻤﻋﺪﺑ ﻲﻣ لﺎ
ﺪﻨﺷﺎﺑ . ﺮﺑ ﻲﻠﺒﻗ تﺎﻌﻟﺎﻄﻣ هﺪﻤﻋ يور
ﻦﻴﻧﻮﭘوﺮﺗ حﻮﻄﺳ و ﺖﺳا هﺪﺷ مﺎﺠﻧا T
رد ﺎﻣ ﻪﻌﻟﺎﻄﻣ ﻦﻳا
،
حﻮﻄﺳ ﻦﻴﺑ طﺎﺒﺗرا ﻦﻴﻧﻮﭘوﺮﺗ
ﻲﻣﺮﺳ حﻮﻄﺳ و I ﺎﺑ CRP
ﻻﺎﺑ ﺖﻴﺳﺎﺴﺣ ار
ﻢﻳدﺮﻛ ﻲﺳرﺮﺑ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد .
شور ﻖﻴﻘﺤﺗ
ﻲﻔﻴﺻﻮﺗ تﺎﻌﻟﺎﻄﻣ عﻮﻧ زا ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ -
ﻲﻣ ﻲﻌﻄﻘﻣ ﺪﺷﺎﺑ
يور ﺮﺑ ﻪﻛ 52
ﻪﻛ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ رﺎﻤﻴﺑ ار ﻪﻌﻟﺎﻄﻣ ﻪﺑ دورو ﻂﻳاﺮﺷ
و هدﻮﺑ اراد ﻲﻟاﻮﺘﻣ ترﻮﺻ ﻪﺑ
، ﻴﻨﻴﻠﻛ ﻪﺑ نﺎﺘﺳرﺎﻤﻴﺑ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ ﻚ
ﺎﺿر مﺎﻣا ﺮﻬﺷ رد
ﺪﻧدﻮﺑ هدﺮﻛ ﻪﻌﺟاﺮﻣ ﺪﻬﺸﻣ ﺪﻳدﺮﮔ مﺎﺠﻧا ،
.
ﻲﻨﻴﻟﺎﺑ ﻪﭽﺨﻳرﺎﺗ و تﺎﻋﻼﻃا نارﺎﻤﻴﺑ
و ﻲﻜﺷﺰﭘ ﻪﻘﺑﺎﺳ سﺎﺳا ﺮﺑ
ﻚﻤﻛ ﺎﺑ ﻊﻤﺟ ﻪﻣﺎﻨﺸﺳﺮﭘ
ﺪﺷ يروآ .
ﺪﻣ لﻮﻃ ،ﺲﻨﺟ ،ﻦﺳ ت
ﺪﻧﻮﻴﭘ و ﺪﻧﻮﻴﭘ هﺪﻨﻫد عﻮﻧ )
روادﺎﻛﺎﻳ هﺪﻧز (
ﺪﻳدﺮﮔ ﺖﺒﺛ .
مﺎﻤﺗ
نارﺎﻤﻴﺑ
، ﻞﻜﺗوﺮﭘ ﺖﺤﺗ دراﺪﻧﺎﺘﺳا
ﺮﮕﺑﻮﻛﺮﺳ ﻲﻨﻤﻳا
ﻪﺳ ﻲﻳوراد
ﻞﻣﺎﺷ : و ﻦﻳرﻮﭙﺳﻮﻠﻜﻴﺳ ،نﻮﻟوﺰﻴﻧدﺮﭘ ﻞﻴﺘﻓﻮﻣ
تﻻﻮﻨﻓﻮﻜﻴﻣ ﺎﻳ
ﻦﻳﺮﭘﻮﻴﺗازآ راﺮﻗ
ﺘﺷاد ﺪﻨ . ﺪﻫاﻮﺷ ﺎﺑ نارﺎﻤﻴﺑ ،ﻲﺒﻠﻗ ﻲﻳﺎﺳرﺎﻧ ﻲﻨﻴﻟﺎﺑ
و ﻲﻤﻴﺧﺪﺑ دﻮﺟو لﺎﻌﻓ ﺖﻧﻮﻔﻋ
، زا ﺪﻧﺪﺷ فﺬﺣ ﻪﻌﻟﺎﻄﻣ .
5
ﻲﻠﻴﻣ زا نﻮﺧ ﺮﺘﻴﻟ رﺎﻤﻴﺑ
ا ﻪﺑ ن و ﻲﻫﺎﮕﺤﺒﺻ رﻮﻃ زا ﺲﭘ
12
ﺎﺘﺷﺎﻧ ﺖﻋﺎﺳ ﺬﺧا
ﺪﻳدﺮﮔ حﻮﻄﺳ و ﻻﺎﺑ ﺖﻴﺳﺎﺴﺣ ﺎﺑ CRP
، ﺎﺑ
ﺖﻴﻛ Bio system (282AA)
و ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ I
ﻴﻛ ﺖ
Bind Mono (EIA-38K2K1) ﺖﺧﺎﺳ
وUSA ﺎﺑ شور
Elisa هزاﺪﻧا ﺪﺷ يﺮﻴﮔ .
وﺮﺗ حﻮﻄﺳ ﻦﻴﮕﻧﺎﻴﻣ ﻪﺴﻳﺎﻘﻣ ياﺮﺑ ﻦﻴﻧﻮﭘ
وI hs-CRP رد
زا نﺎﮔﺪﻧﺮﻴﮔ ﻦﻴﺑ و هﺪﻧز هﺪﻨﻫد
روادﺎﻛ
، نﻮﻣزآ زا ﻲﺗ يرﺎﻣآ
ﺪﺷ هدﺎﻔﺘﺳا .
ﺢﻄﺳ ﻦﻴﺑ ﻲﮕﺘﺴﺒﻤﻫ ﻲﺳرﺮﺑ ياﺮﺑ ﻦﻴﻧﻮﭘوﺮﺗ
و I
hs-CRP هوﺮﮔ ﺮﻫ رد
ﺪﺷ هدﺎﻔﺘﺳا ﻦﻣﺮﻴﭙﺳا نﻮﻣزآ زا ، .
ﻪﻳﺰﺠﺗ
و هداد ﻞﻴﻠﺤﺗ زا هدﺎﻔﺘﺳا ﺎﺑ ﺎﻫ
مﺮﻧ راﺰﻓا )SPSS ﺶﻳاﺮﻳو 15
(
ﺪﺷ مﺎﺠﻧا و
Pvalue زا ﺮﺘﻤﻛ
5
% ، ﺮﻈﻧ زا آ ﻲﻨﻌﻣ يرﺎﻣ رد راد
ﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ .
ﻪﺘﻓﺎﻳ ﺎﻫ
زا 52
،رﺎﻤﻴﺑ 27 رﺎﻤﻴﺑ ) 52 د ﺪﺻر ( و دﺮﻣ 25 رﺎﻤﻴﺑ ) 48
رد ﺪﺻ ( نز ﺪﻧدﻮﺑ . نارﺎﻤﻴﺑ ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 4
/ 13 98± / 42 لﺎﺳ و
ﻪﺑ ﺐﻴﺗﺮﺗ ﻞﻗاﺪﺣ 16 لﺎﺳ ﺮﺜﻛاﺪﺣ و 68
لﺎﺳ دﻮﺑ . ﻦﻴﮕﻧﺎﻴﻣ
يﻼﺘﺑا تﺪﻣ ﻪﺑ
يرﺎﻤﻴﺑ 87 /
±6 76 / 3 دﻮﺑ لﺎﺳ . ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ،
13 ) 25 (%
زا رﺎﻤﻴﺑ و ﺪﺴﺟ
39 ) 75 (%
زا رﺎﻤﻴﺑ هﺪﻧز هﺪﻨﻫد
ﺪﻧدﻮﺑ هدﺮﻛ ﺖﻓﺎﻳرد ﺪﻧﻮﻴﭘ .
لوﺪﺟ 1 - ﻪﺴﻳﺎﻘﻣ ﻦﻴﮕﻧﺎﻴﻣ ﻧﻮﭘوﺮﺗ ﻦﻴ مﺮﺳI
و
hs-CRP
رد هوﺮﮔ ود نارﺎﻤﻴﺑ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ
* رد زا ﺪﻧﻮﻴﭘ نﺎﮔﺪﻧﺮﻴﮔ ﺎﺑ ﻪﺴﻳﺎﻘﻣ هﺪﻧز هﺪﻨﻫد
) 05 / 0
P<
(
لوﺪﺟ ﻳ
،ﻚ ﻣ ﻴ ﮕﻧﺎ ﻴ ﻦ فاﺮﺤﻧا و ﻲﻣﺮﺳ حﻮﻄﺳ رﺎﻴﻌﻣ
ﻴﻧﻮﭘوﺮﺗ ﻦ I
و hs-CRP ار
و يﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ ﻞﻛ رد زا ﻚﻴﻜﻔﺗ ﻪﺑ
هﺪﻨﻫد و هﺪﻧز يﺎﻫ ﻲﻣ نﺎﺸﻧ روادﺎﻛ
ﺪﻫد . رد مﺮﺳ ﻦﻴﻧﻮﭘوﺮﺗ 3
ﺮﻔﻧ ) 5 / 7 (%
نارﺎﻤﻴﺑ زا
، زا ﺮﺗﻻﺎﺑ
ﺪﺣ ﻲﻌﻴﺒﻃ ) 3 / 1 ﻧ رد مﺮﮔﻮﻧﺎ
ﻲﻠﻴﻣ ﺮﺘﻴﻟ ( دﻮﺑ .
ّﻞﻛ رد
،نارﺎﻤﻴﺑ ﻦﻴﺑ ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ مﺮﺳ
hs-CRP
ﻲﻨﻌﻣ طﺎﺒﺗرا ﺪﺸﻧ هﺪﻫﺎﺸﻣ يراد
) 04 / 0
،r=- 60 / 0
= (P
؛
ﻲﻨﻌﻣ طﺎﺒﺗرا ﻦﻴﻨﭽﻤﻫ يراد
ﻦﻴﺑ ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ مﺮﺳ
hs-CRP رد
و روادﺎﻛ هﺪﻨﻫد زا هﺪﺷﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ هﺪﻧز
ﺪﻳدﺮﮕﻧ هﺪﻫﺎﺸﻣ ﺰﻴﻧ .
ﻦﻴﮕﻧﺎﻴﻣ hs-CRP
روادﺎﻛ هﺪﻨﻫد زا هﺪﺷﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد
،
ﻪﺑ ﻲﻨﻌﻣ رﻮﻃ زا ﺮﺗﻻﺎﺑ يراد
دﻮﺑ هﺪﻧز هﺪﻨﻫد )
002 / 0
= (P
، ﻲﻟو
ﺮﺳ ﻦﻴﻧﻮﭘوﺮﺗ ﻦﻴﮕﻧﺎﻴﻣ ود رد م
هوﺮﮔ
، ﻲﻨﻌﻣ توﺎﻔﺗ نﺎﺸﻧ يراد
داﺪﻧ ) 62 / 0
= (.P
ﺚﺤﺑ
رد ﻪﻌﻟﺎﻄﻣ ﺮﺿﺎﺣ
، ﻲﻨﻌﻣ طﺎﺒﺗرا ﺢﻄﺳ ﻦﻴﺑ يراد
ﻦﻴﻧﻮﭘوﺮﺗ I
ﻲﻣﺮﺳ حﻮﻄﺳ ﺎﺑ ﺎﺑCRP
ﻴﺳﺎﺴﺣ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد ﻻﺎﺑ ﺖ
هﺪﻫﺎﺸﻣ ﺪﺸﻧ
. ﻲﻨﻌﻣ طﺎﺒﺗرا نﻮﻨﻛﺎﺗ ﻲﻛﺪﻧا تﺎﻌﻟﺎﻄﻣ يراد
ﻦﻴﺑ
ﻄﺳ ﻮ ح ﻧﻮﭘوﺮﺗ ﺎﺑ مﺮﺳ ﻦﻴ hs-CRP
ار رد ارﺎﻤﻴﺑ نﺎﺸﻧ يﺪﻧﻮﻴﭘ ن
هداد ﺪﻧا درﻮﻣ ﻚﻳ رد ﻪﻛ طﺎﺒﺗرا
hs-CRP ﺎﺑ
ﻦﻴﻧﻮﭘوﺮﺗ مﺮﺳ I
) 5 ( و رد ﺮﮕﻳد درﻮﻣ ﺎﺑ
ﻦﻴﻧﻮﭘوﺮﺗ )T
6 ( ﻲﻨﻌﻣ راد ﻪﻛ ﺖﺳا هدﻮﺑ
ﻲﻠﻋ ﻲﻨﻌﻣ ﺞﻳﺎﺘﻧ ﻢﻏر راد
، ﺮﻫ رد ود درﻮﻣ
، ﻒﻴﻌﺿ رﺎﻴﺴﺑ طﺎﺒﺗرا
درﻮﻣ رد ﻪﻛ ﺖﺳا هدﻮﺑ ﻦﻴﻧﻮﭘوﺮﺗ
،I ﻲﮕﺘﺴﺒﻤﻫ ﺐﻳﺮﺿ 16
/ 0 و
درﻮﻣ رد ﻦﻴﻧﻮﭘوﺮﺗ 132 T
/ 0 ﻦﻴﻧﻮﭘوﺮﺗ رد ﻲﻤﻛ ﻪﻛ دﻮﺑ ﺮﺘﺸﻴﺑI
دﻮﺑ ؛ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد لﺎﺣ ﻦﻳا ﺎﺑ
، ﺪﺸﻧ هﺪﻫﺎﺸﻣ طﺎﺒﺗرا ﻦﻳا .
توﺎﻔﺗ زا ﻲﻜﻳ ﻪﻌﻟﺎﻄﻣ ﻲﻠﺻا يﺎﻫ
ﺮﺿﺎﺣ ﻲﻠﺒﻗ تﺎﻌﻟﺎﻄﻣ ﺎﺑ
،
دﻮﺑ نارﺎﻤﻴﺑ ﻲﺳرﺮﺑ نﺎﻣز توﺎﻔﺗ ﻪﺑ طﻮﺑﺮﻣ رد ﻪﻛ
ﻪﻌﻟﺎﻄﻣ ﺮﺿﺎﺣ هﺪﺷ ﻲﺳرﺮﺑ لﺎﺴﻜﻳ زا ﺮﺘﺸﻴﺑ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ تﺪﻣ لﻮﻃ ﺎﺑ نارﺎﻤﻴﺑ
ﻮﺑ ﺪﻧد
؛ ﻲﻟﺎﺣرد ﺮﻳﺎﺳ رد ﻪﻛ تﺎﻌﻟﺎﻄﻣ
، زا ﺲﭘ تﺪﻣ مﺎﻤﺗ رد
ﺪﻧﻮﻴﭘ
، دﻮﺑ ﻪﺘﻓﺮﮔ ترﻮﺻ ﻲﺳرﺮﺑ .
يرﺎﻤﻴﺑ زوﺮﺑ ناﺰﻴﻣ ﻲﺒﻠﻗ يﺎﻫ
تﺪﻣ ﺎﺗ ﺮﻄﺧ ﻦﻳا ﻪﻛ ﺖﺳا ﺮﺗﻻﺎﺑ ﻪﻴﻠﻛ ﻲﻳﺎﺳرﺎﻧ ﺎﺑ نارﺎﻤﻴﺑ رد ﻲﻣ هﺪﻫﺎﺸﻣ ﺰﻴﻧ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ زا ﺲﭘ ﻲﻫﺎﺗﻮﻛ دﻮﺷ
) 7 ، 8 .(
Stolear و
ﺶﻧارﺎﻜﻤﻫ
، ﻲﻣﺮﺳ حﻮﻄﺳ ﺶﻳاﺰﻓا ﻴﻧﻮﭘوﺮﺗ
ﻦ T
ار رد ﻲﻠﻘﺘﺴﻣ ﻞﻣﺎﻋ ناﻮﻨﻋ ﻪﺑ ﺶﻴﭘ
و گﺮﻣ ناﺰﻴﻣ ﻲﻨﻴﺑ ﺮﻴﻣ
ﺪﻧداد نﺎﺸﻧ يﺰﻴﻟﺎﻳد نارﺎﻤﻴﺑ )
9 ( ، ﻲﻟو Stoffel و
ﺶﻧارﺎﻜﻤﻫ
يﺮﮕﻳد ﻪﻌﻟﺎﻄﻣ رد
، ﻦﻴﻧﻮﭘوﺮﺗ ﻲﻣﺮﺳ حﻮﻄﺳ ﺶﻳاﺰﻓا ار I
ﻪﺑ
رد ﻲﻠﻘﺘﺴﻣ ﻞﻣﺎﻋ ناﻮﻨﻋ ﺶﻴﭘ
ناﺰﻴﻣ ﻲﻨﻴﺑ و گﺮﻣ
ﺮﻴﻣ نارﺎﻤﻴﺑ
ﺪﻧداد نﺎﺸﻧ يﺰﻴﻟﺎﻳد )
10 .(
د نﺎﺸﻧ تﺎﻌﻟﺎﻄﻣ هدا
ا ﺪﻧ زا ﺶﻴﺑ رد ، 70
% ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ
ﻪﻴﻠﻛ
، بﺎﻬﺘﻟا دﻮﺟو
، ناﺰﻴﻣ ﺶﻳاﺰﻓا ﺚﻋﺎﺑ ﻲﻣ CRP
و ددﺮﮔ
ﺰﻴﻧ ﻦﻴﻧﻮﭘوﺮﺗ رد
75
% ﻦﻳا ﺖﺳا ﻪﺘﺷاد ﺶﻳاﺰﻓا نارﺎﻤﻴﺑ )
9 .(
يﻻﺎﺑ حﻮﻄﺳ ﻲﻫاﺮﻤﻫ ﻦﻴﻧﻮﭘوﺮﺗ وCRP
، و گﺮﻣ ناﺰﻴﻣ
ﻲﻣ تﺪﺷ يﺰﻴﻟﺎﻳد نارﺎﻤﻴﺑ رد ار ﺮﻴﻣ ﺮﻫ و ﺪﻫد
ود
، ﻞﻣاﻮﻋ
ياﺮﺑ ﺮﻄﺧ ﻞﻘﺘﺴﻣ ﻲﻣ ﻚﻴﻣروا ﻲﺗﺎﭘﻮﻴﻣﻮﻳدرﺎﻛ
ﺪﻨﺷﺎﺑ . ﻦﻳا
ﻪﻴﺿﺮﻓ
، ﻲﻠﺒﻗ تﺎﻌﻟﺎﻄﻣ ار
ﺎﺑ ﻦﻴﻧﻮﭘوﺮﺗ ﻦﻴﺑ ﻲﻄﺧ طﺎﺒﺗرا ﻚﻳ ﻪﻛ
هداد نﺎﺸﻧCRP ﺪﻧا
ﻲﻣ ﺪﻴﻳﺄﺗ ، ﺪﻨﻛ
) 3 .(
ﺮﺑ تﺎﻌﻟﺎﻄﻣ ﺮﺘﺸﻴﺑ يور
ﻦﻴﻧﻮﭘوﺮﺗ ﻲﻣ T
ﺪﺷﺎﺑ . Hickson ﻪﻌﻟﺎﻄﻣ رد
لﺎﺳ رد يا 2009
ﺪﻧﻮﻴﭘ زا ﺲﭘ ﻦﻴﻧﻮﭘوﺮﺗ يﻻﺎﺑ حﻮﻄﺳ ﻪﻛ داد نﺎﺸﻧ
، ﺎﺑ هاﺮﻤﻫ
و ﺖﺳا نارﺎﻤﻴﺑ يﺎﻘﺑ ﺶﻫﺎﻛ ﺮﻄﺧ
ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ هاﺮﻤﻫ
،T ﺎﺑ
ﻦﻳا يﻻﺎﺑ حﻮﻄﺳ ﺮﮕﻧﺎﺸﻧ
ﻲﻣ ﺶﻳاﺰﻓا ﻲﻧﻮﺧ ﺪﺑﺎﻳ
) 11 .(
Apple
ﺎﺒﺗرا ﻪﻛ ﺪﻧداد نﺎﺸﻧ ﺶﻧارﺎﻜﻤﻫ و ط
ﻴﺳﺎﺴﺣ ﺎﺑCRP رد ﻻﺎﺑ ﺖ
يﺰﻴﻟﺎﻳد نارﺎﻤﻴﺑ ﺮﻴﻣ و گﺮﻣ ﺶﻳاﺰﻓا
، ﻦﻴﻧﻮﭘوﺮﺗ زا يﻮﻗ T
ﺮﺗ
ﺖﺳا ) 12 .(
ﻪﺠﻴﺘﻧ رد ﺖﺳا ﻦﻜﻤﻣ CRP ﺖﻧﻮﻔﻋ
ﻦﻣﺰﻣ يﺎﻫ
هوﺮﮔ ﺮﻴﻐﺘﻣ
نارﺎﻤﻴﺑ ﻞﻛ
زا ﺪﻧﻮﻴﭘ هﺪﻧﺮﻴﮔ هﺪﻧز هﺪﻨﻫد
ﺪﻧﻮﻴﭘ هﺪﻧﺮﻴﮔ روادﺎﻛ زا
ﻲﻨﻌﻣ ﺢﻄﺳ د
يرا ﻲﺗ نﻮﻣزآ
ﻦﻴﻧﻮﭘوﺮﺗ )I
ﻲﻠﻴﻣ رد مﺮﮔﻮﻧﺎﻧ ﺮﺘﻴﻟ
( 32 /
±0 53 / 0 2
/
±0 52 / 0 32
/
±0 57 / 0 62
/ 0
hs-CRP
) ﻲﻠﻴﻣ ﻲﻠﻴﻣ رد مﺮﮔ ﺮﺘﻴﻟ
( 27 / 3 90± / 2 12
/ 4 46± / 3 6
/ 0 18± / 1 002
/ 0
*
ﺪﻨﺟﺮﻴﺑ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﻤﻠﻋ ﻪﻠﺠﻣ
هرود 20 هرﺎﻤﺷ ، 3
، ﺰﻴﻳﺎﭘ 1392
ﻮﺳ و ﺰﻴﻟﺎﻳد ء
و ﻲﻗوﺮﻋ بﺎﻬﺘﻟا ﻦﻴﻨﭽﻤﻫ و ﻪﻳﺬﻐﺗ آ
درﺎﻛﻮﻴﻣ ﺐﻴﺳ
ﺪﺑﺎﻳ ﺶﻳاﺰﻓا
، ﻦﻴﻧﻮﭘوﺮﺗ ﻲﻟو
،T ﻚﻳ ﺮﮕﻧﺎﺸﻧ ﻲﺻﺎﺼﺘﺧا رﺎﻴﺴﺑ
ﺖﺳا درﺎﻛﻮﻴﻣ ﺐﻴﺳآ .
ﻪﺠﻴﺘﻧ يﺮﻴﮔ
ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد
، ﻲﻨﻌﻣ طﺎﺒﺗرا يراد
ﻦﻴﺑ ﻦﻴﻧﻮﭘوﺮﺗ ﺎﺑ مﺮﺳ I
Hs-CRP ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ نارﺎﻤﻴﺑ رد
ﺪﺸﻧ هﺪﻫﺎﺸﻣ ﻦﻳا ﻪﻛ
عﻮﺿﻮﻣ
، ﺮﺑ دﺎﺠﻳا رد بﺎﻬﺘﻟا ﻲﻟﺎﻤﺘﺣا ﺶﻘﻧ ﻪﻴﻠﻋ درﺎﻛﻮﻴﻣ ﺐﻴﺳآ
ﻲﻣ نارﺎﻤﻴﺑ ﻦﻳا رد ﺪﺷﺎﺑ
.
ﺮﻜﺸﺗ و ﺮﻳﺪﻘﺗ
ﻪﻟﺎﻘﻣ ﻦﻳا
، نﺎﻳﺎﭘ زا ﻪﺘﻓﺮﮔﺮﺑ هرﺎﻤﺷ ﻪﻣﺎﻧ
6704 - ت ياﺮﺑ
ﻞﮔ ﻲﺒﺟر هﺰﺋﺎﻓ يﺮﺘﻛد ﻪﺟرد ﺬﺧا ﻪﺑ بﻮﺼﻣ ﻲﺗﺎﻘﻴﻘﺤﺗ حﺮﻃ و
هرﺎﻤﺷ 89245 ﻲﻣ ﻪﻛ ﺪﺷﺎﺑ ضراﻮﻋ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ﺖﻳﺎﻤﺣ ﺎﺑ
ﻣ ﻪﻴﻠﻛ ﺪﻧﻮﻴﭘ ﺪﻬﺸ
ﺪﻬﺸﻣ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد و هﺪﺷ مﺎﺠﻧا
ﺖﺳا .
ﻊﺑﺎﻨﻣ :
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6- Connolly GM, Cunningham R, McNamee PT, Young IS, Maxwell AP. Troponin T is an independent predictor of mortality in renal transplant recipients. Nephrol Dial Transplant. 2008; 23(3): 1019-25.
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9- Stolear JC, Georges B, Shita A, Verbeelen D. The predictive value of cardiac troponin T measurements in subjects on regular haemodialysis. Nephrol Dial Transplant. 1999; 14(8): 1961-7.
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Abstract Original Article
Correlation between Serum level of Troponin I and High Sensetive CRP in Renal transplant Patients
Abbas Ali Zeraati1, Farzaneh Sharifipour1, Faezeh Rajabigol2, Hourak Pourzand3, Seyyed Seifollah Beladi Mousavi4*
Background and Aim: Accompaniment of highserum levels of CRP to troponin increases the mortality rate in dialysispatients, and both of them are considered to be independent risk factors foruremic cardiomyopathy. In the present study, the relationship betweenserum troponin I and hs-CRP in renal transplant patients was investigated.
Materials and Methods: This .study was conducted on 52 patients undergone kidney transplantation. The patients’ serum troponin I and hs-CRP were measured. Clinical characteristics of them including sex, age, duration of disease, and donor type were obtained by their respective medical record review. Spearman’s correlation coefficient method was applied to specify correlation between serum troponin and hsCRP levels.
Results: In the current study, 52 patients (27males and 25 females) with the mean age of 42.98±13.4 yrs were studied. It was found that Hs-CRP levels statistically differed between recipients who had received kidneyfrom deceased and those from live donors. The formers who had received kidney from deceased donors showed significantly higher hsCRP levels compared to recipients from. live donors, but the difference between serum troponin I in the two groups was not significant. There wasno significant correlation between serum troponin I and hs-CRP in the total population (p=0.6, r=-0.04), and also in recipients who had received kidney from live or deceased donors.
Conclusion: Regarding the insignificant relationship between serum troponinI and hs-CRP in kidney transplant patients, it seems that inflammation has no role on myocardial injury.
Key Words: Troponin I, hs-CRP, Kidney Transplantation
Journal of Birjand University of Medical Sciences. 2013; 20 (3): 312-316.
Received: September 17, 2012 Accepted:June 19, 2013
1 Assistant Professor of Nephrology, Department of Internal Diseases, Kidney Transplantation Complications Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 General physician, Kidney Transplantation Complications Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant professor, Department of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Corresponding author, Associate Professor of Nephrology, Internal Medicine Department, Chronic Renal Failure Research Center,
