تﺎﺤﻔﺻ : 161 ﺎﺗ 166
لﻮﺌﺴﻣ هﺪﻨﺴﻳﻮﻧ :
ﺖﺠﺣ ﻦﺴﺤﻣ .
ﺖﺳاﻮﺧرد مﺎﻤﺗ ﻲﻧﺎﺸﻧ ﻪﺑ ﺪﻳﺎﺑ ﺎﻫ
[email protected] ﺪﻧﻮﺷ هدﺎﺘﺳﺮﻓ
.
ﻝﻮﻠﺳ ﺶﻘﻧ ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﺭﺩ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
ﻲﺒﻠﻗ ﻱﺎﻫ
ﺖﺠﺣ ﻦﺴﺤﻣ MSc*
، ﺖﺳﺩ ﯼﺪﻬﻣ 1ﮎﺎﭘ
MSc
ﻥﺍﺮﻳﺍ ،ﻡﺮﻬﺟ ،ﻡﺮﻬﺟ ﯽﮑﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ ،ﯼﺭﺎﺘﺳﺮﭘ ﻩﺪﮑﺸﻧﺍﺩ*
،ﻡﺮﻬﺟ ،ﻡﺮﻬﺟ ﯽﮑﺷﺰﭘ ﻡﻮﻠﻋ ﻩﺎﮕﺸﻧﺍﺩ ،ﯼﺭﺎﺘﺳﺮﭘ ﻩﺪﮑﺸﻧﺍﺩ1 ﻥﺍﺮﻳﺍ
ﻩﺪﻴﮑﭼ
ﻪﻣﺪﻘﻣ : ﺎﺑ ﺖﻓﺮﺸﻴﭘ ﺩﻮﺟﻭ ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﺭﺩ ﺩﺎﻳﺯ ﻱﺎﻫ
ﻲﺒﻠﻗ ﻱﺎﻫ
، ﻪﺑ ﺹﻮﺼﺧ
،ﺱﻮﺘﮐﺭﺎﻔﻧﺍ ﻫ
ﻥﺎﻨﭽﻤ ﻥﺍﺭﺎﻤﻴﺑ ﺯﺍ ﻱﺩﺎﻳﺯ ﺩﺍﺪﻌﺗ ﺕﻼﻤﺣ ﻪﺑ ﻼﺘﺒﻣ
،ﻲﺒﻠﻗ
ﺎﺳﺭﺎﻧ ﻱﺭﺎﻤﻴﺑ ﻪﺑ ﻳ
ﻼﺘﺒﻣ ﺐﻠﻗ ﻦﻣﺰﻣ ﻲ ﯽﻣ
ﺖﺳﺩ ﻱﺭﺎﻤﻴﺑ ﻦﻳﺍ ﺎﺑ ﮒﺮﻣ ﻥﺎﻣﺯ ﺎﺗ ﻭ ﺪﻧﻮﺷ ﻲﻣ ﻡﺮﻧ ﻪﺠﻨﭘﻭ
ﺪﻨﻨﻛ . ﺵﻭﺭ ﺯﺍ ﻱﺩﺪﻌﺘﻣ ﻲﻧﺎﻣﺭﺩ ﻱﺎﻫ ﻪﻠﻤﺟ
ﻥﻭﺭﺩ ﺕﺍﺰﻴﻬﺠﺗ ﻭ ﺐﻠﻗ ﺪﻧﻮﻴﭘ ،ﻲﻧﺎﻣﺭﺩﻭﺭﺍﺩ -
ﻥﻭﺮﺑ ﻭ ﻲﻣ ﺭﺍﺮﻗ ﻩﺩﺎﻔﺘﺳﺍ ﺩﺭﻮﻣ ﻥﺍﺭﺎﻤﻴﺑ ﻦﻳﺍ ﻲﮔﺪﻧﺯ ﺖﻴﻔﻴﻛ ﺩﻮﺒﻬﺑ ﻱﺍﺮﺑ ﻲﺒﻠﻗ ﺩﺮﻴﮔ
ﻪﮐ ﻭ ﻥﺍﺭﺎﻤﻴﺑ ﻱﺍﺮﺑ
ﻥﺎﺘﺳﺭﺎﻤﻴﺑ ﺪﻨﺘﺴﻫ ﻥﺍﺮﮔ ﺭﺎﻴﺴﺑ ﺎﻫ .
ﻝﻮﻠﺳ ﻭ ﺖﻓﺎﺑ ﻲﺳﺪﻨﻬﻣ ،ﻚﻴﺘﻧﮊ ﻢﻠﻋ ﺭﺩ ﺕﺎﻘﻴﻘﺤﺗ ﻲﻧﺎﻣﺭﺩ
، ﺍﺭ ﻥﺍﺭﺎﻤﻴﺑ ﻦﻳﺍ ﺕﺎﺠﻧ ﺪﻴﻣﺍ ﺖﺳﺍ ﻩﺩﺍﺩ ﺶﻳﺍﺰﻓﺍ
. ﻑﺪﻫ
ﺍ ﻪﻌﻟﺎﻄﻣ ﻦﻳ ﻭ ﯽﺳﺭﺮﺑ ،ﯼﺭﻭﺮﻣ ﻝﻮﻠﺳ ﺶﻘﻧ ﻦﻴﻴﺒﺗ
ﻥﺎﻣﺭﺩ ﺭﺩ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ ﯽﻳﺎﺳﺭﺎﻧ
ﯼﺎﻫ ﺖﺳﺍ ﻲﺒﻠﻗ .
ﻪﺠﻴﺘﻧ ﻱﺮﻴﮔ ﻲﻳﺎﻣﺯﺁﺭﺎﻛ ﻭ ﺕﺎﻘﻴﻘﺤﺗ : ﻥﺎﺸﻧ ﻲﻨﻴﻟﺎﺑ ﻱﺎﻫ
ﯽﻣ ﺩ ﻫ ﻪﻛ ﺪﻨ ﻲﻃ ۶ - ۴ ﻝﻮﻠﺳ ﺪﻧﻮﻴﭘ ﺯﺍ ﺲﭘ ﻩﺎﻣ ﻦﻴﺑ ﭗﭼ ﻦﻄﺑ ﺩﺮﻜﻠﻤﻋ ،ﺐﻠﻗ ﻪﺑ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
۷ ﺎﺗ ۹
% ﺶﻫﺎﻛ ﻲﻟﻮﺘﺴﻴﺳ ﻱﺎﻬﺘﻧﺍ ﻢﺠﺣ ،ﺶﻳﺍﺰﻓﺍ ﻭ
ﺧ ﻥﻮ ﮒﺭ ﻭ ﻲﻧﺎﺳﺭ ﺩﻮﺒﻬﺑ ﻪﺘﻜﺳ ﺭﺎﭼﺩ ﻪﻘﻄﻨﻣ ﺭﺩ ﻱﺯﺎﺳ
ﯽﻣ ﺎﻳ ﺪﺑ . ﻦﻳﺍ ﺮﺑ ﻩﻭﻼﻋ
، ﺕﺎﻘﻴﻘﺤﺗ ﺭﺩ
ﻩﺪﻨﻳﺁ ﺮﮕﻧ ﻭ ﺩﺭﻮﻣ - ﻩﺪﻴﺳﺭ ﺕﺎﺒﺛﺍ ﻪﺑ ﺵﻭﺭ ﻦﻳﺍ ﻲﻳﺁﺭﺎﻛ ﺰﻴﻧ ﻱﺪﻫﺎﺷ ﻭ
ﻭ ﺭﻮﻣﻮﺗ ﭻﻴﻫ ﺖﺳﺍ ﻩﺪﺸﻧ ﻩﺪﻫﺎﺸﻣ ﻲﻛﺎﻧﺮﻄﺧ ﻲﻤﺘﻳﺭﺁ
.
ﻩﮊﺍﻭﺪﻴﻠﮐ ﺎﻫ : ﻝﻮﻠﺳ ﻝﻮﻠﺳ ﻲﺒﻠﻗ ﻱﺭﺎﻤﻴﺑ ،ﻱﺭﺎﺘﺳﺮﭘ ،ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
Stem cells roll in heart disease treatment
Hojjat M.* MSc, Dastpak M.1
٭Faculty of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
1Faculty of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran Abstract
Introduction: Despite many advances in the treatment of heart disease, particularly myocardial infarction, many patients with heart attacks catch chronic heart failure and are associated with this disease until death. Several therapeutic procedures including drug-therapy, heart transplantation and heart’s inside- and outside equipment are used to improve the quality of life of patients which are very expensive for patients and hospitals. By researches in genetics, tissue engineering and cell therapy, hoping to save these patients has increased. The purpose of this review study was to analyze and clarify the role of stem cells in treating heart failures.
Conclusion: Researches and clinical trials show that during 4 to 6 months after transplantation of stem cells to the heart, left ventricular function increases between 7 to 9%, volume of end systolic decreases and blood supply and vessel construction promotes in stroke region. Moreover, in prospective and case- control studies, the efficiency of this method proved and no dangerous arrhythmia or tumor has been observed.
Keywords: Stem Cells‚ Nursing‚ Heart Disease
ﻪﻣﺪﻘﻣ
ﺎﺑ ﻩﺯﻭﺮﻣﺍ ﺖﻓﺮﺸﻴﭘ
ﻡﻮﻠﻋ ﺖﻓﺎﺑ ﻲﺳﺪﻨﻬﻣ ﻭ ﻪﻳﺎﭘ
، ﻝﻮﻠﺳ ﺷﻭﺭ ﻲﻧﺎﻣﺭﺩ ﯽ
ﺑ ﻱﺍﺮﺑ ﻦﻳﺰﮕﻳﺎﺟ ﻭ ﺪﻳﺪﺟ ﻴ
ﻱﺭﺎﻤﻴﺑ ﺮﺘﺸ ﻲﺑﺎﺴﺘﻛﺍ ﻭ ﻱﺩﺍﺯﺭﺩﺎﻣ ،ﻦﻣﺰﻣ ﻱﺎﻫ
ﻲﻣ ﺏﻮﺴﺤﻣ ﺩﻮﺷ
] ۱ ، ۲ .[
ﻥﺩﺮﻛﺍﺪﻴﭘ ﺖﻴﻣﻮﻤﻋ ﺎﺑ ﻝﻮﻠﺳ
،ﯽﻧﺎﻣﺭﺩ ﺮﺑ ﻩﻭﻼﻋ
ﻝﻮﻃ ﺶﻳﺍﺰﻓﺍ ﺮﻤﻋ
ﻢﻟﺎﺳ ﻲﮔﺪﻧﺯ ، ﻪﺑ ﻱﺮﺗ
ﻥﺎﺴﻧﺍ ﯽﻣ ﻩﺩﺍﺩ ﺪﻳﻮﻧ ﺎﻫ ﺩﻮﺷ
] ۳ ،
۴ .[
ﻝﺎﺳ ﺭﺩ ﻒﻠﺘﺨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﺎﺗ ﻩﺪﺷ ﺚﻋﺎﺑ ﺮﻣﺍ ﻦﻳﺍ ﻥﻮﻴﻠﻴﻣ ﺮﻴﺧﺍ ﻱﺎﻫ
ﺎﻫ
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻪﻨﻴﻣﺯ ﺭﺩ ﺭﻻﺩ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﻱﺍﺮﺑ ﻱﺎﻫ
ﺵﻭﺭ ﻦﻳﺍ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻪﺑ ﺍﺭ ﻥﺍﺭﺎﻤﻴﺑ ﻭ ﺪﻨﻳﺎﻤﻧ ﻪﻨﻳﺰﻫ ﻒﻠﺘﺨﻣ ﺎﻫ
ﻖﻳﻮﺸﺗ
ﺪﻨﻨﻛ ] ۴ ، ۵ .[
ﺵﻭﺭ ﻦﻳﺍ ﻲﻣ ﺎﻫ
ﻪﺑ ﺍﺭ ﻥﺍﺭﺎﺘﺳﺮﭘ ﺶﻘﻧ ﺪﻨﻧﺍﻮﺗ ﻥﺍﻮﻨﻋ
ﻩﺭﻭﺎﺸﻣ ﺖﺒﻗﺍﺮﻣ ،ﻩﺪﻨﻫﺩ ﻲﻧﺍﻮﺗﺯﺎﺑ ﻭ ﻲﻧﺎﻣﺭﺩ ﻢﻴﺗ ﺯﺍ ﻱﻮﻀﻋ ﻭ ﻩﺪﻨﻨﻛ
) ﺮﻫ ﺭﺩ
ﺢﻄﺳ ﻪﺳ ( ﺍﺭ ﻪﻨﻴﻣﺯ ﻦﻳﺍ ﺭﺩ ﻲﻫﺎﮔﺁ ﻦﺘﺷﺍﺩ ﻪﺑ ﺯﺎﻴﻧ ﻭ ﻩﺩﻮﻤﻧ ﻝﻮﺤﺗ ﺭﺎﭼﺩ
ﺪﻨﻳﺎﻤﻧ ﺖﻳﻮﻘﺗ .
ﻪﺑ ﻱﺭﺎﺘﺳﺮﭘ ﻤﻠﻋ ﻥﺍﻮﻨﻋ
ﯽ ﻥﺎﻴﻣ ﻪﺘﺷﺭ ﻥﺎﻤﻫ ،ﻱﺍ ﻪﮐ ﻪﻧﻮﮔ
ﻪﺑ ﻭ ﺪﻳﺪﺟ ﺕﺍﺰﻴﻬﺠﺗ ﻭ ﺎﻫﺭﺍﺰﺑﺍ ﺎﺑ ﺖﺳﺍ ﻪﺘﺴﻧﺍﻮﺗ ﻥﻮﻨﮐﺎﺗ ﺭﺎﮔﺯﺎﺳ ﺯﻭﺭ
ﻮﺷ ﻭ ﺩ
ﻞﺒﻗ ﺯﺍ ﺮﺗﺯﺭﺎﺑ ﻱﺭﻭﺎﻨﻓ ﻭ ﻢﻠﻋ ﺪﺷﺭ ﺎﺑ ﻥﺎﻣﺰﻤﻫ ﺎﺘﺳﺍﺭ ﻦﻳﺍ ﺭﺩ ﺍﺭ ﺩﻮﺧ ﺶﻘﻧ ﻩﻮﻠﺟ ﺩﺭﺍﺩ ﻝﻭﺬﺒﻣ ﺹﺎﺧ ﻪﺟﻮﺗ ﺰﻴﻧ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻦﻳﺍ ﻪﺑ ﻲﺘﺴﻳﺎﺑ ،ﺪﻳﺎﻤﻧ ﺮﮔ .
ﻲﻤﻧ ﺪﻳﺪﺟ ﻲﻧﺎﻣﺭﺩ ﻩﻮﻴﺷ ﻦﻳﺍ ﺖﺧﺎﻨﺷ ﻥﻭﺪﺑ ﻥﺍﺭﺎﺘﺳﺮﭘ ،ﺍﺬﻟ ﺮﻓ ﺪﻨﻧﺍﻮﺗ
ﺪﻨﻳﺁ
ﻦﻳﺍ ﺯﺍ ﻩﺪﻨﻳﺁ ﺭﺩ ﻪﮐ ﻲﻧﺎﻳﻮﺟﺩﺪﻣ ﻱﺍﺮﺑ ﺍﺭ ﺐﺳﺎﻨﻣ ﻲﻧﺎﻣﺭﺩ ﻭ ﻲﺘﺒﻗﺍﺮﻣ ﺵﻭﺭ ﻩﺮﻬﺑ ﺎﻫ ﻲﻣ ﺪﻨﻣ ﺪﻨﻳﺎﻤﻧ ﺍﺮﺟﺍ ﻭ ﻦﻳﻭﺪﺗ ﺪﻧﻮﺷ .
ﻥﺍﺭﺎﺘﺳﺮﭘ ،ﺮﮕﻳﺩ ﻱﻮﺳ ﺯﺍ
ﻪﺑ ﻥﺍﻮﻨﻋ ﺱﺮﺘﺳﺩﺭﺩ ﻝﺎﻌﻓ ﻭ ﻦﻳﺮﺗ ﻪﻌﻣﺎﺟ ﺖﻣﻼﺳ ﻭ ﻥﺎﻣﺭﺩ ﻢﻴﺗ ﻮﻀﻋ ﻦﻳﺮﺗ
ﻪﺑ ﻪﮐ ﻪﭽﻧﺁ ﻲﺘﺴﻳﺎﺑ ﻡﻮﺳﺮﻣ ﻥﺎﻣﺭﺩ ﻩﻮﻴﺷ ﺭﺩ ﻝﻮﺤﺗ ﻭ ﺯﻭﺭ ﻢﻠﻋ ﻥﺍﻮﻨﻋ
ﺍ ﻱﺭﺎﻤﻴﺑ ﺐﻠﻏ ﻪﺘﺷﺍﺩ ﻪﻃﺎﺣﺍ ﻥﺁ ﻪﺑ ﻭ ﺪﻨﺳﺎﻨﺸﺑ ﺍﺭ ﺖﺳﺍ ﻩﺪﺷ ﻲﻓﺮﻌﻣ ﺎﻫ
ﺪﻨﺷﺎﺑ . ﻭ ﺐﻳﺎﻌﻣ ﺯﺍ ﻥﺍﺭﺎﺘﺳﺮﭘ ﻲﻫﺎﮔﺁ ﺶﻳﺍﺰﻓﺍ ﻑﺪﻫ ﺎﺑ ﺮﺿﺎﺣ ﺶﻫﻭﮋﭘ ،ﺍﺬﻟ
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻱﺎﻳﺍﺰﻣ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺭﺩ ﻲﻤﻠﻋ ﻱﺎﻫﺩﺭﻭﺎﺘﺳﺩ ﻦﻳﺮﺗﺪﻳﺪﺟ ،
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻪﻨﻴﻣﺯ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺖﻓﺎﺑ ﺭﺩ ﻲﻟﻮﻠﺳ ﺖﺷﺎﻛ ﻱﺎﻤﻧﺭﻭﺩ ﻭ ﻱﺎﻫ
ﺐﻴﺳﺁ ﻩﺪﻳﺩ ﻡﺎﺠﻧﺍ ﺪﺷ . ﻦﻴﺑ ﻦﻳﺍ ﺭﺩ
، ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﻪﺑ ﻪﺑ ﻲﺒﻠﻗ ﻱﺎﻫ
ﺵﻭﺭ
ﻝﻮﻠﺳ ﻪﺑ ﻲﻧﺎﻣﺭﺩ ﺶﻟﺎﭼ ﺯﺍ ﻲﻜﻳ ﻥﺍﻮﻨﻋ ﻪﺟﻮﺗ ﻲﻧﺎﻬﺟ ﻪﻌﻣﺎﺟ ﻲﻧﺎﻣﺭﺩ ﻱﺎﻫ
ﺪﺷ ﻲﺻﺎﺧ .
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻪﭽﺨﻳﺭﺎﺗ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ
ﻝﻮﻠﺳ ﺪﻧﻮﻴﭘ ﻥﻮﺧ ﻱﺎﻫ
ﻲﻤﻴﺧﺪﺑ ﺭﺩ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﺯﺎﺳ ﻱﺭﺎﻤﻴﺑ ﻭ ﺎﻫ
ﻱﺎﻫ
ﺩﻭﺪﺣ ﺎﻴﻤﻛﻮﻟ ﺪﻨﻧﺎﻣ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ۴۰
ﺪﺷ ﺯﺎﻏﺁ ﻞﺒﻗ ﻝﺎﺳ ]
۶ ، ۷ .[
ﻦﻳﺍ
ﻘﻘﺤﻣ ﻦﻫﺫ ﺭﺩ ﺹﺎﺧ ﻩﺰﻴﮕﻧﺍ ﭻﻴﻫ ﻥﻭﺪﺑ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﺎ
ﻩﺩﺎﻔﺘﺳﺍ ﺩﺭﻮﻣ ﻥ
ﻲﻣ ﺭﺍﺮﻗ ﻝﺎﺳ ﺭﺩ ﺎﻫﺭﻮﻣﻮﺗ ﺭﺩ ﺪﻳﺪﺟ ﻲﻧﻮﺧ ﻕﻭﺮﻋ ﺪﺷﺭ ﺮﺒﺧ ﻪﻜﻨﻳﺍ ﺎﺗ ﺖﻓﺮﮔ
۱۹۹۰ ﻲﻣ ﺮﻜﻓ ﻪﻛ ﺍﺭ ﻥﺍﺪﻨﻤﺸﻧﺍﺩ ﺯﺎﻓ ﺭﺩ ﻂﻘﻓ ﺪﻳﺪﺟ ﻲﻧﻮﺧ ﻕﻭﺮﻋ ﺪﻧﺩﺮﻛ
ﻲﻣ ﻪﺘﺧﺎﺳ ﻲﻨﻴﻨﺟ ﻝﻮﻠﺳ ﻒﺸﻛ ﺖﻤﺳ ﻪﺑ ﺪﻧﻮﺷ
ﮒﺭ ﻱﺎﻫ ﺎﺳ ﻭ ﺩﺍﺩ ﻕﻮﺳ ﺯ
ﻝﻮﻠﺳ ﺖﻓﺮﺸﻴﭘ ﺭﺩ ﻢﻴﻈﻋ ﻲﻟﻮﺤﺗ ﺩﻮﻤﻧ ﺩﺎﺠﻳﺍ ﻥﺎﺴﻧﺍ ﺭﺩ ﻲﻧﺎﻣﺭﺩ
] ۸ [.
ﻝﻮﻠﺳ ﺯﺍ ﻲﺻﺎﺧ ﻉﻮﻧ ﻪﻛ ﺪﻨﺘﻓﺎﻳﺭﺩ ﻥﺍﺮﮕﺸﻫﻭﮋﭘ ﺩﻮﺟﻭ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﺭﺩ ﺎﻫ
ﺭﺍﺩ ﻧ ﻪﻛ ﺪ ﯽﻣ ﻧﺍﻮﺗ ﺪﻨ ﺖﻓﺎﺑ ﻲﺧﺮﺑ ﻪﺑ ﻥﺪﺑ ﻱﺎﻫ
ﻮﺷ ﻞﻳﺪﺒﺗ ﺪﻧ . ﻒﺸﻛ ﺯﺍ ﺲﭘ
ﻝﻮﻠﺳ ﻥﻮﺧ ﻱﺎﻫ ﻝﻮﻠﺳ ﻭ ﺯﺎﺳ
ﺖﻳﺎﻤﺣ ﻱﺎﻫ ﻪﻳﺬﻐﺗ ﻭ ﻩﺪﻨﻨﻛ
ﺎﻬﻧﺁ ﻩﺪﻨﻨﻛ ،
ﻝﻮﻠﺳ ﻦﻳﺍ ﻪﻛ ﺪﺷ ﺺﺨﺸﻣ ﺎﺑ ﺩﻮﺧ ﺰﻴﻧ ﺎﻫ
ﻳ ﻝﻮﻠﺳ ﺯﺍ ﺪ ﻱﺮﮕﻳﺩ ﺭﺩﺎﻣ ﻱﺎﻫ
ﺪﻨﺷﺎﺑ ﻪﺘﻓﺎﻳ ﻞﻣﺎﻜﺗ ﻭ ﻩﺩﺮﻛ ﺍﺪﻴﭘ ﻕﺍﺮﺘﻓﺍ .
ﻪﺑ ﺮﺠﻨﻣ ﺎﺘﺳﺍﺭ ﻦﻳﺍ ﺭﺩ ﺕﺎﻘﻴﻘﺤﺗ ﻒﺸﻛ
"
ﻝﻮﻠﺳ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﻲﻨﻴﻨﺟ
"
ﺪﺷ
؛ ﺑ ﺶﻫﻭﮋﭘ ﯼﺍﺮ ﻦﻳﺍ ﺖﺷﺎﻛ
ﻝﻮﻠﺳ ﻪﺑ ﺎﻫ ﻝﺎﺳ ﺯﺍ ﺩﻭﺪﺤﻣ ﺕﺭﻮﺻ ۱۹۹۸
ﺯﺎﻏﺁ ﺪﺷ ] ۹ .[
ﻪﻌﻟﺎﻄﻣ ﺯﺍ ﺪﻌﺑ
ﻚﻴﻟﺭﻭﺍ ﻥﺍﺭﺎﻜﻤﻫ ﻭ ﻝﺎﺳ ﺭﺩ
۲۰۰۱ ﻝﻮﻠﺳ ﻪﻛ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﻨﻴﻨﺟ ﯽ ﻪﺑ ﺍﺭ
،ﺩﺯ ﺪﻧﻮﻴﭘ ﺵﻮﻣ ﺐﻠﻗ ﻪﻨﻴﻣﺯ ﻦﻳﺍ ﺭﺩ ﺕﺎﻘﻴﻘﺤﺗ
ﺩﺮﻛ ﺍﺪﻴﭘ ﺶﻳﺍﺰﻓﺍ .
ﺯﺍ ﺲﭘ
ﻥﺁ
، ﮓﺳ ﻭ ﻥﻮﻤﻴﻣ ،ﺪﻨﻔﺳﻮﮔ ،ﺮﺗﻮﺒﻛ ﻥﻮﭼ ﻒﻠﺘﺨﻣ ﺕﺎﻧﺍﻮﻴﺣ ﻱﻭﺭ ﻪﻌﻟﺎﻄﻣ
ﺵﻭﺭ ﻭ ﺖﻓﺎﻳ ﻪﻣﺍﺩﺍ ﺎﺗ ﺖﻓﺮﮔ ﺭﺍﺮﻗ ﻲﺑﺎﻳﺯﺭﺍ ﺩﺭﻮﻣ ﺖﺷﺎﻛ ﻒﻠﺘﺨﻣ ﻱﺎﻫ
ﻪﺘﻴﻤﻛ ﻪﻜﻨﻳﺍ ﺟﻮﺗ ﺎﺑ ﻲﻜﺷﺰﭘ ﻕﻼﺧﺍ ﻱﺎﻫ
ﺯﺍ ﻞﺻﺎﺣ ﺏﻮﺧ ﺭﺎﻴﺴﺑ ﺞﻳﺎﺘﻧ ﻪﺑ ﻪ
ﻱﻭﺭ ﻲﻧﺎﻣﺭﺩ ﺪﻳﺪﺟ ﻩﻮﻴﺷ ﻦﻳﺍ ﻲﺸﻳﺎﻣﺯﺁ ﻱﺍﺮﺟﺍ ﻩﺯﺎﺟﺍ ﻲﻧﺍﻮﻴﺣ ﺕﺎﻘﻴﻘﺤﺗ ﺪﻧﺩﻮﻤﻧ ﺭﺩﺎﺻ ﺍﺭ ﻥﺎﺴﻧﺍ ]
۱۰ .[
ﺩﺮﻛﺭﺎﻛ ﺭﺩ ﻱﺩﺎﻳﺯ ﺩﻮﺒﻬﺑ ،ﺕﺎﺸﻳﺎﻣﺯﺁ ﺞﻳﺎﺘﻧ
ﺕﺭﻮﺻ ﺕﺎﻘﻴﻘﺤﺗ ﺮﺒﺧ ﺭﺎﺸﺘﻧﺍ ﺎﺑ ﺎﻣﺍ ،ﺪﻧﺩﺍﺩ ﻥﺎﺸﻧ ﺐﻠﻗ ﻭ ﺰﻛﺍﺮﻣ ﻪﺟﻮﺗ ،ﻪﺘﻓﺮﮔ
ﻲﺳﺎﻴﺳ ﻭ ﻲﻗﻮﻘﺣ ،ﻲﻗﻼﺧﺍ ،ﻲﺒﻫﺬﻣ ﺕﺎﺴﺳﻮﻣ ﺴﻣ ﻦﻳﺍ ﻪﺑ
ﺎ ﺪﺷ ﻑﻮﻄﻌﻣ ﻪﻟ
ﺩﺍﺩ ﻕﻮﺳ ﺹﺎﺧ ﻲﻳﻮﺳ ﻭ ﺖﻤﺳ ﻪﺑ ﺍﺭ ﺕﺎﻘﻴﻘﺤﺗ ﺮﻴﺴﻣ ﻭ ]
۱۱ .[
،ﻥﺁ ﺯﺍ ﺲﭘ
ﻝﻮﻠﺳ ﻝﺎﻘﺘﻧﺍ ﻥﺩﻮﺑ ﻦﻤﻳﺍ ﺐﻠﻗ ﻪﺑ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻱﺎﻫ
ﻂﺳﻮﺗ ﻮﻧﺎﻣﺎﻫ ﻭ
ﻥﺍﺭﺎﻜﻤﻫ ﺪﺷ ﺖﺑﺎﺛ
؛ ﻝﻮﻠﺳ ﺪﻧﻮﻴﭘ ﺩﺮﺑﺭﺎﻛ ﺲﭙﺳ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺎﺑ ﻩﺍﺮﻤﻫ
ﺵﻭﺭ ﻭ ﺖﻓﺮﮔ ﺭﺍﺮﻗ ﻪﺟﻮﺗ ﺩﺭﻮﻣ ﺐﻠﻗ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻮﻨﺘﻣ ﻱﺎﻫ
ﺯﺍ ﻲﻋ
ﺭﺰﻴﻟ ﻂﺳﻮﺗ ﺖﺷﺎﻛ ﻭ ﻕﻭﺮﻋ ﻞﺧﺍﺩ ﻖﻳﺭﺰﺗ ،ﺐﻠﻗ ﻪﻠﻀﻋ ﻞﺧﺍﺩ ﻖﻳﺭﺰﺗ ﻪﻠﻤﺟ ﺪﻨﺘﻓﺮﮔ ﺭﺍﺮﻗ ﻲﺳﺭﺮﺑ ﻭ ﻩﺩﺎﻔﺘﺳﺍ ﺩﺭﻮﻣ .
ﻩﺎﮕﺸﻧﺍﺩ ﻢﻬﻣ ﻲﺗﺎﻘﻴﻘﺤﺗ ﺰﻛﺍﺮﻣ ﻭ ﺎﻫ
ﻝﻮﻠﺳ ﻪﻌﻟﺎﻄﻣ ﻪﻨﻴﻣﺯ ﺭﺩ ﺍﺭ ﺩﻮﺧ ﺭﺎﻛ ﻥﺎﻣﺰﻤﻫ ﺎﻜﻳﺮﻣﺁ ﻭ ﺎﭘﻭﺭﺍ ﺭﺩ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﻱﺍﺮﺑ ﻉﻭﺮﺷ ﻦﻣﺰﻣ ﻭ ﻲﺑﺎﺴﺘﻛﺍ ﻱﺩﺍﺯﺭﺩﺎﻣ ﻱﺎﻫ
ﺪﻧﺩﺮﻛ ﻱﻻﺎﺑ ﻪﺑ ﻲﻨﻴﻟﺎﺑ ﻲﻳﺎﻣﺯﺁﺭﺎﻛ ﺮﻫ ﺭﺩ ﻥﺍﺭﺎﻤﻴﺑ ﺩﺍﺪﻌﺗ ﻪﮑﻨﻳﺍ ﺎﺗ ۵۰
ﺮﻔﻧ
ﻘﻘﺤﻣ ﻭ ﺪﻴﺳﺭ ﺎ
ﻪﻠﻤﺟ ﺯﺍ ﻲﻔﻠﺘﺨﻣ ﻥ ﻮﻴﻟﺁ
ﻭ ﺮﺘﺳﺍ ﻭ ﻦﻳﺍ ﺮﺑ ﺍﺭ ﺩﻮﺧ ﺕﺎﻘﻴﻘﺤﺗ
ﺪﻧﺩﻮﻤﻧ ﺰﻛﺮﻤﺘﻣ ﻉﻮﺿﻮﻣ ]
۱۲ [.
ﻪﺑ ﻪﺘﺒﻟﺍ ﺭﺩ ﺖﻠﻋ ﺱﺮﺘﺳﺩ ﺩﺎﻳﺯ ﺩﺍﺪﻌﺗ ﻭ ﻥﺩﻮﺑ
ﻥﻮﺧ ﺶﻫﺎﻛ ﺭﺎﭼﺩ ﻥﺍﺭﺎﻤﻴﺑ ﻦﻴﻟﻭﺍ ﻥﺍﺭﺎﻤﻴﺑ ﺯﺍ ﻩﻭﺮﮔ ﻦﻳﺍ ،ﺐﻠﻗ ﻪﻠﻀﻋ ﻲﻧﺎﺳﺭ
ﺪﻧﺩﺍﺩ ﻞﻴﻜﺸﺗ ﺍﺭ ﻪﻌﻟﺎﻄﻣ ﺩﺭﻮﻣ ﺩﺍﺮﻓﺍ ]
۱۳ .[
ﻪﻜﻨﻳﺍ ﺎﺗ ﺖﻓﺎﻳ ﻪﻣﺍﺩﺍ ﺕﺎﻘﻴﻘﺤﺗ
ﻝﺎﺳ ﺭﺩ ۲۰۰۵ ﻱﻭﺭﺍﺩ ﻭ ﺍﺬﻏ ﻥﺎﻣﺯﺎﺳ ، ﺘﻣ ﺕﻻﺎﻳﺍ
ﺤ ﻩﺪ ﻲﻳﺁﺭﺎﻛ ﺎﻜﻳﺮﻣﺁ
ﻝﻮﻠﺳ ﺩﻮﺧ ﻱﺭﺍﺩﺍ ﺕﻼﻴﻜﺸﺗ ﺭﺩ ﻭ ﺩﻮﻤﻧ ﺪﻴﻳﺎﺗ ﻲﺒﻠﻗ ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﺍﺭ ﻲﻧﺎﻣﺭﺩ
ﺍﺮﺑ ﺍﺭ ﻲﺸﺨﺑ ﻱ
ﻮﺗ ،ﻱﺮﻴﮕﻴﭘ ﺶﻟﺎﭼ ﻞﺣ ﻭ ﻪﻌﺳ
ﻦﻳﺍ ﻩﺍﺭ ﺮﺳ ﺮﺑ ﺩﻮﺟﻮﻣ ﻱﺎﻫ
ﺩﺮﻛ ﺲﻴﺳﺎﺗ ﻥﺎﻣﺭﺩ ﻉﻮﻧ ]
۱۴ ، ۱۵ .[
ﺕﺭﻮﻔﻜﻧﺍﺮﻓ ﻩﺎﮕﺸﻧﺍﺩ ﺭﺩ ﺕﺎﻘﻴﻘﺤﺗ ﻥﺁ ﺯﺍ ﺲﭘ ﻥﺎﻤﻟﺁ
ﺐﻠﻗ ﻪﺴﺳﻮﻣ ،
ﻨﻴﻣ ﻪ ﺁ ﺲﻴﻟﻮﭘ ﻩﺪﺤﺘﻣ ﺕﻻﺎﻳﺍ ﺴﻠﮕﻧﺍ ﻞﺳﺎﻛﻮﻴﻧ ﻩﺎﮕﺸﻧﺍﺩ ،
ﻥﺎﺘ ﻩﺎﮕﺸﻧﺍﺩ ﻭ
ﻱﻮﻟﺎﮔ ﻪﻣﺍﺩﺍ ﺪﻨﻟﺮﻳﺍ ﺖﻓﺎﻳ
] ۱۶ [ ﻴﻠﻣﺪﻨﭼ ﺕﺎﺴﺳﻮﻣ ﻭ ﻪﺴﺳﻮﻣ ﻪﻠﻤﺟ ﺯﺍ ﻲﺘ
ﺎﺘﻳﻭﺍﺮﺗ ﻲﻧﺎﻣﺭﺩ )
ﻦﻴﻄﺴﻠﻓ ،ﺪﻨﻠﻳﺎﺗ ﻲﻟﺎﻐﺷﺍ
ﻭ ﮓﻨﻫ ﮓﻨﻛ ( ﻝﺎﺳ ﺭﺩ ۲۰۰۵ ﺎﺑ ،
ﻲﻧﺎﭙﻤﻛ ﻚﻤﻛ ﻲﻳﻭﺭﺍﺩ ﻱﺎﻫ
ﻭ ﻮﻴﺑ ﺕﺎﻘﻴﻘﺤﺗ ﻪﻌﺳﻮﺗ ﺮﺑ ﻩﻭﻼﻋ ،ﻱﮊﻮﻟﻮﻨﻜﺗ ،
ﻚﻧﺎﺑ ﻞﻴﻜﺸﺗ ﻪﺑ ﻝﻮﻠﺳ
ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﻪﺑ ﻉﻭﺮﺷ ﻥﺎﻣﺰﻤﻫ ﻭ ﺪﻧﺩﺮﻛ ﻡﺍﺪﻗﺍ
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻪﻨﻴﻣﺯ ﺭﺩ ﻎﻴﻠﺒﺗ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺪﻧﺩﻮﻤﻧ ] ۱۷
، ۱۸ [ . ﺪﻧﻭﺭ ﻦﻳﺍ
ﺎﻬﻧ ﺭﺩ ﻪﻜﻨﻳﺍ ﺎﺗ ﺖﻓﺎﻳ ﻪﻣﺍﺩﺍ ﻳ
ﺮﺒﻣﺎﺳﺩ ﺭﺩ ﺖ ۲۰۰۶
ﻦﻴﺑ ﻡﻮﻳﺯﻮﭙﻤﺳ ، ﻲﻠﻠﻤﻟﺍ
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﺭﺩ ﻲﺒﻠﻗ ﻱﺎﻫ
ﮎﻮﮑﻧﺎﺑ ﺭﺩ ﺭﺍﺰﮔﺮﺑ
ﺭﺍﺮﻗ ﺚﺤﺑ ﺩﺭﻮﻣ ﻥﺍﻮﻴﺣ ﻭ ﻥﺎﺴﻧﺍ ﻱﻭﺭ ﺕﺎﻘﻴﻘﺤﺗ ﻦﻳﺮﺧﺁ ﻭ ﺪﺷ ﺖﻓﺮﮔ
. ﺭﺩ
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻊﻣﺎﺟ ﺲﻧﺍﺮﻔﻨﻛ ﺰﻴﻧ ﻝﺎﺳ ﻥﺎﻤﻫ ﺮﺒﻣﺍﻮﻧ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺭﺩ
ﻥﺎﺘﺴﻠﮕﻧﺍ ﻪﻨﻴﻣﺯ ﺭﺩ ﺩﻮﺧ ﺕﺎﻘﻴﻘﺤﺗ ﻦﻳﺮﺧﺁ ﻥﺍﺪﻨﻤﺸﻧﺍﺩ ﻪﻛ ﺪﺷ ﺭﺍﺰﮔﺮﺑ
ﻝﻮﻠﺳ ﻱﺭﺎﻤﻴﺑ ﺭﺩ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻭ ﻒﻠﺘﺨﻣ ﻱﺎﻫ
ﺩﺮﺑﺭﺎﻛ ﻒﻠﺘﺨﻣ ﻱﺎﻫ
ﻝﻮﻠﺳ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﺪﻧﺩﻮﻤﻧ ﻪﻳﺍﺭﺍ ]
۱۹ ، ۲۰ [.
ﻝﻮﻠﺳ ﯼﺩﺎﻴﻨﺑ ﺖﺴﻴﭼ ﻪﺑ ﻲﻌﺑﺎﻨﻣ ﻪﭼ ﺯﺍ ﻭ ﻲﻣ ﺖﺳﺩ
ﺪﻳﺁ
؟
ﺖﻓﺎﺑ ﻝﻮﻠﺳ ﺯﺍ ﻥﺪﺑ ﻒﻠﺘﺨﻣ ﻱﺎﻫ ﻩﺪﺷ ﻞﻴﻜﺸﺗ ﻲﻳﺎﻫ
ﺍ ﺪﻧ ﻲﻳﺎﻧﺍﻮﺗ ﻲﺧﺮﺑ ﻪﻛ
ﻝﻮﻠﺳ ﺩﺪﺠﻣ ﺖﺧﺎﺳ ﺪﻧﺭﺍﺩ ﺍﺭ ﺩﻮﺧ ﻉﻮﻨﻤﻫ ﻱﺎﻫ
؛ ﻝﻮﻠﺳ ﻪﻠﻤﺟ ﺯﺍ ﺐﻠﻗ ﻱﺎﻫ
ﻲﺒﺼﻋ ﻢﺘﺴﻴﺳ ﻭ .
ﻝﻮﻠﺳ ﻥﺎﻴﻣ ﻦﻳﺍ ﺭﺩ ﻱﺍﺭﺍﺩ ﻪﻛ ﺪﻧﺭﺍﺩ ﺩﻮﺟﻭ ﻥﺪﺑ ﺭﺩ ﻲﻳﺎﻫ
ﺍﺮﺑ ﺹﺎﺧ ﻱﺩﺍﺪﻌﺘﺳﺍ ﻱ
ﻝﻮﻠﺳ ﻪﺑ ﻞﻳﺪﺒﺗ ﻭ ﻕﺍﺮﺘﻓﺍ ﺮﮕﻳﺩ ﻲﺼﺼﺨﺗ ﻱﺎﻫ
ﺪﻨﺘﺴﻫ ] ۲۱ ، ۲۲ .[
ﻝﻮﻠﺳ ﻦﻳﺍ ﺯﺭﺎﺑ ﻪﺼﺨﺸﻣ ﻭﺩ ﺎﻫ
ﺪﻧﺭﺍﺩ
؛ ﺮﻴﺛﺎﺗ ﺖﺤﺗ
ﻲﻣ ﺐﺳﺎﻨﻣ ﻂﻳﺍﺮﺷ ﻝﻮﻠﺳ ﺮﮕﻳﺩ ﻪﺑ ﺪﻨﻧﺍﻮﺗ
ﻞﻳﺪﺒﺗ ﻥﺪﺑ ﻲﺼﺼﺨﺗ ﻱﺎﻫ
ﺪﻧﻮﺷ ﻭ ؛ ﻝﻮﻠﺳ ﺖﺧﺎﺳ ﻲﻳﺎﻧﺍﻮﺗ ﻲﻃ ﻭ ﺪﻧﺭﺍﺩ ﺍﺭ ﺩﻮﺧ ﻉﻮﻨﻤﻫ ﻪﻳﺎﭘ ﻱﺎﻫ
ﻲﻣ ﻢﻴﺴﻘﺗ ﺮﻴﻴﻐﺗ ﻥﻭﺪﺑ ﺩﺎﻳﺯ ﻥﺎﻣﺯ ﺭﺩ ﻭ ﺩﺎﻳﺯ ﺕﺎﻤﻴﺴﻘﺗ ﺪﻧﻮﺷ
] ۱ [.
۱ - ﻚﻴﻧﻮﻳﺮﺒﻣﺍ ﻩﺩﻮﺗ ۲
- ﻑﺎﻧﺪﻨﺑ ﻥﻮﺧ ۳
- ﺖﻓﺎﺑ ﺺﺨﺸﻣ ﻎﻟﺎﺑ ﻱﺎﻫ
ﺪﻨﻧﺎﻣ ) ﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻱﺪﻳﺭﻭ ﻥﻮﺧ ،ﻪﻠﻀﻋ ،ﻥ
.(
ﻞﻛ ﺭﺩ ﺎﻣﺍ ۲
ﺍﺭ ﻲﻠﺻﺍ ﻊﺒﻨﻣ
ﻲﻣ ﺎﻬﻧﺁ ﻱﺍﺮﺑ ﺩﻮﻤﻧ ﻲﻓﺮﻌﻣ ﻥﺍﻮﺗ
: ۱ - ﻝﻮﻠﺳ ﻲﻨﻴﻨﺟ ﺎﻳ ﻚﻴﻧﻮﻳﺮﺒﻣﺍ ﻪﻳﺎﭘ ﻱﺎﻫ
ﻩﺩﻮﻤﻧ ﺪﺷﺭ ﻡﻭﺩ ﻪﺘﻔﻫ ﺎﺗ ﻪﻛ ﻲﻜﻴﻧﻮﻳﺮﺒﻣﺍ ﻩﺩﻮﺗ ﺯﺍ ﻪﻛ ﻪﺑ ﺖﺳﺍ
ﺖﺳﺩ
ﻲﻣ ﺪﻳﺁ . ۲ - ﻝﻮﻠﺳ ﻪﺑ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻭ ﻥﻮﺧ ﺯﺍ ﻪﻛ ﻎﻟﺎﺑ ﻪﻳﺎﭘ ﻱﺎﻫ ﺖﺳﺩ
ﻲﻣ ﻲﻣ ﻭ ﺪﻨﻳﺁ ﺭﺩ ﺪﻨﻧﺍﻮﺗ ﻦﻳﺍ ﺪﻨﻳﺎﻤﻧ ﻢﻴﻣﺮﺗ ﺍﺭ ﻥﺁ ﺖﻓﺎﺑ ﻚﻳ ﺐﻳﺮﺨﺗ ﺕﺭﻮﺻ
ﻝﻮﻠﺳ ﻪﺘﻓﺎﻳ ﺺﺼﺨﺗ ﺎﻫ ﻝﻮﻠﺳ ﺯﺍ ﺮﺗ
ﺪﻨﺘﺴﻫ ﻚﻴﻧﻮﻳﺮﺒﻣﺍ ﻪﻳﺎﭘ ﻱﺎﻫ .
ﻲﻣ ﻥﺍﻮﺗ
ﻥﺎﻴﺑ ﻪﻧﻮﮔ ﻦﻳﺍ ﺎﻬﻧﺁ ﺕﻭﺎﻔﺗ ﻥﺎﻴﺑ ﺭﺩ ﻝﻮﻠﺳ ﻪﻛ ﺖﺷﺍﺩ
ﻚﻴﻧﻮﻳﺮﺒﻣﺍ ﻪﻳﺎﭘ ﻱﺎﻫ
ﻲﻠﻛ ﻝﻮﻠﺳ ﻭ ﺮﺗ ﻪﺘﻓﺎﻳ ﺺﺼﺨﺗ ﻲﻤﻛ ﻎﻟﺎﺑ ﻪﻳﺎﭘ ﻱﺎﻫ
ﻲﻣ ﻭ ﺪﻧﺮﺗ ﻪﺑ ﺪﻨﻧﺍﻮﺗ
ﺖﻓﺎﺑ ﻴﺴﻘﺗ ﻱﺮﺗﺩﻭﺪﺤﻣ ﻱﺎﻫ ﺪﻧﻮﺷ ﻢ
] ۱۰ ، ۲۳ ، ۲۴ .[
ﻥﺍﻮﻴﺣ ﺎﻳ ﻥﺎﺴﻧﺍ ﺭﺩ
ﻝﻮﻠﺳ ﻲﻣ ﻞﻜﺷ ﻲﮔﺩﺍﻮﻧﺎﺧ ﺖﺧﺭﺩ ﻚﻳ ﻞﺜﻣ ﺍﺪﺘﺑﺍ ﺯﺍ ﺎﻫ ﻦﻴﻤﻫ ﻪﺑ ﻭ ﺪﻧﺮﻴﮔ
ﻲﻣ ﻢﻴﺴﻘﺗ ﺐﻴﺗﺮﺗ ﺪﻧﺩﺮﮔ
. ﻝﻮﻠﺳ ﻪﺑ ﻩﺎﮕﺸﻳﺎﻣﺯﺁ ﻂﻴﺤﻣ ﺭﺩ ﻲﻨﻴﻨﺟ ﻪﻳﺎﭘ ﻱﺎﻫ
ﻞﻳﺪﺒﺗ ﻱﺰﻴﭼ ﺮﻫ ﻪﺑ ،ﺪﻨﻨﻛ ﻲﻣ ﺪﺷﺭ ﻱﺩﺎﻳﺯ ﺩﺍﺪﻌﺗ ﺮﻫ ﻦﻳﺰﮕﻳﺎﺟ ﻭ ﻩﺪﺷ
ﻲﻣ ﺰﻴﻧ ﻲﺘﻓﺎﺑ ﺮﺛﺍ ﻲﻨﻤﻳﺍ ﺎﻣﺍ ،ﺩﻮﺷ
ﻥﺎﺴﻧﺍ ﺭﺩ ﺎﻬﻧﺁ ﻞﻣﺎﻛ ﺭﻮﻃ ﻪﺑ ﺯﻮﻨﻫ ﺎﻫ
ﻲﻣ ﺖﻓﺎﺑ ﻚﻳ ﺭﺩ ﺪﺣ ﺯﺍ ﺶﻴﺑ ﺪﺷﺭ ﺎﺑ ﻪﻛ ﺍﺮﭼ ؛ﺖﺳﺍ ﻩﺪﺸﻧ ﺺﺨﺸﻣ ﺪﻨﻧﺍﻮﺗ
ﻞﻳﺪﺒﺗ ﺭﻮﻣﻮﺗ ﻪﺑ ﺩﺭﻮﻣ ﻪﻛ ﻲﺘﻓﺎﺑ ﻪﺑ ﺎﻳ ﺪﻧﻮﺷ
ﺎﻳ ﻭ ﺪﻧﻮﺷ ﻞﻳﺪﺒﺗ ،ﺖﺴﻴﻧ ﺮﻈﻧ
ﻢﺘﺴﻴﺳ ﺪﻧﺰﺑ ﺲﭘ ﺍﺭ ﺎﻬﻧﺁ ﺖﺳﺍ ﻦﻜﻤﻣ ﻲﻨﻤﻳﺍ .
ﻭ ﻲﻗﻼﺧﺍ ﻅﺎﺤﻟ ﺯﺍ ﻦﻴﻨﭽﻤﻫ
ﺤﺑ ﺩﺭﻮﻣ ﺎﻬﻧﺁ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺰﻴﻧ ﻲﺒﻫﺬﻣ ﺭﺩ ،ﺩﺭﺍﺩ ﻝﺎﻜﺷﺍ ﻱﺎﺟ ﻭ ﻩﺩﻮﺑ ﺚ
ﻝﻮﻠﺳ ﺽﻮﻋ ﺳ ﻱﻻﺎﺑ ﺩﺍﺮﻓﺍ ﺭﺩ ﻎﻟﺎﺑ ﻱﺎﻫ
ﻲ ﺩﺭﻮﻣ ﻦﻤﻳﺍ ﺭﻮﻃ ﻪﺑ ﻝﺎﺳ
ﻪﺘﻓﺮﮔ ﺭﺍﺮﻗ ﻩﺩﺎﻔﺘﺳﺍ ﺖﺳﺍ
. ﻩﺪﺷ ﻪﺘﻓﺮﮔ ﻮﺟﺩﺪﻣ ﺩﻮﺧ ﻥﺪﺑ ﺯﺍ ﻥﻮﭼ ﻢﺘﺴﻴﺳ ،
ﻲﻤﻧ ﺲﭘ ﺍﺭ ﻥﺁ ﻲﻨﻤﻳﺍ ﺪﻧﺯ
ﺯﺎﻴﻧ ﻲﻨﻤﻳﺍ ﻢﺘﺴﻴﺳ ﻩﺪﻨﻫﺎﻛ ﻱﺎﻫﻭﺭﺍﺩ ﻪﺑ ،
ﻢﻳﺭﺍﺪﻧ ﺖﻓﺎﺑ ﻭ ﺭﻮﻣﻮﺗ ﻪﺑ ﺎﻬﻧﺁ ﻞﻳﺪﺒﺗ ﻝﺎﻤﺘﺣﺍ ، ﻲﻨﻴﺑ ﺶﻴﭘ ﻭ ﻩﺪﺸﻧ ﻝﺮﺘﻨﻛ
ﻪﺑ ﻲﻗﻼﺧﺍ ﺕﻼﻜﺸﻣ ﺰﻴﻧ ﺎﻬﻧﺁ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻭ ﺖﺳﺍ ﺮﺘﻤﻛ ﻩﺪﺸﻧ ﺪﻧﺭﺍﺪﻧ ﻩﺍﺮﻤﻫ
ﻭ ﺩﻮﺑ ﺪﻫﺍﻮﺧ ﺖﺨﺳ ﺭﺎﻴﺴﺑ ﻩﺎﮕﺸﻳﺎﻣﺯﺁ ﻂﻳﺍﺮﺷ ﺭﺩ ﺎﻬﻧﺁ ﺪﺷﺭ ﺽﻮﻋ ﺭﺩ ﺎﻣﺍ ﺪﻨﺘﺴﻴﻧ ﺱﺮﺘﺳﺩ ﺭﺩ ﺩﺎﻳﺯ ﺩﺍﺪﻌﺗ ﻪﺑ .
ﺖﻓﺎﺑ ﻪﺑ ﻦﻴﻨﭽﻤﻫ ﻞﻳﺪﺒﺗ ﻱﺮﺘﻤﻛ ﻱﺎﻫ
ﻲﻣ ﺪﻧﻮﺷ ] ۲۵ ، ۲۶ [.
ﻝﻮﻠﺳ ﻒﻠﺘﺨﻣ ﻱﺎﻫﺩﺮﺑﺭﺎﻛ ﻫ
ﻱﺎ ﯼﺩﺎﻴﻨﺑ
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻪﻧﺎﺴﻓﺍ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻱﺭﺎﻤﻴﺑ ﺯﺍ ﻱﺭﺎﻴﺴﺑ ﻥﺎﻣﺭﺩ ﻱﺍﺮﺑ ﺭﺩ ﺎﻫ
ﺖﺴﻴﺑ ﻲﻤﻠﻋ ﻪﻧﺍﻮﺘﺸﭘ ﻭ ﺖﺳﺍ ﺖﻴﻌﻗﺍﻭ ﻪﺑ ﻞﻳﺪﺒﺗ ﻝﺎﺣ ﺪﻨﭼﻭ
ﻦﻳﺍ ﺯﺍ ﻪﻟﺎﺳ
ﻲﻣ ﺖﻳﺎﻤﺣ ﺖﻴﻌﻗﺍﻭ ﺪﻨﻛ
. ﺼﺼﺨﺘﻣ ﺎ ﺪﻧﺭﺍﺩ ﺎﻋﺩﺍ ﺖﻓﺎﺑ ﻲﺳﺪﻨﻬﻣ ﻥ ﻪﮐ
ﺭﺩ
ﻩﺪﻨﻳﺁ ﻪﻧ ﻱﺍ ﻱﺭﺎﻤﻴﺑ ﺯﺍ ﻱﺭﺎﻴﺴﺑ ﺩﻮﺑ ﺪﻨﻫﺍﻮﺧ ﺭﺩﺎﻗ ﺭﻭﺩ ﻥﺍﺪﻨﭼ ﺎﻫ
ﺪﻨﻧﺎﻣ ﺐﻴﺳﺁ
ﺭﺪﻨﺳ ،ﻲﻧﻮﻣﺭﻮﻫ ﺺﻘﻧ ،ﻲﻋﺎﺨﻧ ﺏﺎﻨﻃ ﻭ
ﺭﺪﻨﺳ ،ﻥﻭﺍﺩ ﻡ ﻭ
ﻲﻨﻤﻳﺍ ﺺﻘﻧ ﻡ ﻭ ﻥﺁ ﺽﺭﺍﻮﻋ ﻭ ﺖﺑﺎﻳﺩ ،ﺖﻴﺗﺍﺮﻜﻧﺎﭘ ،ﻦﻣﺰﻣ ﺖﻴﺗﺎﭙﻫ ،ﻲﻳﺍﺯﺎﻧ ،ﻲﺑﺎﺴﺘﻛﺍ
ﻱﺭﺎﻤﻴﺑ ﺯﺍ ﻱﺭﺎﻴﺴﺑ ﻚﻴﻤﻜﺴﻳﺍ ﻱﺎﻫ
ﺪﻨﻧﺎﻣ ﻲﻧﺎﻘﺘﺣﺍ ﻲﻳﺎﺳﺭﺎﻧ ﻦﻳﮋﻧﺁ ،ﺐﻠﻗ
ﻲﻤﻜﺴﻳﺍ ،ﺭﺍﺪﻳﺎﭘﺎﻧ ﻱﺭﺪﺻ ﺪﺒﻛ
ﻜﺴﻳﺍ ،ﯼ ﻲﻤ ﻜﺒﺷ ﻴ ﻪ ﻲﺒﻠﻗ ﺕﻼﻤﺣ ،ﻢﺸﭼ ﻭ
ﻳﺍ ،ﻱﺰﻐﻣ ﻡﺍﺪﻧﺍ ﻲﻤﻜﺴ ﺪﻨﻳﺎﻤﻧ ﻥﺎﻣﺭﺩ ﺍﺭ ﻪﻴﻠﻛ ﻭ ﺎﻫ
] ۲۸ .[
ﻥﺎﻣﺯ ﻦﻳﺍ ﺭﺩ
،
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻱﻭﺭ ﺕﺎﻘﻴﻘﺤﺗ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻥﺎﻃﺮﺳ ﻥﺎﻣﺭﺩ ﺭﺩ ﻮﻣ ﻢﻴﻣﺮﺗ ،ﺎﻫ
ﻝﻮﻠﺳ ﻲﻨﻳﺰﮕﻳﺎﺟ ،ﺖﺳﻮﭘ ﻭ ﻲﮕﺘﺴﻜﺷ ،ﺮﻤﻳﺍﺰﻟﺁ ،ﻱﺰﻐﻣ ﻱﺎﻫ
،ﺎﻫ
ﻩﺎﮕﺘﺳﺩ ،ﻪﻧﺎﺜﻣ ﻢﻴﻣﺮﺗ ،ﻥﻮﺴﻨﻴﻛﺭﺎﭘ ﺩﺭﺍﺩ ﻪﻣﺍﺩﺍ ﺕﻼﻀﻋ ﻭ ﺵﺭﺍﻮﮔ
] ۱۹ ، ۲۰
ﻭ ۲۹ .[
ﻝﻮﻠﺳ ﻲﻧﺎﻣﺭﺩ ﻱﺭﺎﻤﻴﺑ ﺭﺩ ﻲﺒﻠﻗ ﻱﺎﻫ
ﺭﺩ ﻪﻧﻻﺎﺳ ﺎﻜﻳﺮﻣﺁ ﻩﺪﺤﺘﻣ ﺕﻻﺎﻳﺍ ۱
/ ۱ ﻲﺒﻠﻗ ﻪﺘﻜﺳ ﺭﺎﭼﺩ ﺮﻔﻧ ﻥﻮﻴﻠﻴﻣ ﻩﺪﺷ
ﻭ
ﺯﺍ ﺪﻌﺑ ﺐﻠﻏﺍ ۵
ﻝﺎﺳ ﻪﺑ ﻲﺒﻠﻗ ﻦﻣﺰﻣ ﻲﻳﺎﺳﺭﺎﻧ ﻼﺘﺒﻣ
ﻲﻣ ﻮﺷ ﺪﻧ . ﺕﺭﺎﺒﻋ ﻪﺑ
ﺮﮕﻳﺩ ، ۸ / ۴ ﻣ ﺭﺩ ﺮﻔﻧ ﻥﻮﻴﻠﻴ ﻩﺪﺤﺘﻣ ﺕﻻﺎﻳﺍ
ﺎﺳﺭﺎﻧ ﺭﺎﭼﺩ ﻲﺒﻠﻗ ﻦﻣﺰﻣ ﻲﻳ
ﻪﻧﻻﺎﺳ ﻭ ﺪﻨﺘﺴﻫ ۴۰۰
ﺭﺎﻣﺁ ﻦﻳﺍ ﺮﺑ ﺰﻴﻧ ﺪﻳﺪﺟ ﺩﺭﻮﻣ ﺭﺍﺰﻫ ﻣ ﻪﻓﺎﺿﺍ
ﻲ ﺩﻮﺷ
] ۲۶ ، ۳۰ [ . ﺖﻓﺮﺸﻴﭘ ﺩﻮﺟﻭ ﺎﺑ ﻭ ﻲﻳﻭﺭﺍﺩ ﻊﻳﺎﻨﺻ ﺭﺩ ﺩﺎﻳﺯ ﺭﺎﻴﺴﺑ ﻱﺎﻫ
ﺵﻭﺭ ﻲﻧﺎﻣﺭﺩ ﻱﺎﻫ
، ﻱﺭﺎﻤﻴﺑ ﻪﺑ ﺯﻮﻨﻫ ﻲﺒﻠﻗ ﻱﺎﻫ ﺯﺍ ﻲﻜﻳ ﻥﺍﻮﻨﻋ
ﻞﻜﺸﻣ ﻲﻣ ﺏﻮﺴﺤﻣ ﺎﻴﻧﺩ ﺭﺩ ﺖﻣﻼﺳ ﻩﺪﻨﻨﻛﺪﻳﺪﻬﺗ ﻞﻣﺍﻮﻋ ﻦﻳﺮﺗﺯﺎﺳ ﺪﻧﻮﺷ
.
ﻝﻮﻠﺳ ﺭﺩ ﺯﻮﺘﻴﻣ ﻢﻴﺴﻘﺗ ﺖﻳﺩﻭﺪﺤﻣ ﺖﻠﻋ ﻪﺑ ﺪﻳﺎﺷ ﺮﻣﺍ ﻦﻳﺍ ﺪﺷﺎﺑ ﻲﺒﻠﻗ ﻱﺎﻫ
] ۱۸ [ . ﻭﺪﺣ ﺩ ۵۰
% ﻲﺒﻠﻗ ﻦﻣﺰﻣ ﻲﻳﺎﺳﺭﺎﻧ ﻱﺭﺎﻤﻴﺑ ﻞﻠﻋ
، ﻱﺭﺎﻤﻴﺑ ﻲﺒﻠﻗ ﻱﺎﻫ
ﻲﻤﻜﺴﻳﺍ ﺎﺸﻨﻣ ﺎﺑ ﺘﺴﻫ
ﺪﻨ
؛ ﺵﻭﺭ ﻦﻳﺮﺘﻬﺑ ﻲﺣﺍﺮﺟ ﻭ ﻲﺒﻃ ﻱﺎﻫ
ﺪﻨﻧﺎﻣ
ﻥﻭﺭﺩ ﺕﺍﺰﻴﻬﺠﺗ ،ﻲﻧﺎﻣﺭﺩﻭﺭﺍﺩ ﺰﻴﻧ ﺐﻠﻗ ﺪﻧﻮﻴﭘ ﻭ ﻲﺒﻠﻗ
ﻪﺑ ،ﺩﺎﻳﺯ ﻪﻨﻳﺰﻫ ﺖﻠﻋ
ﻪﺑ ﻲﻨﻤﻳﺍ ﻢﺘﺴﻴﺳ ﻩﺪﻨﻫﺎﻛ ﻱﺎﻫﻭﺭﺍﺩ ﻭ ﻮﻀﻋ ﻩﺪﻨﻫﺩ ﺩﻮﺒﻤﻛ ﻱﻮﮕﺑﺍﻮﺟ ﻲﺑﻮﺧ
ﻥﺍﺭﺎﻤﻴﺑ ﻦﻳﺍ ﻥﺎﻣﺭﺩ ﺪﻨﺘﺴﻴﻧ
. ﻱﺭﺎﻤﻴﺑ ﻭ ﻲﺒﻠﻗ ﻦﻣﺰﻣ ﻲﻳﺎﺳﺭﺎﻧ ﻱﺎﻫ
ﺐﻠﻗ ﻚﻴﻤﻜﺴﻳﺍ ﻥﺎﻨﭽﻤﻫ ،
ﻢﻬﻣ ﮒﺮﻣ ﻞﻠﻋ ﻦﻳﺮﺗ ﻞﻴﻜﺸﺗ ﺍﺭ ﺎﻴﻧﺩ ﺭﺩ ﺮﻴﻣﻭ
ﻲﻣ ﺪﻨﻫﺩ ] ۲۱ ، ۲۹ .[
ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻦﻴﻨﭼ ﻥﺎﻣﺭﺩ ﻱﺍﺮﺑ
ﻱﺭﺎﻤﻴﺑ ﺪﻳﺪﺟ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻲﻳﺎﻫ ﯼ
ﻲﻣ ﺏﻮﺴﺤﻣ ﻮﺷ
ﺩ .
ﺯﺍ ﺲﭘ ﻪﺘﻜﺳ ﻠﻀﻋ ﺐﻳﺮﺨﺗ ﺎﻳ ﻲﺒﻠﻗ ﻦﻣﺰﻣ ﻲﻳﺎﺳﺭﺎﻧ ﺯﻭﺮﺑ ،ﻲﺒﻠﻗ ﻱﺎﻫ ﺐﻠﻗ ﻪ
) ﻲﻤﻜﺴﻳﺍ ﻪﻠﻤﺟ ﺯﺍ ﻲﻠﻴﻟﺩ ﺮﻫ ﻪﺑ (،
ﻲﺒﺳﺎﻨﻣ ﻲﺿﺎﺒﻘﻧﺍ ﺕﺭﺪﻗ ﺮﮕﻳﺩ ﺐﻠﻗ
ﺖﺷﺍﺩ ﺪﻫﺍﻮﺨﻧ .
ﻭﺭﺍﺩ ﻲﻳﺍﺬﻏ ﻢﻳﮊﺭ ﺖﻳﺩﻭﺪﺤﻣ ،ﻲﻧﺎﻣﺭﺩ ،ﺖﻴﻟﺎﻌﻓ ﺖﻳﺩﻭﺪﺤﻣ ،
ﻡﺍﺪﻛ ﺮﻫ ﻪﻛ ﺐﻠﻗ ﺪﻧﻮﻴﭘ ﻭ ﺐﻠﻗ ﺭﺩ ﻲﻜﻴﻧﺎﻜﻣ ﻱﺎﻫﺭﺍﺰﺑﺍ ﻦﺘﺷﺍﺬﮔ ﺖﻳﺩﻭﺪﺤﻣ ﺪﻧﺭﺍﺩ ﺍﺭ ﺩﻮﺧ ﺹﺎﺧ ﻱﺎﻫ ﺵﻭﺭ ﺯﺍ
ﺪﻨﺘﺴﻫ ﻡﻮﺳﺮﻣ ﯽﻧﺎﻣﺭﺩ ﯼﺎﻫ .
ﻪﻴﺻﻮﺗ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻦﻳﺮﺧﺁ ﻩﺪﺷ
، ﺖﺳﺍ ﺐﻠﻗ ﻪﻠﻀﻋ ﻲﻟﻮﻠﺳ ﻢﻴﻣﺮﺗ .
ﻦﻳﺍ ﺭﺩ
ﺵﻭﺭ
، ﻝﻮﻠﺳ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﻲﻣ ﻝﺎﻘﺘﻧﺍ ﺐﻠﻗ ﻪﻠﻀﻋ ﻞﺧﺍﺩ ﻪﺑ ﺎﺑ ﻭ ﺪﻨﺑﺎﻳ
ﺎﻴﻬﻣ ﻲﻣ ﻲﻌﺳ ﺐﺳﺎﻨﻣ ﻂﻳﺍﺮﺷ ﻥﺩﺮﻛ ﻝﻮﻠﺳ ﺪﻴﻟﻮﺗ ﺩﻮﺷ
ﻭ ﻲﺒﻠﻗ ﺪﻳﺪﺟ ﻱﺎﻫ
ﮒﺭ ﺐﻴﺳﺁ ﻪﻴﺣﺎﻧ ﺭﺩ ﺩﺪﺠﻣ ﻱﺯﺎﺳ ﺩﻮﺷ ﻡﺎﺠﻧﺍ ﻩﺪﻳﺩ
.
ﺐﻠﻗ ﻪﻠﻀﻋ ﺭﺩ ﻲﻟﻮﻠﺳ ﺪﻧﻮﻴﭘ ﻱﺍﺮﺑ ﺯﺍ ،
ﻝﻮﻠﺳ ،ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻱﺎﻫ
ﻝﻮﻠﺳ ﻱﺎﻫ ﯽﻨﻴﻨﺟ ﺕﻮﻓ ﻩﺪﻨﻫﺩ ﺩﺍﺮﻓﺍ ﺐﻠﻗ ﻪﻠﻀﻋ ﻝﻮﻠﺳ ، ﻝﻮﻠﺳ ،ﻩﺪﺷ
ﻝﻮﻠﺳ ،ﺩﺮﻓ ﺩﻮﺧ ﻂﻄﺨﻣ ﺎﻳ ﻑﺎﺻ ﻪﻠﻀﻋ ﺒﻠﻗ ﻱﺎﻫ
ﯽ ﻨﻴﻨﺟ ﯽ ﺪﻨﺑ ﻥﻮﺧ ، ﻑﺎﻧ
ﺖﺳﺍ ﻩﺪﺷ ﻩﺩﺎﻔﺘﺳﺍ ﺩﺮﻓ ﻲﻄﻴﺤﻣ ﻥﻮﺧ ﻭ ]
۱۸ ، ۱۹ .[
ﻪﻛ ﺖﺳﺍ ﺮﻛﺫ ﻪﺑ ﻡﺯﻻ
ﻝﻮﻠﺳ ﻩﻮﻗﺪﻨﭼ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ ﻱﺍ
ﺪﻧﺭﺍﺩ ﺩﻮﺟﻭ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﺭﺩ ، ﺭﺍﺪﻘﻣ ﻪﺑ ﻪﻛ
ﻲﻣ ﻩﺪﻳﺩ ﻲﻄﻴﺤﻣ ﻥﻮﺧ ﺭﺩ ﺰﻴﻧ ﻢﻛ ﺪﻧﻮﺷ
. ﺎﻬﻧﺁ ﺯﺍ ﻲﻫﻭﺮﮔ ﻪﮐ
ﻪﺑ ﻡﺎﻧ
ﻝﻮﻠﺳ ﻡﻮﻴﻠﺗﻭﺪﻧﺍ ﻩﺪﻨﻳﺍﺯ ﻱﺎﻫ ﻲﻣ ﻪﺘﺧﺎﻨﺷ
ﺪﻧﻮﺷ
)
ﻝﻮﻠﺳ ﻪﺘﺳﺩ ﺯﺍ
ﻚﺗ ﻱﺎﻫ
ﻪﺘﺴﻫ ﺰﻐﻣ ﻱﺍ ﻥﺍﻮﺨﺘﺳﺍ ( ﮒﺭ ﻱﺍﺮﺑ ﻪﮕﻧ ﻩﺪﻧﺯ ﻭ ﻱﺯﺎﺳ ﻝﻮﻠﺳ ﻦﺘﺷﺍﺩ
ﻱﺎﻫ
ﺪﻧﻮﻴﭘ ﺪﻴﻔﻣ ﺭﺎﻴﺴﺑ ﻩﺪﺷ ﺪﻨﺘﺴﻫ
. ﺩﺎﻔﺘﺳﺍ ﻭ ﺪﺷﺭ ﺭﻮﺘﻛﺎﻓ ﻲﻌﺿﻮﻣ ﺰﻳﻮﺠﺗ ﺎﺑ ﺯﺍ ﻩ
ﻲﻤﻴﺷ ﻱﺎﻫﻭﺭﺍﺩ ﻲﻧﺎﻣﺭﺩ
، ﺶﻳﺍﺰﻓﺍ ﻲﻄﻴﺤﻣ ﻥﻮﺧ ﺭﺩ ﺎﻬﻧﺁ ﺩﺍﺪﻌﺗ ﺪﺑﺎﻳ ﻲﻣ
] ۳ ،
۴ .[
ﻱﺍﺮﺑ ﻲﻟﻮﻠﺳ ﻊﺑﺎﻨﻣ ﻦﻳﺮﺘﻬﺑ ﻪﻛ ﺖﺳﺍ ﺮﻣﺍ ﻦﻳﺍ ﺪﻳﻮﻣ ﺕﺎﻘﻴﻘﺤﺗ ﺞﻳﺎﺘﻧ ﺐﻴﺳﺁ ﺐﻠﻗ ﻪﻠﻀﻋ ﻥﺎﻣﺭﺩ ﻝﻮﻠﺳ ،ﻩﺪﻳﺩ
ﻝﻮﻠﺳ ﻭ ﻲﺘﻠﻜﺳﺍ ﺕﻼﻀﻋ ﻱﺎﻫ ﻱﺎﻫ
ﺪﻧﻮﺷ ﻩﺩﺍﺩ ﺖﺸﻛ ﺪﻳﺎﺑ ﻪﻛ ﺪﻨﺘﺴﻫ ﺩﺮﻓ ﺩﻮﺧ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ .
ﻝﻮﻠﺳ ﻦﻳﺍ ﺭﺩ ﺎﻫ
ﺪﻨﻣﻭﺎﻘﻣ ﺰﻴﻧ ﻲﻤﻜﺴﻳﺍ ﻭ ﻲﮕﺘﺴﺧ ﺮﺑﺍﺮﺑ .
ﺖﺳﻼﺑﻮﻴﻣ ﺎﻫ ) ﻝﻮﻠﺳ ﻲﺘﻠﻜﺳﺍ ﺕﻼﻀﻋ ﻱﺎﻫ (،
ﻝﻮﻠﺳ ﻪﻋﻮﻤﺠﻣ ﻱﺎﻫ
ﻲﻧﻼﻀﻋ ﺪﻨﺘﺴﻫ
ﻪﺑ ﻪﻛ ﻪﺑ ﻲﺴﭘﻮﻴﺑ ﻖﻳﺮﻃ ﺯﺍ ﻲﺘﺣﺍﺭ ﻲﻣ ﺖﺳﺩ
ﻭ ﺪﻨﻳﺁ
ﻝﻮﻠﺳ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻱﺎﻫ
، ﮒﺭ ﻱﺍﺮﺑ ﻚﻳﺮﺤﺗ ﺍﺭ ﻱﺯﺎﺳ
ﯽﻣ ﻡﺎﺠﻧﺍ ﺪﻨﻫﺩ .
ﺖﺳﻼﺑﻮﻴﻣ ﻝﻮﻠﺳ ﺎﻫ ﻪﻧ ﻪﻛ ﺪﻨﺘﺴﻫ ﺩﺮﻓ ﺩﻮﺧ ﻎﻟﺎﺑ ﻪﻳﺎﭘ ﻱﺎﻫ ﻲﻨﻤﻳﺍ ﻢﺘﺴﻴﺳ
ﻲﻣ ﻊﻓﺩ ﺍﺭ ﺎﻬﻧﺁ ﺩﺭﺍﺩ ﺩﻮﺟﻭ ﺎﻬﻧﺁ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺭﺩ ﻲﻗﻼﺧﺍ ﻞﻜﺸﻣ ﻪﻧ ﻭ ﺪﻨﻛ
.
ﻝﻮﻠﺳ ﻦﻳﺍ ﻲﻣ ﺍﺭ ﺎﻫ ﻖﻳﺮﻃ ﺯﺍ ﻥﺍﻮﺗ ﺪﻧﻮﺳ ﺩﻭﺮﻣ
ﺭﺩ ﻲﻧﻮﺧ ﻕﻭﺮﻋ ﻞﺧﺍﺩ ﻪﺑ
ﺐﻴﺳﺁ ﻪﻘﻄﻨﻣ ﻱﺯﺮﻣ ﻪﻴﺣﺎﻧ ﺎﻳ ﺯﺎﺑ ﻲﺣﺍﺮﺟ ﻖﻳﺮﻃ ﺯﺍ ﺎﻳ ﺩﻮﻤﻧ ﻖﻳﺭﺰﺗ ﻩﺪﻳﺩ
ﺩﺮﻛ ﻖﻳﺭﺰﺗ ﺐﻠﻗ ﻪﻠﻀﻋ ﻞﺧﺍﺩ ﻪﺑ ﺎﻤﻴﻘﺘﺴﻣ ﻲﭘﻮﻜﺳﻮﻛﺍﺭﻮﺗ )
ﺩ ﻦﻳﺍ ﺵﻭﺭ ﻭ
ﺎﭘﻭﺭﺍ ﺭﺩ ﻣ ﺯﺎﺠ ﺖﺳﺍ .(
ﻞﺧﺍﺩ ﻖﻳﺭﺰﺗ ﺵﻭﺭ ﺭﺩ ﻝﺎﻘﺘﻧﺍ ﻱﺍﺮﺑ ﺮﺘﺸﻴﺑ ﻪﻛ ﻲﻗﻭﺮﻋ
ﻝﻮﻠﺳ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﺍ ﻲﻄﻴﺤﻣ ﻥﻮﺧ ﺎﻳ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻩﺩﺎﻔﺘﺳ
ﻲﻣ ﻮﺷ ،ﺩ
ﺩﻮﺟﻭ ﻲﻟﻮﺒﻣﺁ ﺮﻄﺧ ﺯﻭﺮﺑ ﻝﺎﻤﺘﺣﺍ ﻞﺧﺍﺩ ﻪﺑ ﻢﻴﻘﺘﺴﻣ ﻖﻳﺭﺰﺗ ﺭﺩ ﻭ ﺩﺭﺍﺩ
) ﺩﺭﺎﻜﻳﺮﭘ ،ﺐﻠﻗ ﻪﻠﻀﻋ ،ﺩﺭﺎﻛﻭﺪﻧﺁ (
ﻝﻮﻠﺳ ﻝﺎﻘﺘﻧﺍ ﻱﺍﺮﺑ ﺮﺘﺸﻴﺑ ﻪﻛ ﻱﺎﻫ
ﺖﺳﻼﺑﻮﻴﻣ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﻪﻠﻀﻋ
ﻮﺷ ﻜﻴﻧﺎﻜﻣﻭﺮﺘﻜﻟﺍ ﻪﺸﻘﻧ ﻪﻴﻬﺗ ،ﺩ ﯽ
ﺐﻠﻗ ﯼﺍﺮﺑ
ﻱﺭﻭﺮﺿ ﻲﻟﻮﻠﺳ ﻖﻳﺭﺰﺗ ﻞﺤﻣ ﻦﻴﻴﻌﺗ ﺖﺳﺍ
. ﺵﻭﺭ ﻦﻳﺍ ﺭﺩ
، ﻖﻳﺮﻃ ﺯﺍ
ﻲﭘﻮﻜﺳﻭﺭﻮﻠﻓ ﻭ ﻲﻓﺍﺮﮔﻮﻧﻮﺳ
، ﺐﻴﺳﺁ ﻱﺯﺮﻣ ﻪﻘﻄﻨﻣ ﻪﺑ ﻲﻟﻮﻠﺳ ﻥﻮﻠﻛ ﻩﺪﻳﺩ
ﻲﻣ ﺢﻴﻘﻠﺗ ﺩﻮﺷ
؛ ﻪﺑ ﺐﻠﻗ ﻲﮔﺭﺎﭘ ﺮﻄﺧ ﻪﺘﺒﻟﺍ ﻪﺘﻜﺳ ﺭﺩ ﺹﻮﺼﺧ
ﺰﻴﻧ ﻲﺒﻠﻗ ﻱﺎﻫ
ﺩﺭﺍﺩ ﺩﻮﺟﻭ . ﺤﻣ ﺩﺭﺍﻮﻣ ﺮﮕﻳﺩ ﺯﺍ ﻝﻮﻠﺳ ﺖﻳﺩﻭﺪ
ﻥﺎﻣﺯ ﻪﺑ ﺯﺎﻴﻧ ،ﺖﺳﻼﺑﻮﻴﻣ ﻱﺎﻫ
ﻦﻴﺣ ﺐﻴﺳﺁ ﻝﺎﻤﺘﺣﺍ ﻭ ﻲﻧﻻﻮﻃ ﺖﺸﻛ ﺪﻨﻳﺁﺮﻓ
ﺖﺳﺍ ﻲﺑﺎﻬﺘﻟﺍ ]
۳۰ ، ۳۱ ، ۳۲
، ۳۳ [.
ﻪﺑ ﺮﮕﻳﺩ ﺕﺭﺎﺒﻋ
، ﻝﻮﻠﺳ ﺝﺍﺮﺨﺘﺳﺍ ﺯﺍ ﺲﭘ ﺺﻟﺎﺧ ﻭ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
ﺎﻬﻧﺁ ﻱﺯﺎﺳ
ﻪﺑ ﻲﻫﺎﮕﺸﻳﺎﻣﺯﺁ ﻂﻳﺍﺮﺷ ﺭﺩ ﺩﺪﺠﻣ ﺖﺸﻛ ﻪﻠﻴﺳﻭ
، ﺍﺭ ﻝﻮﻠﺳ ﺵﻭﺭ ﻪﺑ ﻱﺎﻫ
ﻲﻣ ﺢﻴﻘﻠﺗ ﻒﻠﺘﺨﻣ ﺪﻨﻨﻛ
. ﻲﻣ ﺭﺎﻛ ﻦﻳﺍ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻡﺎﺠﻧﺍ ﺎﺑ ﻩﺍﺮﻤﻫ ﺪﻧﺍﻮﺗ
ﻥﺁ ﻥﻭﺪﺑ ﺎﻳ ﺐﻠﻗ ﺭﺩ ﺪﻳﺪﺟ ﻲﻧﻮﺧ ﺩﺮﻴﮔ ﻡﺎﺠﻧﺍ
. ﻲﻧﺍﺭﺎﻤﻴﺑ ﺩﻮﺒﻬﺑ ﺪﺻﺭﺩ ﻪﺘﺒﻟﺍ
ﻪﻛ ﺎﻬﻧﺁ ﺭﺩ ﻪﺘﻓﺮﮔ ﻡﺎﺠﻧﺍ ﺐﻠﻗ ﻲﻧﻮﺧ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻡﺎﺠﻧﺍ ﻦﻴﺣ ﻲﻟﻮﻠﺳ ﺪﻧﻮﻴﭘ
ﺮﺗﻻﺎﺑ ﺖﺳﺍ ﻩﺪﺷ ﺵﺭﺍﺰﮔ ]
۳۴ [،
ﻝﻮﻠﺳ ﻲﺘﺣ ﻪﻛﺍﺮﭼ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺭﺩ ﺰﻴﻧ
ﻥﻮﺧ ﻥﺎﻳﺮﺟ ﺩﻮﺒﻧ ﻂﻳﺍﺮﺷ ﻲﻣ ﻲﻓﺎﻛ
ﺪﻧﺮﻴﻣ . ﻝﻮﻠﺳ ﺎﺑ ﻩﺍﺮﻤﻫ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ،
ﻲﻣ ﻖﻳﺭﺰﺗ ﺰﻴﻧ ﻱﺩﺍﻮﻣ ﻮﺷ
ﻠﺗ ﺖﻴﻟﺎﻌﻓ ﻪﮐ ﺩ ﻮ
ﻲﻣ ﺩﻮﺒﻬﺑ ﺍﺭ ﺎﻫﺯﺍﺮﻣ ،ﺪﺸﺨﺑ
ﻥﺎﮑﻣ ﺚﻋﺎﺑ ﻝﻮﻠﺳ ﻲﺑﺎﻳ
ﻝﻮﻠﺳ ﺪﺷﺭ ﻭ ﻩﺪﺷ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ ﺍﺭ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
ﻲﻣ ﮏﻳﺮﺤﺗ ﺪﻳﺎﻤﻧ
. ﻪﺑ ﻖﻴﻗﺩ ﺭﻮﻃ ﺮﺗ
، ﻝﻮﻠﺳ ﺪﻧﻮﻴﭘ ﺎﺑ ﻥﺎﻣﺰﻤﻫ ﻱﺎﻫ
،ﯼﺩﺎﻴﻨﺑ
ﻥﮊ ﻖﻳﺭﺰﺗ ﺎﻫ ﮒﺭ ﻱ ،ﺯﺎﺳ ،ﺲﻳﺯﻮﺘﭘﻮﭘﺁﺪﺿ ﻥﮊ ،ﻕﻭﺮﻋ ﻩﺪﻧﺯﺎﺳ ﻱﺎﻫﺭﻮﺘﻛﺎﻓ
ﻲﺘﻧﺁ ﻥﺍﺪﻴﺴﻛﺍ ﺪﺷﺭ ﺭﻮﺘﻛﺎﻓ ﻭ ﺎﻫ
، ﻠﺗ ﺖﻴﻟﺎﻌﻓ ﻮ ﻲﻣ ﺩﻮﺒﻬﺑ ﺍﺭ ﺎﻫﺯﺍﺮﻣ ﺪﻨﺸﺨﺑ
.
ﻱﺎﻫﺭﻮﺘﻛﺎﻓ ﺪﻨﻧﺎﻣ
، GM ، PGF ، VEGF ﻭ SDF1
، GCSF
ﺳ ﺎ ﻛﻮﺘﻳ ﺎ ﻦﻳ ﻦﻴﺌﺗﻭﺮﭘ ،ﺎﻫ ﻚﻳﺮﺤﺗ ﻞﻣﺎﻋ ﻱﺎﻫ
ﻲﻟﻮﻠﺳ ﻱﺎﻫﺭﻮﺘﻛﺎﻓ ،
ﻚﻳﺮﺤﺗ ﺭﻮﺘﻛﺎﻓ ﻭ ﺖﻔﺟ ﻩﺪﻨﻫﺩﺪﺷﺭ ﺖﻴﺳﻮﻟﻮﻧﺍﺮﮔ ﻊﻤﺠﺗ ﻩﺪﻨﻨﻛ
ﺎﻫ ﺚﻋﺎﺑ
ﻝﻮﻠﺳ ﻝﺎﻘﺘﻧﺍ ﺐﻴﺳﺁ ﻞﺤﻣ ﻪﺑ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
ﻲﻣ ﻩﺪﻳﺩ ﻮﺷ ﺪﻧ ] ۳۵ ، ۳۶ .[
ﻝﻮﻠﺳ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﻲﺘﻓﺎﺑ ﺭﻮﺘﻛﺎﻓ ﻥﻮﭼ ﻱﺮﮕﻳﺩ ﻲﻘﻳﺭﺰﺗ ﺩﺍﻮﻣ ﺮﻴﺛﺎﺗ ﺖﺤﺗ
ﻮﺘﻛﺎﻓ ،ﻲﻧﺍﻮﺨﺘﺳﺍ ﻲﻠﻜﺷﺪﻨﭼ ﻦﻴﺌﺗﻭﺮﭘ ، β ﺭ
PDGF-AB ﻦﻳﺪﻴﺘﻴﺳﺍﺯﺁ ﻭ
ﻲﻣ ﻕﺍﺮﺘﻓﺍ ﻭ ﺪﺷﺭ ﻪﺑ ﻉﻭﺮﺷ ﺪﻨﻳﺎﻤﻧ
. ﻪﺠﻴﺘﻧ ﺭﺩ
، ﮒﺭ ﻊﻳﺮﺴﺗ ﺎﺑ ﻱﺯﺎﺳ
ﻥﮋﻴﺴﻛﺍ ﻲﻧﺎﺳﺭ ﻩﺪﻴﺸﺨﺑ ﺩﻮﺒﻬﺑ ﺍﺭ ﺖﻓﺎﺑ ﻝﻮﻠﺳ ،
ﻪﺑ ﻱﺎﻫ ﺏﺍﻮﺧ ﺍﺭ ﺐﻠﻗ ﻪﺘﻓﺭ
ﻝﺎﻌﻓ ﻩﺭﺎﺑﻭﺩ ﻩﺩﺮﮐ
ﻝﻮﻠﺳ ﻦﻳﺰﮕﻳﺎﺟ ﺎﻳ ﻗ ﻱﺎﻫ
ﻠﺒ ﻲﻣ ﻲ ﻮﺷ ﺪﻧ . ﻩﻭﻼﻋ ﺢﻴﻘﻠﺗ ﺮﺑ
ﻩﺪﻳﺪﭘ ﺮﺛﺍ ﺭﺩ ،ﻲﻟﻮﻠﺳ ﻝﺎﻘﺘﻧﺍ ﻦﻴﺣ ﺩﺍﻮﻣ ﻦﻳﺍ ﻱﺭﺎﻴﺴﺑ ،ﻲﺒﻠﻗ ﻪﺘﻜﺳ ﻥﻮﭼ ﻱﺍ
ﻝﻮﻜﻟﻮﻣ ﺯﺍ ﻝﻮﻠﺳ ﺐﻴﺳﺁ ﺮﺛﺍ ﺭﺩ ﺎﻫﺯﺎﻨﻴﻛﻮﻴﻤﻴﻛ ﻭ ﻩﺪﻨﺒﺴﭼ ﻱﺎﻫ ﻭ ﺐﻠﻗ ﻱﺎﻫ
ﻨﻳﺁﺮﻓ ﺯﻭﺮﺑ ﺐﻴﺳﺁ ﻪﻘﻄﻨﻣ ﻪﺑ ﺏﺎﻬﺘﻟﺍ ﺪ ﻝﺎﻘﺘﻧﺍ ﻪﺑ ﻭ ﻩﺩﺮﻛ ﺖﻛﺮﺣ ﻩﺪﻳﺩ
ﻝﻮﻠﺳ ﻱﺎﻫ ﯼﺩﺎﻴﻨﺑ ﻲﻣ ﻚﻤﻛ ﺪﻨﻨﻛ ] ۳۷ .[
ﻢﻬﻣ ﻘﻘﺤﻣ ﻲﻧﺍﺮﮕﻧ ﻦﻳﺮﺗ ﺎ
ﺭﺩ ﻥ
ﻦﻳﺍ ﻲﻳﺎﻣﺯﺁﺭﺎﻛ ﻪﻧﻮﮔ ﻲﻨﻴﻟﺎﺑ ﻱﺎﻫ
، ﻲﻜﻳﺮﺘﻜﻟﺍ ﻁﺎﺒﺗﺭﺍ ﻱﺭﺍﺮﻗﺮﺑ ﻡﺪﻋ
ﻝﻮﻠﺳ ﻪﺘﺷﺎﻛ ﻱﺎﻫ ﻝﻮﻠﺳ ﻪﻴﻘﺑ ﺎﺑ ﻩﺪﺷ
ﻲﻣ ﻪﻛ ﺖﺳﺍ ﺐﻠﻗ ﻱﺎﻫ ﺚﻋﺎﺑ ﺪﻧﺍﻮﺗ
ﺩﺩﺮﮔ ﻲﻤﺘﻳﺭﺁ .
ﺮﻃﺎﺧ ﻦﻴﻤﻫ ﻪﺑ
، ﻪﻠﻳﺮﺒﻴﻓﺩ ﻥﻭﺭﺩ ﺰﻴﻧ ﻲﺒﻠﻗ ﻚﻴﺗﺎﻣﻮﺗﺍ ﻩﺪﻨﻨﻛ
ﻲﻣ ﺭﺍﺮﻗ ﺐﻠﻗ ﻪﺑ ﺵﻭﺭ ﻦﻳﺍ ؛ﺪﻨﻫﺩ
ﺭﺍﺮﻗ ﺐﻳﻮﺼﺗ ﺩﺭﻮﻣ ﻲﻧﺎﻣﺭﺩ ﻩﻮﻴﺷ ﻥﺍﻮﻨﻋ
ﺖﺳﺍ ﻪﺘﻓﺮﮔ ]
۳۸ .[
ﻱﻭﺭﺍﺩ ﻭ ﺍﺬﻏ ﻥﺎﻣﺯﺎﺳ ﻩﺪﺤﺘﻣ ﺕﻻﺎﻳﺍ
ﺎﻜﻳﺮﻣﺁ ﻪﺑ ﺭﻮﻈﻨﻣ ﻝﻮﻠﺳ ﺢﻴﻘﻠﺗ ﻱﺎﻫ
ﺖﺳﺍ ﻩﺩﻮﻤﻧ ﻊﺿﻭ ﻲﻨﻴﻧﺍﻮﻗ ﺐﻠﻗ ﺭﺩ ﻪﻳﺎﭘ .
۱ - ﻲﻘﻳﺭﺰﺗ ﺕﺎﺒﻴﻛﺮﺗ ﻲﻨﻤﻳﺍ ﺯﺍ
ﻪﺑ ﺑ ﻪﺘﻓﺭﺭﺎﻛ ﻞﺻﺎﺣ ﻥﺎﻨﻴﻤﻃﺍ ﻲﺘﺴﻳﺎ ﻮﺷ
ﺩ ؛ ۲ - ﺖﻓﺎﺑ ﺯﺍ ﻪﻛ ﻲﻧﻮﻔﻋ ﻱﺎﻫ
ﺱﻭﺮﻳﻭ ﻱﻭﺎﺣ ﻱﺭﺎﻤﻴﺑ ﻱﺎﻫ
ﻪﺘﻓﺮﮔ ﻝﻮﻠﺳ ﺪﻨﺘﺴﻫ ﺯﺪﻳﺍ ﺱﻭﺮﻳﻭ ﻥﻮﭼ ﺍﺯ
ﺩﻮﺸﻧ ؛ ۳ - ﺯﺍ ﻩﻮﻴﺷ ﺢﻴﺤﺻ ﻱﺍ ﯼﺍﺮﺑ
ﻩﺩﺎﻔﺘﺳﺍ ﺖﻓﺎﺑ ﺭﺩ ﻝﻮﻠﺳ ﺢﻴﻘﻠﺗ ﻮﺷ
ﺎﺗ ﺩ
ﺩﺩﺮﮕﻧ ﺖﻓﺎﺑ ﺐﻳﺮﺨﺗ ﺚﻋﺎﺑ ]
۱۵ ، ۲۵ .[
ﻪﻌﻟﺎﻄﻣ ﺭﺩ ﻥﺍﺭﺎﺑﺯﻭﺍ
ﻪﻴﻛﺮﺗ ﺭﺩ ﻥﺍﺭﺎﻜﻤﻫ ﻭ
، ۶ ﻪﻠﻀﻋ ﺐﻴﺳﺁ ﺭﺎﭼﺩ ﺭﺎﻤﻴﺑ
ﻝﺎﺳ ﺎﻬﻧﺁ ﻱﺭﺎﻤﻴﺑ ﻪﻛ ﺐﻠﻗ ﻭ ﻲﻓﺍﺮﮔﻮﻳﺩﺍﺭ ﺕﺎﻌﻟﺎﻄﻣ ﻭ ﺩﻮﺑ ﻩﺪﺷ ﺯﺮﺤﻣ ﺎﻫ
ﺩﻮﻤﻧ ﺪﻴﻳﺎﺗ ﺍﺭ ﻥﺁ ﻲﻨﻴﻟﺎﺑ ﻢﻳﻼﻋ ﺩﻮﺑ ﻩ
ﺍ ﺭﺩ ﻦﻴﻨﭽﻤﻫ ،ﺪﻧ ﻲﻓﺍﺮﮔﻮﻳﺩﺭﺎﻛﻮﻛ
ﺭﺍﺪﻘﻣ ﻪﺑﺮﺿ ﻢﺠﺣ ﭗﭼ ﻦﻄﺑ ﯼﺍ
(LVEF) ﺯﺍ ﺮﺘﻤﮐ
۲۵ % ﻲﻣ ﻥﺎﺸﻧ ﺪﻧﺩﺍﺩ
ﻦﻴﻣﺎﺗﻮﺑﻭﺩ ﺱﺮﺘﺳﺍ ﺖﺴﺗ ،ﻲﻓﺍﺮﮔﻮﻳﮋﻧﺁ ﺖﺤﺗ ﻭ ﻭ ﻡﻮﻴﻟﺎﺗ ﻦﻜﺳﺍ ،
ﻊﻄﻘﻣ ﯼﺭﺎﮕﻧ ﻳ ﺎ ﺯﻮﭘ ﺮﺸﻧ ﺎﺑ ﯽﻓﺍﺮﮔﻮﻣﻮﺗ ﻳ
ﻥﻭﺮﺘ (PET) ﻭ ﺪﻧﺩﻮﺑ ﻪﺘﻓﺮﮔ ﺭﺍﺮﻗ
ﻩﺪﻧﺯ ﻩﺪﺷ ﺪﻴﻳﺎﺗ ﺎﻬﻧﺁ ﺭﺩ ﺐﻠﻗ ﻪﻠﻀﻋ ﺖﻓﺎﺑ ﻥﺩﻮﺑ ﻝﻮﻠﺳ ﺖﺤﺗ ؛ﺩﻮﺑ
ﻲﻧﺎﻣﺭﺩ
ﺪﻨﺘﻓﺮﮔ ﺭﺍﺮﻗ ﺐﻠﻗ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻞﻤﻋ ﺎﺑ ﻩﺍﺮﻤﻫ .
ﺪﻌﺑ ﻩﺎﻣ ﺭﺎﻬﭼ ﺯﺍ
،ﻞﻤﻋ ﻱﺮﻴﮕﻴﭘ ﺯﺍ ﻞﺒﻗ ﻪﺑ ﺖﺒﺴﻧ ﻥﺍﺭﺎﻤﻴﺑ ﻲﮔﺪﻧﺯ ﺖﻴﻔﻴﻛ ﻪﻛ ﺩﺍﺩ ﻥﺎﺸﻧ ﺎﻫ
ﻪﺘﻓﺎﻳ ﺩﻮﺒﻬﺑ ﻞﻤﻋ ﻭ
ﻪﻘﺒﻃ ﺮﻈﻧ ﺯﺍ ﻲﻳﺎﺳﺭﺎﻧ ﻱﺪﻨﺑ
ﺐﻠﻗ ﻦﻤﺠﻧﺍ ﻲﺒﻠﻗ ﺕﻻﺎﻳﺍ
ﻩﺪﺤﺘﻣ ﺎﻜﻳﺮﻣﺁ
، ﻦﻴﻳﺎﭘ ﺱﻼﻛ ﻚﻳ ﻡﺍﺪﻛﺮﻫ ﺮﺗ
ﺪﻧﺩﻮﺑ ﻪﺘﻓﺎﻳ ﺩﻮﺒﻬﺑ ﻭ ﻩﺪﻣﺁ .
،ﻮﻛﺍ ﺞﻳﺎﺘﻧ ﻞﺤﻣ ﺭﺩ ﺍﺭ ﺐﻠﻗ ﺩﺮﻛﺭﺎﻛ ﺩﻮﺒﻬﺑ ،ﺩﺪﺠﻣ ﻡﻮﻴﻟﺎﺗ ﻦﻜﺳﺍ ﻭ PET
ﺰﻴﻧ ﺖﻳﺎﻬﻧ ﺭﺩ ﻭ ﺩﺍﺩ ﻥﺎﺸﻧ ﻲﻟﻮﻠﺳ ﺖﺷﺎﻛ
، ﻘﻘﺤﻣ ﺎ ﺍﺭ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻦﻳﺍ ﻥ
ﺪﻧﺩﻮﻤﻧ ﻪﻴﺻﻮﺗ ﻪﺘﻓﺮﺸﻴﭘ ﻲﺒﻠﻗ ﻦﻣﺰﻣ ﻲﻳﺎﺳﺭﺎﻧ ﺭﺎﭼﺩ ﻥﺍﺭﺎﻤﻴﺑ ﻱﺍﺮﺑ ]
۳۵ .[
ﻪﻌﻟﺎﻄﻣ ﺭﺩ ﻮﻧﺎﻣﺎﻫ
ﻥﺍﺭﺎﻜﻤﻫ ﻭ
، ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ۵
ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻦﻴﺣ ﺭﺎﻤﻴﺑ
ﺭﺰﺗ ﺐﻠﻗ ﻪﻠﻀﻋ ﻪﺑ ﺮﻧﻭﺮﻛ ﺪﺷ ﻖﻳ
. ﻞﻤﻋ ﻦﻳﺍ ﺭﺩ ﺎﻫ
، ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻥﺪﻴﺸﻛ
ﺖﻓﺮﮔ ﻡﺎﺠﻧﺍ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﺎﺑ ﻥﺎﻣﺰﻤﻫ ﺰﻴﻧ .
ﭻﻴﻫ ﻲﻤﺘﻳﺭﺁ ﻭ ﻱﺰﻳﺮﻧﻮﺧ ﻪﻧﻮﮔ
ﻧ ﻩﺪﻫﺎﺸﻣ ﻲﺒﻠﻗ ﺪﻳﺪﺟ ﺸ
ﻱﺮﻴﮕﻴﭘ ﺭﺩ ﻭ ﺪ ﻥﺍﺭﺎﻤﻴﺑ ﻦﻳﺍ ﺪﻌﺑ ﻝﺎﺳ ﻚﻳ ﻱﺎﻫ
،
ﭻﻴﻫ ﻩﺩﻮﺗ ﻪﻧﻮﮔ ﻱﺍ ﺖﺷﺍﺪﻧ ﺩﻮﺟﻭ ﻭ
ﺩﻮﺒﻬﺑ ﺭﺎﻤﻴﺑ ﻲﻜﻴﻨﻴﻠﻛ ﻭ ﻲﻨﻴﻟﺎﺑ ﻢﻳﻼﻋ
ﻪﺘﻓﺎﻳ ﺩﻮﺑ . ﻦﻴﻣﻭﺩ ﻱﺍﺮﺑ ﺭﺎﺑ
، ﻱﻭﺭ ﻩﻭﺮﮔ ﻦﻴﻤﻫ ۴
ﺍﺭ ﻥﺎﻣﺭﺩ ﻦﻳﺍ ﺮﮕﻳﺩ ﺭﺎﻤﻴﺑ
ﺪﻌﺑ ﻝﺎﺳ ﻚﻳ ﺎﺗ ﻭ ﺪﻧﺩﻮﻤﻧ ﺍﺮﺟﺍ ﺰﻴﻧ
ﻭ ﺐﻠﻗ ﻪﻌﻟﺎﻄﻣ ﺭﺩ ﻱﺭﻮﻣﻮﺗ ﻉﻮﻧ ﭻﻴﻫ
ﭻﻴﻫ ﻲﻃ ﻱﺪﻳﺪﺟ ﻲﻤﺘﻳﺭﺁ ﻉﻮﻧ ۱۴
ﺪﺸﻧ ﺵﺭﺍﺰﮔ ﻱﺮﻴﮕﻴﭘ ﻩﺎﻣ .
ﺩﻮﺒﻬﺑ
ﺍ ﻲﻃ ﺐﻠﻗ ﺩﺮﻛﺭﺎﻛ ﮑﺳ
ﻦ ﻡﻮﻴﻟﺎﺗ ﺍ ﻭ ﻪﺑ ﻲﻓﺍﺮﮔﻮﻳﺩﺭﺎﻛﻮﻛ ﻩﺪﺷ ﺺﺨﺸﻣ ﻲﺑﻮﺧ
ﺩﻮﺑ . ﻘﻘﺤﻣ ﺮﮕﻳﺩ ﻩﻭﺮﮔ ﺎ
ﻝﺎﺳ ﺭﺩ ﻥ ۲۰۰۵
، ﻝﻮﻠﺳ ﺖﺷﺎﻛ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﺯﺍ ﺍﺭ
ﻝﺎﻧﺎﻛ ﺩﺎﺠﻳﺍ ﻖﻳﺮﻃ ﺞﻳﺎﺘﻧ ﺯﻮﻨﻫ ﻪﻛ ﺪﻧﺩﻮﻤﻧ ﺶﻳﺎﻣﺯﺁ ﺐﻠﻗ ﺭﺩ ﻱﺭﺰﻴﻟ ﻱﺎﻫ
ﺖﺳﺍ ﻩﺪﺸﻧ ﺮﺸﺘﻨﻣ ﻞﻣﺎﮐ ﺎﻬﻧﺁ ﻪﻌﻟﺎﻄﻣ .
ﺯﻭﺮﺘﺳﺍ ﻱﻭﺭ ﻲﻟﻮﻤﻌﻣ ﻲﻧﺎﻣﺭﺩ ﺕﺎﻣﺍﺪﻗﺍ ﻡﺎﺠﻧﺍ ﺯﺍ ﺲﭘ ﻥﺎﻤﻟﺁ ﺭﺩ ﻥﺍﺭﺎﻜﻤﻫ ﻭ
۱۰ ﺪﻧﺩﺮﻛ ﺍﺮﺟﺍ ﺍﺭ ﻞﻤﻋ ﻦﻴﻤﻫ ﺰﻴﻧ ﻲﺒﻠﻗ ﻪﺘﻜﺳ ﺭﺎﭼﺩ ﺭﺎﻤﻴﺑ
؛ ﺕﻭﺎﻔﺗ ﻦﻳﺍ ﺎﺑ
ﻭ ﺪﺷ ﻡﺎﺠﻧﺍ ﺪﻧﻮﻴﭘ ﻞﻤﻋ ﺯﺍ ﻞﺒﻗ ﺯﻭﺭ ﻚﻳ ﻥﺍﻮﺨﺘﺳﺍ ﺰﻐﻣ ﻥﺪﻴﺸﻛ ﻪﻛ ﻝﻮﻠﺳ ﻱﻭﺎﺣ ﻝﻮﻠﺤﻣ ﻚﺗ ﻪﻳﺎﭘ ﻱﺎﻫ
ﻪﺘﺴﻫ ﻖﻳﺮﻃ ﺯﺍ ﻱﺍ ﮒﺮﺧﺮﺳ
ﺩﺭﺍﻭ
ﺐﻴﺳﺁ ﻱﺯﺮﻣ ﻪﻘﻄﻨﻣ ﺭﺩ ﻭ ﻩﺪﺷ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﺪﺷ ﻖﻳﺭﺰﺗ ﻩﺪﻳﺩ
. ﻱﺮﻴﮕﻴﭘ ﺭﺩ
ﻥﻮﺧ ﺪﻌﺑ ﻩﺎﻣ ﻪﺳ ﻱﺎﻫ ﺰﻴﻧ ﺐﻠﻗ ﺩﺮﻛﺭﺎﻛ ﻭ ﺶﻳﺍﺰﻓﺍ ﻪﻌﻳﺎﺿ ﻞﺤﻣ ﻪﺑ ﻲﻧﺎﺳﺭ
ﺎﻳ ﺩﻮﺒﻬﺑ ﻪﺘﻓ ﺩﻮﺑ . ﻲﻣ ﺍﺭ ﺵﻭﺭ ﻦﻳﺍ ﻪﮐ ﺪﺷ ﺩﺎﻬﻨﺸﻴﭘ ﺖﻳﺎﻬﻧ ﺭﺩ ﻥﺍﻮﺗ
ﻪﺘﻜﺳ ﺯﺍ ﺲﭘ ﻪﻠﺻﺎﻓﻼﺑ ﻝﺎﺳ ﺎﻳ ﻲﺒﻠﻗ ﻱﺎﻫ
ﺩﺍﺩ ﻡﺎﺠﻧﺍ ﺪﻌﺑ ﺎﻫ .
ﺵﻭﺭ ﻦﻳﺍ
ﻞﻤﻋ ﻞﻤﺤﺗ ﻲﻳﺎﻧﺍﻮﺗ ﻲﺘﺣ ﻪﻛ ﻲﻧﺎﺴﻛ ﻱﺍﺮﺑ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻥﻮﭼ ﻲﻳﺎﻫ
ﻲﻣ ﺰﻴﻧ ﺪﻧﺭﺍﺪﻧ ﺍﺭ ﺐﻠﻗ ﺭﺍﺮﻗ ﻩﺩﺎﻔﺘﺳﺍ ﺩﺭﻮﻣ ﺪﻧﺍﻮﺗ
ﺩﺮﻴﮔ . ﺎﺑ ﻦﻳﺍ ﺩﻮﺟﻭ ﻪﻛ
ﺩﺭﻮﻣ ﺭﺩ ﺕﺎﻘﻴﻘﺤﺗ ﻝﻮﻠﺳ
ﺩﺭﺍﺩ ﻪﻣﺍﺩﺍ ﺯﻮﻨﻫ ﻲﻧﺎﻣﺭﺩ
، ﺭﺎﭼﺩ ﻥﺍﺭﺎﻤﻴﺑ ﺭﺩ ﺎﻣﺍ
ﻲﻣ ﺰﻴﻧ ﺐﻠﻗ ﻲﻧﺎﻘﺘﺣﺍ ﻦﻣﺰﻣ ﻲﻳﺎﺳﺭﺎﻧ ﻪﺑ ﺍﺭ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻦﻳﺍ ﻥﺍﻮﺗ
ﺩﺮﺑ ﺭﺎﻛ
؛
ﻝﻮﻠﺳ ﺯﺍ ﻱﺮﺘﺸﻴﺑ ﻢﺠﺣ ﻪﺑ ﺎﻬﻧﺁ ﺭﺩ ﻪﺘﺒﻟﺍ ﺯﺎﻴﻧ ﻪﻳﺎﭘ ﻱﺎﻫ
ﺖﺳﺍ ] ۱۹ ، ۲۰
،
۳۶ .[
ﻂﺳﻮﺗ ﺰﻴﻧ ﻱﺮﮕﻳﺩ ﻪﻌﻟﺎﻄﻣ ﺖﺳﺎﺑ
ﻱﻭﺭ ﻥﺍﺭﺎﻜﻤﻫ ﻭ ۶۰
ﻪﺘﻜﺳ ﺭﺎﭼﺩ ﺭﺎﻤﻴﺑ
ﻲﺒﻠﻗ ﻪﮐ ﻪﺑ ﺪﻧﺪﺷ ﺏﺎﺨﺘﻧﺍ ﻲﻓﺩﺎﺼﺗ ﺕﺭﻮﺻ ﺪﺷ ﻡﺎﺠﻧﺍ
. ﻪﺑ ﻂﺳﻮﺘﻣ ﺭﻮﻃ
،
۸ / ۴ ﻲﻣ ﺎﻬﻧﺁ ﻲﺒﻠﻗ ﻪﺘﻜﺳ ﺯﻭﺮﺑ ﺯﺍ ﺯﻭﺭ ﺖﺷﺬﮔ
. ﺰﻐﻣ ﻥﺪﻴﺸﻛ ﻥﺍﺭﺎﻤﻴﺑ ﻦﻳﺍ ﺭﺩ
ﺪﺷ ﻡﺎﺠﻧﺍ ﻞﻤﻋ ﺯﺍ ﻞﺒﻗ ﺯﻭﺭ ﻚﻳ ﻥﺍﻮﺨﺘﺳﺍ .
ﻝﻮﻠﺳ ﻞﻤﻋ ﺯﻭﺭ ﺩﺭﻮﻣ ﻱﺎﻫ
ﺮﻈﻧ
ﻖﻳﺮﻃ ﺯﺍ ﺪﻧﻮﺳ ﻝﻮﻠﺳ ﻱﻭﺎﺣ ﻝﻮﻠﺤﻣ ﻭ ﺪﻧﺪﺷ ﻪﻌﻳﺎﺿ ﻞﺤﻣ ﺩﺭﺍﻭ
، ﺭﺩ
ﻪﻘﻄﻨﻣ ﺐﻴﺳﺁ ﻞﺤﻣ ﻱﺯﺮﻣ ﻳﺩ
ﻖﻳﺭﺰﺗ ﻩﺪ ﺷ
ﺪ . ﻞﻤﻋ ﻡﺎﺠﻧﺍ ﺯﺍ ﺲﭘ ﻩﺎﻣ ﺪﻨﭼ
ﻪﺑ ﺶﻳﺎﻣﺯﺁ ﺖﺤﺗ ﻩﻭﺮﮔ ﺭﺩ ﻥﺍﺰﻴﻣ ﻂﺳﻮﺘﻣ ﺭﻮﻃ
ﺯﺍ ﺶﻴﺑ ﻪﺑ EF ۶۷
%
ﺩﻮﺑ ﻪﺘﻓﺎﻳ ﺶﻳﺍﺰﻓﺍ
؛ ﻲﻟﺎﺣﺭﺩ ﻪﺑ ﺭﺍﺪﻘﻣ ﻦﻳﺍ ﺪﻫﺎﺷ ﻩﻭﺮﮔ ﺭﺩ ﻪﻛ ۷
/ ۰ % ﺰﻴﻧ
ﻲﻤﻧ ﺪﻴﺳﺭ . ﻩﺮﻛ ﺭﻮﺸﮐ ﺭﺩ ﻱﺮﮕﻳﺩ ﻪﻌﻟﺎﻄﻣ ﺎﻣﺍ ﯽﺑﻮﻨﺟ
ﻂﺳﻮﺗ ﻭ ﺕﻮﻛ
ﻥﺍﺭﺎﻜﻤﻫ
، ﻨﻌﻣ ﻑﻼﺘﺧﺍ ﭻﻴﻫ ﯽ
ﺕﺎﻨﻳﺎﻌﻣ ﺭﺩ ﻱﺭﺍﺩ ۱۲
- ۳ ﻪﻧﻮﻤﻧ ﺭﺩ ﺪﻌﺑ ﻩﺎﻣ
۵ ﺩﺍﺪﻧ ﻥﺎﺸﻧ ﻲﻳﺎﺗ ]
۲۰ .[
ﻥﻮﺧ ﻲﻧﺎﺳﺭ ۳۰ % ﻪﺘﻓﺎﻳ ﺶﻫﺎﻛ ﺩﻮﺑ
ﻭ LVEF
ﻦﻴﺑ ۱۵ ﺎﺗ ۵۷ % ﺩﺍﺩ ﻥﺎﺸﻧ ﺶﻳﺍﺰﻓﺍ .
ﻲﺳﺭﺮﺑ ﻦﻴﻨﭽﻤﻫ ﻪﺘﺴﻫ ﻱﺎﻫ
،ﻱﺍ
ﺶﻳﺍﺰﻓﺍ ۱۵ % ﻭ ﻥﮋﻴﺴﻛﺍ ﺏﺬﺟ ۱۸
% ﺐﻴﺳﺁ ﺖﻓﺎﺑ ﺭﺩ ﻥﻮﺧﺪﻨﻗ ﺏﺬﺟ ﻩﺪﻳﺩ
ﻞﻤﻋ ﺯﺍ ﻞﺒﻗ ﻪﺑ ﺖﺒﺴﻧ ﺍﺭ
ﺩﺍﺩ ﻥﺎﺸﻧ . ﻦﻳﺍ ﻂﻘﻓ ﻪﻛ ﺪﻫﺎﺷ ﻩﻭﺮﮔ ﺭﺩ ﺞﻳﺎﺘﻧ
ﺪﺸﻧ ﻩﺪﻫﺎﺸﻣ ﺪﻧﺩﻮﺑ ﻪﺘﻓﺮﮔ ﺭﺍﺮﻗ ﺐﻠﻗ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﺪﻧﻮﻴﭘ ﻲﺣﺍﺮﺟ ﺖﺤﺗ ] ۳۷ .[
ﻝﻮﻠﺳ ﺎﺑ ﻞﻣﺎﻌﺗ ﺭﺩ ﻱﺭﺎﺘﺳﺮﭘ ﻲﻧﺎﻣﺭﺩ
ﻪﺑ ﻱﺭﺎﺘﺳﺮﭘ ﻤﻠﻋ ﻥﺍﻮﻨﻋ
ﯽ ﻦﻴﺑ ﻪﺘﺷﺭ ﻱﺍ
، ﻝﺎﺳ ﺩﻮﺧ ﻲﻠﺻﺍ ﺖﻴﻫﺎﻣ ﻪﻛ ﺖﺳﺎﻫ
ﺖﻓﺮﺸﻴﭘ ﺩﻮﺟﻭ ﺎﺑ ﺍﺭ ﻩﺩﻮﻤﻧ ﻆﻔﺣ ﻒﻠﺘﺨﻣ ﻡﻮﻠﻋ ﺭﺩ ﻩﺪﻤﻋ ﺕﺍﺮﻴﻴﻐﺗ ﻭ ﺎﻫ
ﺖﺳﺍ . ﻱﺭﺎﺘﺳﺮﭘ ﺩﺮﺒﻫﺍﺭ
، ﻪﺑ ﺖﻣﺪﺧ ﻡﺎﺠﻧﺍ ﻱﺍﺮﺑ ﺩﻮﺟﻮﻣ ﺕﺎﻧﺎﻜﻣﺍ ﻡﺎﻤﺗ ﻦﺘﻓﺮﮔ
ﺎﻘﺗﺭﺍ ﻭ ﻮﺟﺩﺪﻣ ﺯﺍ ﺖﺒﻗﺍﺮﻣ ﻦﻳﺮﺘﻬﺑ ﯼ
ﺖﺳﺍ ﻪﻌﻣﺎﺟ ﻭ ﺩﺮﻓ ﺖﻣﻼﺳ ﺢﻄﺳ
] ۳۹ .[
ﺪﻳﺎﺑ ﻱﺭﺎﺘﺳﺮﭘ ﻢﻠﻋ ،ﺎﻴﻧﺩ ﺭﺩ ﺶﻧﺍﺩ ﺪﻴﻟﻮﺗ ﺖﻋﺮﺳ ﺶﻳﺍﺰﻓﺍ ﺎﺑ ﻥﻮﻨﻛﺍ ﻑﺍﺪﻫﺍ ﻪﺑ ﺮﺘﻬﺑ ﻲﺑﺎﻴﺘﺳﺩ ﻱﺍﺮﺑ ﻭ ﻩﺩﻮﻤﻧ ﻆﻔﺣ ﺍﺭ ﺩﻮﺧ ﻞﻘﺘﺴﻣ ﺖﻳﻮﻫ ﺩﻮﺧ ﻪﻧﺎﺘﺳﻭﺩﺮﺸﺑ
، ﺥﺭ ﺕﺍﺮﻴﻴﻐﺗ ﻭ ﺩﻮﺟﻮﻣ ﻂﻳﺍﺮﺷ ﺯﺍ ﺲﻜﻋ ﺎﺑ ،ﻩﺩﺍﺩ
ﻠﻤﻌﻟﺍ ﯽ
ﻪﺑ ﺪﻳﺎﻤﻧ ﻦﻴﻤﻀﺗ ﺍﺭ ﻦﻜﻤﻣ ﻪﺠﻴﺘﻧ ﻦﻳﺮﺘﻬﺑ ،ﺐﺳﺎﻨﻣ ﻭ ﻊﻗﻮﻣ .
ﺖﻓﺮﺸﻴﭘ ﻱﺎﻫ
ﻡﻮﻠﻋ ﺭﺩ ﺮﻴﺧﺍ ﺑ ﻪﻳﺎﭘ
ﻪ ﻱﮊﻮﻟﻮﻳﺰﻴﻓ ﺹﻮﺼﺧ ﻭ
ﻡﻮﻠﻋ ﻲﻟﻮﻠﺳ ﻭ ﻲﻟﻮﻜﻟﻮﻣ ﻖﻓﺍ ،
ﻩﺯﺎﺗ ﻱﺭﺎﻤﻴﺑ ﻲﺧﺮﺑ ﻥﺎﻣﺭﺩ ﺮﻴﺴﻣ ﺭﺩ ﺍﺭ ﻱﺍ ﻱﻭﺭ ﺶﻴﭘ ﻦﻣﺰﻣ ﻭ ﺩﺎﺣ ﻱﺎﻫ
ﻲﻣ ﻪﻛ ﺖﺳﺍ ﻩﺩﺮﻛ ﺯﺎﺑ ﺮﺸﺑ ﻩﺪﻨﻨﻛﺭﺍﻭﺪﻴﻣﺍ ﺭﺎﻴﺴﺑ ﺪﻧﺍﻮﺗ
ﻭ ﺪﺷﺎﺑ ﻪﺘﻔﮔ ﻪﺑ
ﺐﺣﺎﺻ ﻥﺍﺮﻈﻧ
، ﻟﻮﺤﺗ ﯽ ﺪﻳﺎﻤﻧ ﺩﺎﺠﻳﺍ ﻲﻜﺷﺰﭘ ﻡﻮﻠﻋ ﺭﺩ ﻑﺮﮕﺷ .
ﻱﻮﺳ ﺯﺍ
ﺮﮕﻳﺩ
، ﺕﻻﻮﺤﺗ ﻦﻳﺍ
، ﺖﺤﺗ ﺰﻴﻧ ﺍﺭ ﻱﺭﺎﺘﺳﺮﭘ ﻪﺑ ﺯﺎﻴﻧ ﻭ ﻩﺩﺍﺩ ﺭﺍﺮﻗ ﺮﻴﺛﺎﺗ
ﺺﻴﺨﺸﺗ ﻩﺩﻮﻤﻧ ﺯﺮﺤﻣ ﺍﺭ ﻱﺭﺎﺘﺳﺮﭘ ﺪﻳﺪﺟ ﻱﺎﻫ ﺖﺳﺍ
. ﺎﺑ ﺰﻴﻧ ﻱﺭﺎﺘﺳﺮﭘ ﻳ
ﺭﺩ ﺪ
ﺩﺭﺍﻭ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﻪﻄﻴﺣ ﺏﺎﺘﻛ ﻭ ﻩﺪﺷ
ﺶﻳﺍﺮﻳﻭ ﺎﻳ ﺪﻳﺪﺟ ﻱﺎﻫ ﺪﻳﺪﺟ ﻱﺎﻫ
ﺪﻳﺎﺑ ﻱﺭﺎﺘﺳﺮﭘ ﺮﺒﺘﻌﻣ ﻊﺑﺎﻨﻣ ﻣ
ﺒﺎ ﻪﻨﻴﻣﺯ ﻦﻳﺍ ﺭﺩ ﻲﻠﻣﺎﻛ ﺚﺣ ﻪﻳﺍﺭﺍ
ﺪﻨﻳﺎﻤﻧ . ،ﺍﺬﻟ
ﻪﺑ ﻱﺭﺎﺘﺳﺮﭘ ﻡﻮﻠﻋ ﺎﺑ ﻂﺒﺗﺮﻣ ﻭ ﺎﻳﻮﭘ ﻲﻤﻠﻋ ﻥﺍﻮﻨﻋ
ﻪﻳﺎﭘ
، ﺎﺑ ﻳ ﻩﻭﻼﻋ ﺪ ﺮﺑ
ﻩﺩﺎﻣﺁ ﺎﻫﺩﺭﻭﺎﺘﺳﺩ ﻦﻳﺍ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻱﺍﺮﺑ ﺍﺭ ﻪﻨﻴﻣﺯ ﺕﺍﺮﻴﻴﻐﺗ ﻦﻳﺍ ﺖﺧﺎﻨﺷ ﺪﻳﺎﻤﻧ ﻭ ﺩﻮﺧ ﻩﺎﮕﻳﺎﺟ ﻭ ﻪﻳﺮﻈﻧ
ﺶﻳﺎﻫ ﻱﺎﻫﺩﺮﻜﻳﻭﺭ ﻦﻴﻨﭼ ﻪﺑ ﺖﺒﺴﻧ ﺍﺭ
ﺪﻧﺍﺩﺮﮔ ﺺﺨﺸﻣ ﻭ ﻦﻴﻴﺒﺗ ﻲﻨﻳﻮﻧ ]
۴۰ .[
ﻪﺠﻴﺘﻧ ﻱﺮﻴﮔ
ﻲﻳﺎﻣﺯﺁﺭﺎﻛ ﻭ ﺕﺎﻘﻴﻘﺤﺗ ﺐﻠﻏﺍ ﯼﺎﻫ
ﻩﺩﺍﺩ ﻥﺎﺸﻧ ﻲﻨﻴﻟﺎﺑ ﺍ
ﺪﻧ ﻲﻃ ﻪﻛ ۶ - ۴ ﻩﺎﻣ
ﻝﻮﻠﺳ ﺪﻧﻮﻴﭘ ﺯﺍ ﺲﭘ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
، ﻦﻴﺑ LVEF ۷ ﺎﺗ ۹ % ﺶﻳﺍﺰﻓﺍ
، ﻢﺠﺣ
ﻴﺳ ﻱﺎﻬﺘﻧﺍ ﺴ
ﺶﻫﺎﻛ ﻲﻟﻮﺘ ﻥﻮﺧ ﻭ
ﮒﺭ ﻭ ﻲﻧﺎﺳﺭ ﺭﺎﭼﺩ ﻪﻘﻄﻨﻣ ﺭﺩ ﻱﺯﺎﺳ
ﺩﻮﺒﻬﺑ ﻪﺘﻜﺳ ﯽﻣ
ﺎﻳ ﺪﺑ . ﻩﺪﻨﻳﺁ ﺕﺎﻘﻴﻘﺤﺗ ﺭﺩ ﻲﺘﺣ ﺮﮕﻧ
ﻭ ﺩﺭﻮﻣ - ﺰﻴﻧ ﻱﺪﻫﺎﺷ
ﺑ ﺵﻭﺭ ﻦﻳﺍ ﻲﻳﺁﺭﺎﻛ ﺖﺳﺍ ﻩﺪﻴﺳﺭ ﺕﺎﺒﺛﺍ ﻪ
. ﺪﺷﺭ ﻩﺩﻮﺗ ﭻﻴﻫ ﺎﺑ ﻲﻧﺎﻃﺮﺳ ﻪﺘﻓﺎﻳ
ﻱﺭﺍﺩﺮﺑﺮﻳﻮﺼﺗ ﻧ ﻩﺪﻫﺎﺸﻣ ﺰﻴﻧ ﻲﺴﻴﻃﺎﻨﻐﻣ ﻱﺎﻫ
ﺸ ﻝﻮﻃ ﺭﺩ ﻲﻤﺘﻳﺭﺁ ﭻﻴﻫ ﻭ ﻩﺪ
ﻱﺮﻴﮕﻴﭘ ﺕﺪﻣ ﺵﺭﺍﺰﮔ
ﺖﺳﺍ ﻩﺪﺸﻧ .
ﺮﻫ ﻱﺩﺎﻳﺯ ﻥﺎﻣﺯ ﻥﺎﺴﻧﺍ ﺪﻨﭼ ﻲﻨﻌﻳ ﻥﺪﺑ ﻩﺪﻧﺯﺎﺳ ﺪﺣﺍﻭ ﺩﻮﺟﻭ ﺯﺍ ﻪﻛ ﺖﺳﺍ
ﻩﺩﺍﺩ ﻡﺎﺠﻧﺍ ﻪﻨﻴﻣﺯ ﻦﻳﺍ ﺭﺩ ﺍﺭ ﻱﺩﺎﻳﺯ ﺭﺎﻴﺴﺑ ﺕﺎﻘﻴﻘﺤﺗ ﻭ ﻩﺪﺷ ﻩﺎﮔﺁ ﻝﻮﻠﺳ ﻪﺘﺴﻧﺍﺩﺎﻧ ﺎﻣﺍ ،ﺖﺳﺍ ﻝﻮﻠﺳ ﺩﺮﻜﻠﻤﻋ ﺩﺭﻮﻣ ﺭﺩ ﻭﺍ ﻱﺎﻫ
ﺭﺎﻴﺴﺑ ﻥﻮﮔﺎﻧﻮﮔ ﻱﺎﻫ
ﺖﺳﺍ ﺩﺎﻳﺯ . ﻝﻮﻠﺳ ﻩﺭﺎﺑﺭﺩ ﺐﻠﻄﻣ ﻦﻳﺍ ﺎﻘﻴﻤﻋ ﺰﻴﻧ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
ﻲﻣ ﻕﺪﺻ ﺪﻨﮐ .
ﺭﺩ ﻪﻛ ﻱﺩﺎﻳﺯ ﺕﺎﻘﻴﻘﺤﺗ ﺩﻮﺟﻭ ﺎﺑ ﻝﻮﻠﺳ ﺩﺮﺑﺭﺎﻛ ﺩﺭﻮﻣ
ﺭﺩ ﻱﺩﺎﻴﻨﺑ ﻱﺎﻫ
ﻱﺭﺎﻤﻴﺑ ﻥﺎﻣﺭﺩ ﺖﺳﺍ ﻡﺎﺠﻧﺍ ﻝﺎﺣ ﺭﺩ ﻲﺒﻠﻗ ﻱﺎﻫ
، ﻪﺘﺴﻧﺍﺩ ﺩﺭﻮﻣ ﺭﺩ ﺎﻣ ﻱﺎﻫ
ﺶﻫﻭﮋﭘ ﺞﻳﺎﺘﻧ ﺵﻭﺭ ﻭ ﺎﻫ
ﻪﺑﺯﻭﺭ ﺎﻬﻧﺁ ﻡﺎﺠﻧﺍ ﻱﺎﻫ ﻲﻣ ﺮﺘﺸﻴﺑ ﺯﻭﺭ
ﺩﻮﺷ . ﺯﺍ
ﺳ ﻲﻓﺮﻃ ﻮﺌ ﻘﻘﺤﻣ ﻦﻫﺫ ﺭﺩ ﺩﻮﺟﻮﻣ ﺕﻻﺍ ﺎ
ﻩﺪﺷ ﺮﺘﺸﻴﺑ ﺰﻴﻧ ﻥ ﺖﺳﺍ
. - ﻦﻳﺮﺘﻬﺑ
ﻗ ﻪﺘﻜﺳ ﺭﺎﭼﺩ ﻥﺍﺭﺎﻤﻴﺑ ﻱﺍﺮﺑ ﻝﻮﻠﺳ ﺪﻧﻮﻴﭘ ﻥﺎﻣﺯ ﻲﺒﻠ
ﻡﺍﺪﮐ
؟ﺖﺳﺍ - ﻦﻳﺮﺘﻬﺑ
ﻘﻠﺗ ﺵﻭﺭ ﻴ
؟ﺖﺳﺍ ﻡﺍﺪﻛ ﻲﻟﻮﻠﺳ ﺢ -
ﻝﻮﻠﺳ ﻊﺒﻨﻣ ﻦﻳﺮﺘﻬﺑ ﻱﺎﻫ
ﯼﺩﺎﻴﻨﺑ ﻡﺍﺪﻛ
؟ﺖﺳﺍ - ﺍﺮﺑ ﻥﺍﺭﺎﻤﻴﺑ ﻦﻳﺮﺘﻬﺑ ﻱ
؟ﺪﻨﻣﺍﺪﻛ ،ﺪﻧﻮﻴﭘ -
ﻦﻳﺍ ﻖﻳﺭﺰﺗ ﺐﺳﺎﻨﻣ ﺯﻭﺩ
ﻝﻮﻠﺳ
؟ﺖﺳﺍ ﺭﺍﺪﻘﻣ ﻪﭼ ﺎﻫ -
ﻦﻳﺍ ﺮﻴﺜﻜﺗ ﺪﻧﻭﺭ ﺭﺩ ﻝﻮﺌﺴﻣ ﻱﺎﻫﺭﻮﺘﻛﺎﻓ
ﻝﻮﻠﺳ
؟ﺪﻨﻣﺍﺪﻛ ﺐﻠﻗ ﺖﻓﺎﺑ ﺭﺩ ﺎﻫ -
ﻝﻮﻠﺳ ﻖﻳﺭﺰﺗ ﺵﻭﺭ ﻦﻳﺮﺘﻬﺑ ﺎﻫ
ﯼ ﯼﺩﺎﻴﻨﺑ
؟ﺖﺳﺍ ﻡﺍﺪﻛ ﺐﻠﻗ ﻪﺑ -
ﻝﻮﻠﺳ ﺎﻳﺁ ﻝﺎﺳ ﻱﺍﺮﺑ ﻱﺪﻧﻮﻴﭘ ﻱﺎﻫ ﻩﺪﻧﺯ ﻱﺩﺎﻳﺯ ﻱﺎﻫ
ﻲﻣ
؟ﺪﻨﻧﺎﻣ ﺡﺮﻄﻣ ﺳ ﻦﻴﻨﭼ ﻥﺪﺷ ﻮﺌ
ﻲﻣ ﺚﻋﺎﺑ ﻲﺗﻻﺍ ﻝﻮﻠﺳ ﺎﺗ ﺩﻮﺷ
ﻪﺑ ﻲﻧﺎﻣﺭﺩ ﺕﺭﻮﺻ
ﺩﻮﺸﻧ ﻪﻴﺻﻮﺗ ﻼﻌﻓ ﻲﻨﻴﻟﺎﺑ ﺮﻴﮔﺍﺮﻓ ﺵﻭﺭ
، ﻘﻘﺤﻣ ﺎﻣﺍ ﺎ ﺩ ﻭ ﻥ ﻧﺍ ﻪﺑ ﻥﺍﺪﻨﻤﺸ
ﺐﻠﻗ ﺪﻧﻮﻴﭘ ﻦﻴﺸﻧﺎﺟ ﺍﺭ ﻥﺁ ﻭ ﺪﻧﺭﺍﻭﺪﻴﻣﺍ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻦﻳﺍ ﻩﺪﻨﻳﺁ ﻲﻣ
ﺪﻨﻧﺍﺩ .
ﻘﻘﺤﻣ ﻱﻭﺭﺍﺮﻓ ﺮﮕﻳﺩ ﻢﻬﻣ ﻪﺘﮑﻧ ﺎ
ﻪﺘﺷﺭ ﻥﺍﺮﮕﺸﻫﻭﮋﭘ ﻭ ﻱﺭﺎﺘﺳﺮﭘ ﻥ
ﻱﺎﻫ
ﻱﺭﺎﻤﻴﺑ ﻱﺍﺮﺑ ﻲﻧﺎﻣﺭﺩ ﺵﻭﺭ ﻦﻳﺍ ﻪﻨﻳﺰﻫ ﺎﻳﺁ ﻪﮐ ﺖﺳﺍ ﻦﻳﺍ ﺮﮕﻳﺩ ﻲﺒﻠﻗ ﻱﺎﻫ
ﺵﻭﺭ ﻪﻴﻘﺑ ﻪﺑ ﺖﺒﺴﻧ ﻪﺑ ﻥﻭﺮﻘﻣ ﻝﻭﺍﺪﺘﻣ ﻱﺎﻫ
ﺎﻳ ﺖﺳﺍ ﻪﻓﺮﺻ ﺎﻳﺁ ﻭ ﺮﻴﺧ
ﻪﺑ ﻞﻴﺴﻧﺎﺘﭘ ﺯﺍ ﻲﺑﻮﺧ ﻪﺑ ﺭﺩ ﺩﻮﺟﻮﻣ ﻱﺎﻫ
ﺵﻭﺭ ﻱﺮﻴﮔﺭﺎﮐ ﻩﺩﺎﻔﺘﺳﺍ ﻲﻠﺒﻗ ﻱﺎﻫ
ﻩﺪﺷ
؟ﺖﺳﺍ
ﻊﺑﺎﻨﻣ ﻊﺑﺎﻨﻣ
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