Journal of Iranian Blood Transfusion
فصلنامه پژوهشی خون
bloodj
Medical Sciences
http://bloodjournal.ir
91
journal91
1027-9520
1735-8248
10.66224/bloodj
fa
jalali
1402
12
1
gregorian
2024
3
1
21
1
online
1
fulltext
fa
مقایسه اثر درمان ترکیبی آهنزداها (دفروکسامین ـ دفریپرون، دفروکسامین ـ دفرازیروکس) با دفروکسامین و دفرازیروکس به تنهایی در بیماران بتا تالاسمی ماژور شهر یاسوج
Comparison of combined chelation therapy effects (deferoxamine-deferiprone, deferoxamine-deferasirox) with Deferoxamine and Deferasirox in beta-thalassemia major in Yasuj
هماتولوژي
Hematology
پژوهشي
Research
<div><span style="font-size:10pt"><span style="text-justify:inter-ideograph"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span style="font-weight:bold"><span lang="FA" style="line-height:80%"><span style="font-family:Jadid"><span style="font-weight:normal">چکید</span></span></span><span lang="AR-SA" style="line-height:80%"><span style="font-family:Jadid"><span style="font-weight:normal">ه</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:Jadid"><span style="font-weight:normal"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:inter-ideograph"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i><span lang="FA" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:Titr">سابقه و هدف </span></span></span></i></b></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">مصرف آهنزداها برای بیماران بتا تالاسمی ماژور امری ضروری و حیاتی است. این مطالعه با هدف تعیین عوارض و علائم بالینی و آزمایشگاهی مونوتراپی و درمان ترکیبی آهنزداها در بیماران بتا تالاسمی ماژور شهر یاسوج انجام شد.</span></span></span></b></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:inter-ideograph"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i><span lang="FA" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:Titr">مواد و روشها</span></span></span></i></b></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">در مطالعه مقطعی- توصیفی- تحلیلی حاضر، 103 بیمار مبتلا به بتا تالاسمی ماژور شهر یاسوج طی سالهای 1401-1400 مورد ارزیابی قرار گرفتند. پس از جمعآوری اطلاعات دموگرافی، بالینی و آزمایشگاهی بیماران، نتایج</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">به</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">صورت</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">میانگین </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">±</span></span></span></b><b><span style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> انحراف</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">معیار</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">و درصد</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">گزارش شدند</span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">.</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> درجه اختلاف آماری</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">بین</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">نسبتها با</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">استفاده</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">از</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">آزمون</span></span></span></b><b> </b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">کروسکال- والیس با استفاده از 20 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">SPSS</span></span></span></b><b><span style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> انجام شد.</span></span></span></b></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i><span lang="FA" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:Titr">یافتهها</span></span></span></i></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><a name="_Hlk136507237"><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">میانگین سن بیماران 34/8 </span></span></span></b></a><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">±</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> 74/24 سال بود. 4/54 درصد (56 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">n=</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">) جمعیت مورد مطالعه را مردان و 6/45 درصد (47 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">n=</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">) را زنان تشکیل دادند.</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> میانگین فریتین در بین گروههای مختلف مطالعه از نظر آماری تفاوت معناداری داشت (028/0 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">p=</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">). بیمارانی که دفروکسامین مصرف میکردند، بیشترین میانگین فریتین سرم را نشان دادند (3397 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">±</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> 5/5925 نانوگرم) و بیمارانی که دفروکسامین را به همراه دفریپرون یا دفرازیروکس مصرف میکردند نسبت به مصرف دفروکسامین به تنهایی، میانگین فریتین پایینتری داشتند (به ترتیب2560 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">±</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> 3348 و 3322 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">±</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus""> 4269 نانوگرم). در پی مصرف آهنزداها، 6/47 درصد بیماران (49 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">n=</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">) بدون عارضه بالینی و 4/52 درصد (54 </span></span></span></b><b><span dir="LTR" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:"Times New Roman Bold","serif"">n=</span></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">) دارای حداقل یک عارضه بودند.</span></span></span></b></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:inter-ideograph"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i><span lang="FA" style="font-size:9.0pt"><span style="line-height:80%"><span style="font-family:Titr">نتیجه گیری</span></span></span></i></b></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:80%"><span style="font-family:"2 Lotus"">نتایج مطالعه نشان داد، دفروکسامین میتواند به صورت ترکیبی با داروهای خوراکی تأثیر بسیار زیادی در کاهش رسوب آهن و میزان فریتین سرم داشته باشد.</span></span></span></b></span></span></span></span></span></span></span><br>
<br>
</div>
<div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:12.0pt">Abstract</span></b><b><span style="font-size:12.0pt"></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i>Background and Objectives</i></b></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif"">Chelation therapy is essential for beta-thalassemia major. This study aims to determine the complications clinical and laboratory symptoms of monotherapy and combined treatment of iron chelators in beta-thalassemia major patients in Yasuj.</span></span></span></span></span><br>
<br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i>Materials and Methods</i></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif"">In this cross-sectional-descriptive-analytical study, 103 patients with beta-thalassemia major in Yasuj city were evaluated during 2021-2022. After collecting the demographic, clinical and laboratory information of the patients, the results were reported as mean ± standard deviation and percentage. The degree of statistical differences between ratios was calculated using the Kruskal-Wallis test.</span></span></span></span></span><br>
<br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i>Results</i></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif"">The average age of our patients was reported to be 24.74 ± 8.34 years. 54.4% (n = 56) of the study patients were men and 45.6% (n = 47) were women. The results of the present study showed that there was a statistically significant difference in mean ferritin among different study groups (p = 0.028). Patients treated with deferoxamine showed the highest mean serum ferritin (5925.5 ± 3397ng%) and patients who took deferoxamine together with deferiprone or deferasirox had a lower mean ferritin compared to deferoxamine alone (3348 ± 2560, 4269 ± 3322 ng%), respectively. Also, the present study showed that after taking iron removers, 47.6% of patients (n = 49) had no clinical complications and 52.4% (n = 54) had at least one complication.</span></span></span></span></span><br>
<br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><i>Conclusions </i></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif"">Our results showed that Deferoxamine can have a great effect in reducing iron deposition and serum ferritin levels in combination with oral drugs.</span></span></span></span></span><br>
</div>
کلمات کلیدی: بتا تالاسمی ماژور, شلاتورهای آهن, دفروکسامین, دفرازیروکس, درمان ترکیبی دارویی
Key words: beta-Thalassemia Major, Iron Chelating Agents, Deferoxamine, Deferasirox, Drug Therapy,Combination
21
32
http://bloodjournal.ir/browse.php?a_code=A-10-1031-1&slc_lang=fa&sid=1
P.
Etemad far
پیمان
اعتمادفر
9100319475328460024757
9100319475328460024757
No
استادیار دانشکده پزشکی دانشگاه علوم پزشکی یاسوج
A.
Azizi
ارسلان
عزیزی
9100319475328460024758
9100319475328460024758
No
استادیار دانشکده پزشکی دانشگاه علوم پزشکی یاسوج
J.M.
Malekzadeh
جان محمد
ملک زاده
9100319475328460024759
9100319475328460024759
No
استادیار دانشکده بهداشت دانشگاه علوم پزشکی یاسوج
M.
Saghazadeh
مژگان
صقازاده
9100319475328460024760
9100319475328460024760
No
استادیار دانشکده علوم پایه دانشگاه آزاد اسلامی واحد قم
O.S.
Esmaeili
عذرا سادات
اسماعیلی
9100319475328460024761
9100319475328460024761
No
مرکز تحقیقات انتقال خون ـ مؤسسه عالی آموزشی و پژوهشی طب انتقال خون
M.
Parsian
محمد
پارسیان
9100319475328460024762
9100319475328460024762
No
مرکز تحقیقات سلولی مولکولی دانشکده پزشکی دانشگاه علوم پزشکی یاسوج
F.
Rad
فریبا
راد
rad89@gmail.com
9100319475328460024763
9100319475328460024763
Yes
دانشیار مرکز تحقیقات سلولی مولکولی دانشکده پزشکی دانشگاه علوم پزشکی یاسوج