دوره 33، شماره 338: هفته دوم مرداد ماه 1394:901-916

بررسی وضعیت سطح سرمی ویتامین D قبل از عمل جراحی در بیماران مبتلا به بیماری‌های دژنراتیو ستون فقرات

محمدرضا تاجی , فرید ذوالفقاری, علیرضا فرید معیر, بهرام سلیمانی

چکیده


مقدمه: مطالعات اپیدمیولوژیک شیوع بالایی از کمبود ویتامین را در مناطق مختلف دنیا و از جمله کشورمان گزارش کرده‌اند. هدف از اجرای این مطالعه، تعیین شیوع کمبود ویتامین D در بیماران مبتلا به بیماری دژنراتیو ستون فقرات (فتق دیسک بین مهره‌ای، تنگی کانال نخاعی و ناپایداری ستون فقرات) که کاندیدای عمل جراحی ستون فقرات بودند و نیز بررسی ارتباط کمبود این ویتامین با سن، جنسیت، چاقی، مصرف سیگار، مصرف مکمل و ... و اندازه‌گیری این متغیرها بود.

روش‌ها: در این مطالعه‌ی مقطعی و غیر مداخله‌ای، سطح سرمی D(OH)25 به روش الکتروکمی لومینسانس تعیین شد. وضعیت سایر متغیرها از طریق پرسش‌نامه‌های مربوط مشخص گردید. جهت تجزیه و تحلیل داده‌ها، از آزمون‌های تک متغیره و آنالیز رگرسیون چندگانه استفاده شد.

یافته‌ها: در مجموع، 110 بیمار وارد مطالعه شدند. میانگین سطح سرمی D(OH)25، ng/ml 75/18 ± 45/27 بود. 5/44 درصد دچار کمبود ویتامین D [ng/ml 20 > D(OH)25] بودند و 3/17 درصد سطح ناکافی ویتامین D [ng/ml 30 > D(OH)25 ≥ 20] داشتند. در گروه با سابقه‌ی مصرف مکمل، هیپوویتامینوز D همچنان شیوع 6/47 درصد داشت. شیوع کمبود ویتامین D به صورت معنی‌داری در گروه سنی جوان‌تر (39-20 سال)
(003/0 = P) و نیز افراد بدون سابقه‌ی مصرف مکمل (001/0 P <) بالاتر بود. در مقابل، زنان در مقایسه با مردان به طور معنی‌داری سطوح بالاتر ویتامین D (030/0 = P) و به همان نسبت، میزان بیشتری (001/0 > P) از مصرف مکمل ویتامین D را داشتند. در مورد سایر متغیرها، ارتباط معنی‌داری مشاهده نشد.

نتیجهگیری: کمبود ویتامین D در بیماران با بیماری‌های دژنراتیو ستون فقرات حتی بیماران تحت درمان با مکمل ویتامین، شیوع بالایی دارد. از طرفی، استناد به عوامل خطر از قبل شناخته شده مثل سن بالا و جنس مؤنث به تنهایی جهت تعیین احتمال کمبود، کافی نیست. از این رو، غربال‌گری کمبود با سنجش سطح سرمی D(OH)25 و به دنبال آن، درمان کامل و صحیح در بیماران مبتلا به بیماری‌های دژنراتیو ستون فقرات به ویژه بیماران با مداخلات جراحی توصیه می‌گردد.


واژگان کلیدی


ویتامین D؛ ستون فقرات؛ دژنراسیون دیسک بین مهره‌ای

تمام متن:

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