فراوانی تظاهرات پوستی در بیماران مبتلا به لپتوسپیروز بستری در بیمارستان رازی قائم‌شهر از سال 92 تا 98

سابقه و هدف: ﻟﭙﺘﻮﺳﭙﯿﺮوز ﯿﮏ ﺑﯿﻤﺎرﯿ ﺗﺐ‌دار ﺣﺎد اﺳﺖ ﮐﻪ ﻃﯿﻒ وﺳﯿﻌﯽ از ﻋﻼﺋﻢ را در ﺑﺮ ﻣﯽ‌ﮔﯿﺮد، اﯿﻦ ﻋﻼﺋﻢ ﻣﯽ‌ﺗﻮاﻧﺪ از ﻓﺮم ﻣﻼﯿﻢ ﯿﻌﻨﯽ ﺑﯿﻤﺎرﯿ ﻣﺸﺎﺑﻪ آﻧﻔﻮﻻﻧﺰا ﺗﺎ ﻋﻼﺋﻢ ﺷﺪﯿﺪﺗﺮ ﺑﯿﻤﺎرﯿ ﻣﺜﻞ زردﯿ، ﺧﻮﻧﺮﯿﺰﯿ، ﻧﺎرﺳﺎﯿﯽ ﮐﻠﯿﻮﯿ و ﻣﺮگ ﺑﺎﺷﺪ. در اﯿن بﯿمارﯿ ﺿﺎﻳﻌﺎت ﭘﻮﺳﺘﻲ ﻣﻌﻤﻮﻻ ﺑﻪ ﺷﻜﻞ ﻣﺎﻛﻮﻻر، ﻣﺎﻛﻮﻟﻮﭘﺎﭘﻮﻻر، ﻛﻬﻴﺮ، ﭘﺘﺸﻲ ﻣﻲ‌ﺑﺎﺷﺪ. با توجه به تنوع علائم اﯿن بﯿمارﯿ در اﯿن زمﯿنه مطالعه‌اﯿ در جهت بررسﯿ فراوانﯿ تظاهرات پوستﯿ در بﯿماران مبتلا به لپتوسپﯿروز با اﯿن تشخﯿص طراحﯿ گردﯿد.مواد و روش‌ها: اﯿن مطالعه مقطعﯿ، به صورت گذشته‌نگر بوده که از ابتداﯿ سال 1392 تا پاﯿان سال 1398 و با استفاده از داده‌هاﯿ موجود انجام شد. جمعﯿت مورد بررسﯿ تمامﯿ بﯿماران مبتلا به لپتوسپﯿروز بسترﯿ در بﯿمارستان رازﯿ قائم‌شهر بوده است که بﯿمارﯿ آن‌ها از طرﯿق آزماﯿشات سرولوژﯿک اثبات شده است. اطلاعات چک لﯿست شامل، سن، جنس، شغل، علائم بالﯿنﯿ، اولﯿن علامت شروع بﯿمارﯿ، علائم پوستﯿ بﯿمار شامل هر نوع ضاﯿعه پوستﯿ‌اﯿ اعم از پاپول، ماکول، پتشﯿ، پورپورا، راش‌هاﯿ هموراژﯿک و ... بوده است که در ابتداﯿ بﯿمارﯿ تظاهر پﯿدا کرده، در سﯿر درمان چگونه تغﯿﯿر داشته است و نﯿز در انتهاﯿ درمان چه ضاﯿعاتﯿ باقﯿ مانده ثبت گردﯿد. تمامﯿ اطلاعات مربوط به بﯿماران در فرم مخصوص ثبت مﯿ‌گردد. تجزﯿه و تحلﯿل داده‌ها توسط نرم‌افزار spss نسخه 20 انجام شد.ﯿافته‌ها: تعداد 800 نفر (652 نفر 81/50 درصد) مرد و 148 نفر (18/50 درصد) زن در اﯿن مطالعه مورد بررسﯿ قرار گرفتند. مﯿانگﯿن سنﯿ بﯿماران مورد مطالعه  16/23±48/55  سال با حداقل سن 15 و حداکثر سن 87 سال بوده است. براﯿ بررسﯿ ارتباط بﯿن علائم پوستﯿ با جنس و سن بﯿماران از آزمون مجذور کاﯿ استفاده شد. اﯿن آزمون نشان داد که از بﯿن بﯿماران 150 نفر مبتلا به اﯿکتر (62/76 درصد) بوده‌اند که به‌طور معنادارﯿ بﯿش‌ترﯿن فراوانﯿ را نسبت به ساﯿر علائم پوستﯿ داشتند (0/001

prevalence of cutaneous manifestations in patients with leptospirosis admitted to razi hospital in ghaemshahr from 2014 to 2020

background and purpose: leptospirosis is an acute febrile illness that affects the whole range of symptoms, the symptoms can be a mild form of the flu-like illness to more severe symptoms such as jaundice, bleeding, kidney failure, and death. in this disease, the skin lesions are usually in the form of macular, maculopapular, urticaria, and petechiae. due to the variety of symptoms of this disease, to add to our knowledge in this field, we designed a study to evaluate the skin symptoms of this disease in patients admitted with this diagnosis.materials and methods: this cross-sectional study was conducted from the beginning of 2014 to the end of 2020. the studied population was all hospitalized patients with leptospirosis whose disease was proven through serological tests. checklist information includes age, sex, occupation, clinical signs, the first sign of disease onset, skin symptoms including any skin lesion including papules, macules, petechiae, purpura, hemorrhagic rashes, etc. at the beginning of the disease is manifested, and also how it has changed in the course of treatment and also what lesions are valuable to us at the end of treatment. all patient information is recorded on a special form. data analysis was performed by spss software version 20.results: 800 people (652 (81.50%) men and 148 (18.50%) women) were examined in this study. the average age of the studied patients was 48.55 ± 16.23 years with a minimum age of 15 and a maximum age of 87 years. the chi-square test was used to check the relationship between skin symptoms and patients’ gender and age. the result showed that 150 patients had jaundice (62.76%), which was significantly more frequent than other skin symptoms (p<0.001). this test showed that skin symptoms were significantly higher in women than men (38.51 vs 27.91) (p=0.013). the result, however, showed that there is no significant relationship between the presence of skin symptoms and age (p=0.054). bonferroni’s post hoc test showed that the frequency of jaundice (79.59% vs. 58.42%) and the frequency of ecchymosis in women (16.33% vs. 2.11%) were significantly higher (p<0.05). also, this test showed that all types of skin symptoms are significantly related to age classification (p<0.001). also, in the examination of the types of skin symptoms, it has been shown that the highest frequency was related to the symptoms of massage on the fingers (55.56%) (p= 0.637).conclusion: in this study, it was shown that most patients present with fever, chills, and myalgia and the rate of skin lesions in these patients is low and most skin lesions occur in the female population. among skin lesions, jaundice was the most common. headaches, nausea and vomiting, and myalgia were also more common in hospitalized patients for non-skin symptoms. the frequency of jaundice in women, the frequency of ecchymosis in women, and the frequency of other skin symptoms were higher in men.