Razi Journal of Medical Sciences

fa بررسی رابطه بین متغیرهای زمینه ای و پارامترهای اقلیمی با فراوانی بیماری التهابی روده(IBD ) در استان گیلان Investigating the relationship between contextual variables and climatic parameters with the frequency of inflammatory bowel disease (IBD) in Gilan province گوارش Gastroentrology پژوهشي Research زمینه و هدف: میزان بروز بیماری التهابی روده در مناطق جغرافیائی مختلف فرق دارد. این بیماری در کشورهای صنعتی شایعتر است. تعداد مبتلایان به این بیماری در ایران نزدیک به 10000 نفر میباشد. در استان گیلان تعداد زیادی در حدود 3000 به این بیماری مبتلا هستند. از این رو هدف مقاله بررسی رابطه بین متغیرهای زمینه ای و فراوانی بیماری التهابی روده (IBD) در استان گیلان است. روش کار: این تحقیق به لحاظ هدف کاربردی و به لحاظ ابزار گردآوری اطلاعات کتابخانه-ای- میدانی است. حجم اطلاعات فراوانی بیماریIBD ثبت شده درمرکز تحقیقات گوارش و کبد مرکز آموزشی درمانی تحقیقاتی بیمارستان رازی رشت در استان گیلان از سال 1397-1395 بود. مشخصات دموگرافیک، شهر محل زندگی، انواع بیماریهای التهابی روده با تفکیک کولیت زخمی و کرون و جنس و عناصر اقلیمی (رطوبت، دما، فشار و بارندگی)  به عنوان متغیر مستقل و   بیماری IBD به عنوان متغیر وابسته بود. از آمار توصیفی و آزمون آماری Chi Square در سطح معناداری 5/0 p< با کاربرد نرم افزار SPSS با نسخه 21 جهت تجزیه و تحلیل داده ها استفاده شد. یافته‌ها: بیشترین آمار مبتلایان به بیماری التهابی روده-کولیت بر اساس ماه تشخیص بیماری درشهریور با  44 نفر (2/77%) و کمترین آن درمهر با2  نفر (100%) بوده است. البته ارتباط معنا داری از نظر همبستگی وجود نداشت (9/0p=). بیشترین آمار مبتلایان به کولیت مردان در تابستان   با 41 بیمار (6/21%)،کمترین آمار کولیت مردان در بهار  با 4 بیمار (1/2%)، بیشترین آمار مبتلایان به کولیت زنان در  تابستان  با 47 بیمار (7/24%)، کمترین آمار کولیت زنان در پائیز   با 7 بیمار (7/3%) میباشد. ارتباط معناداری از نظر همبستگی وجود داشت (01/0p=). اختلاف آماری معنی داری بین ماه تولد بیماران، شهر محل زندگی بیماران و ابتلا به بیماری کرون و کولیت اولسراتیو وجود نداشت ( 05/0p<). در 6 شهر ارتباط معناداری از نظر همبستگی بین تعداد کل بیماران، بیماران مرد و بیماران زن با عناصر اقلیمی: رطوبت، دما، فشار و بارندگی وجود نداشت. نتیجه‌گیری: در تبیین یافته ها می توان گفت؛ مطالعات انجام شده توسط دانشمندان و محققان تاثیر تغییرات جوی بر اساس فصل و ماه تولد بر واکنش‌های طبیعی بدن را مورد تایید قرار داده است. بر این اساس هرگونه تغییرات جزئی ایجاد شده در دما، فشار و رطوبت هوا می‌تواند سبب ایجاد تغییراتی در رفتار و شرایط جسمانی و روانی افراد شود. Background: Inflammatory bowel disease (IBD) is a group of diseases that cause inflammation of the walls of the large intestine and small intestine, the most common of which are ulcerative colitis and Crohn's disease. There are similarities in that both diseases cause inflammation of the intestinal wall, although there are many differences in the areas involved and the depth of inflammation between the two diseases. There are many similarities in the treatment plan for the two diseases. It is important to note that Crohn's disease, in addition to affecting the large intestine and small intestine, can also affect the esophagus, esophagus, stomach, and anus, while ulcerative colitis primarily affects the colon and rectum. Affects the intestines. It is hypothesized that IBD is more likely to occur in genetically predisposed individuals in environmental exposures that are associated with abnormal immune responses. While several environmental factors have been raised, there are many differences regarding the role of these potential factors (1, 3). It seems that in the last few decades due to the type of nutrition (which is one of the environmental factors) such as increasing consumption of cow's milk in infants instead of breast milk, increasing consumption of sugar, sweets, high fat consumption, reducing fiber consumption , The world has been associated with an increase in IBD. The incidence and prevalence of IBD is increasing in the world and has become common in Iran in the last 30 years. Inflammatory bowel disease is among the most common diseases increasing rapidly in some countries and Iran, especially in Gilan. Approximately 30000 cases of IBD have been recorded at Gilan Gastroenterology and Liver Research Center. It seems that genetic and environmental factors to be involved in this disease. The objective of this study is to investigate the relationship between environmental factors and the geographical distribution of inflammatory bowel disease (IBD) in Gilan province. The incidence of inflammatory bowel disease varies from region to region. The disease is more common in industrialized countries. The number of patients with this disease in Iran is close to 10,000. In Gilan province, a large number of about 3,000 people suffer from this disease. Therefore, the purpose of this paper is to investigate the relationship between contextual variables and frequency of inflammatory bowel disease (IBD) in Gilan province. With these details, the aim of this paper is to investigate the relationship between contextual variables and climatic elements with the prevalence of inflammatory bowel disease (IBD) in Gilan province. Methods: This research is applied in terms of purpose and in terms of library-field-to-field data collection tools. The volume of information on the prevalence of IBD disease registered in the Digestive and Liver Research Center of Razi Hospital Research and Training Center in Rasht Hospital in Gilan Province was from 2016-2017. Demographic characteristics, city of residence, types of inflammatory bowel disease with separation of ulcerative colitis and Crohn's disease and sex and climatic elements (humidity, temperature, pressure and rainfall) as independent variables and IBD disease as dependent variables. Descriptive statistics and Chi Square statistical test were used at a significance level of p <% 5 using SPSS software to analyze the data. Results: The highest number of patients with inflammatory bowel disease - colitis based on the month of diagnosis of the disease in the city with 44 people (77.2%) and the lowest in September with 2 people (100%). The highest number of patients with colitis-men in summer with 41 patients (21.6%), the lowest number of colitis-men in spring with 4 patients (2.1%). The highest number of patients with colitis- Women in summer with 47 patients (24.7%), the lowest colitis-women in the fall with 7 patients (3.7%). There was a significant correlation in terms of correlation (p value = 0.01). According to Chi Square statistical test, there was no significant statistical difference between patients 'birth months, patients' hometowns and Crohn's disease and ulcerative colitis (p <0.05). In 6 cities, there was no significant relationship between the total number of patients, male and female patients with climatic elements: humidity, temperature, pressure and rainfall. From this study, the following results are obtained: Seasonal changes in patients with IBD by gender during the years 2016-2017 from 190 patients were done. The highest number of patients crohn -men in summer with 10 patients (5.3%), the lowest crohn -male statistics in winter and autumn with 2 patients (1.1%), the highest number of crohn -female patients in summer with 9 patients (4.7%) and the lowest crohn -female statistics in autumn with 1 patient (0.5%), there was no significant correlation (p = 0.5). Conclusion: In a study conducted by Stein et al. In 2016, the effect of geographical location, season and UV exposure on disease severity was measured by measuring the rate of hospital discharge of IBD patients nationwide. IBD hospitalization rates in the northern states were higher than in the southern states for both ulcerative colitis and Crohn's disease. However, there was no uniform difference between IBD admission rates by season versus study years. UV index was inversely related, although it was not proportional to the rate of discharge for both Crohn's disease and ulcerative colitis (11). The highest number of patients with inflammatory bowel disease was based on the month of diagnosis in the years between 2016-2017 in September with 57 people and the lowest in October with 2 people. The highest number of patients with inflammatory bowel disease based on the month of diagnosis in September with 11 people (8.5%) and summer with 13 people (22.8%) and the lowest in July, October and March with 0 people (0%). The highest number of patients with inflammatory bowel disease-colitis based on the month of diagnosis was in September with 44 patients (77.2%) and the lowest was in October with 2 patients (100%). However, there was no significant relationship in terms of correlation (p value = 0.9). It can be concluded that studies by scientists and researchers have confirmed the effect of climate change on the body's natural reactions based on the season and month of birth. Accordingly, any minor changes in air temperature, pressure and humidity can cause changes in behavior and physical and mental conditions of individuals. متغیرهای زمینه ای, فصل, ماه تولد, عوامل محیطی, بیماری التهابی روده (IBD), استان گیلان Background variables, Season, Month of birth, Environmental factors, Inflammatory bowel disease (IBD), Gilan province 209 222 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5216-1&slc_lang=fa&sid=1 Seyyedeh Sedigheh Ghorbaninezhad سیده صدیقه قربانی نژاد 3900319475328460054956 3900319475328460054956 No Islamic Azad University, Nour Branch دانشگاه آزاد اسلامی واحد نور، نور، ایران Gholamreza Janbaz Ghobadi غلامرضا جانباز قبادی gh_janbazghobadi@iaunour.ac.ir 3900319475328460054957 3900319475328460054957 Yes Nour Branch, Islamic Azad University, Nour Branch, Nour, Iran گروه جغرافیا دانشگاه آزاد اسلامی واحد نور، نور، ایران Sadreddin Motevalli صدرالدین متولی 3900319475328460054958 0001-0000-5691-8965 No Nour Branch, Islamic Azad University, Nour Branch, Nour, Iran گروه جغرافیای طبیعی، دانشگاه آزاد اسلامی واحد نور، نور، ایران Fariborz Mansour-ghanaei فریبرز منصور قنایی 3900319475328460054959 3900319475328460054959 No University of Guilan گروه علوم پزشکی، دانشگاه گیلان، رشت، ایران