fa اپیدمیولوژی بیماری مولتیپل اسکلروزیس در ایران: یک مطالعه مرور سیستماتیک و متاآنالیز عمومي General مقطعی (Cross sectional) Cross sectional <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">شیوع </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">MS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> در ایران بصورت متفاوت در بازه 5.3 تا 89 در 100،000 گزارش شده است. با توجه به </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">controversy</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> در گزارش میزان شیوع </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">MS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، این مطالعه به روش مرور سیستماتیک همه مستندات و ترکیب آن ها به روش متاآنالیز جهت برآورد کلی شیوع </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">MS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> در ایران صورت گرفت.</span></span><br> <strong><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">روش کار: </span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بررسی سیستماتیک حاضر با تمرکز بر اپیدمیولوژی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">MS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> در ایران بر اساس گایدلاین </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">PRISMA</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> برای مطالعات مرور سیستماتیک و متاآنالیز انجام شد. چهار پایگاه های فارسی زبان </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Magiran</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Iranmedex</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">SID</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Medlib</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> و هفت پایگاه انگلیسی زبان بین المللی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Scopus</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">PubMed</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Science Direct</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> ، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Cochrane</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Web of Science</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">،</span></span> &nbsp;<span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Embase</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">PsycINFO </span></span></span>&nbsp;<span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">و هم چنین موتور جستجوی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Google Scholar</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> برای مطالعات&nbsp; </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">peer-reviewed</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> منتشر شده بدون محدودیت زمانی تا </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">May</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> سال </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">2018</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> جستجو شدند. داده ها با استفاده از نرم افزار </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">Comprehensive meta-analysis ver. 2</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> آنالیز شدند.</span></span><br> <strong><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">نتایج: </span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">با توجه به جستجو در پایگاه های مختلف، 39 (15</span></span><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">٪</span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">) مقاله نهایی شد.</span></span> <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بر اساس مدل اثرات تصادفی: شیوع</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;"> MS </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">در ایران </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">29.3/ 100,000 (95%CI: 25.6-33.5)</span></span></span> <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">برآورد شد</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">.</span></span></span> <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">شیوع</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;"> MS </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">در زنان و مردان به ترتیب</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">16.5/ 100,000 (95%CI: 13.7-23.4) </span></span></span><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">&nbsp;و </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">&nbsp;44.8/ 100,000 (95%CI: 36.3-61.6)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">تخمین زده شد</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">. </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بروز</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;"> MS </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">در ایران</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">3.4/ 100,000 (95%CI: 1.8-6.2) </span></span></span>&nbsp;<span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بر اساس مدل اثرات تصادفی محاسبه شد.</span></span> <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بروز</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;"> MS </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">در مردان </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">1.2/ 100,000 (95%CI: 1.0-1.4) </span></span></span>&nbsp;<span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">و بروز</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;"> MS </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">در زنان </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">48.2/ 100,000 (95%CI: 39.3-</span></span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:14.0pt;">59.1) </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بود.</span></span> <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">مدل رگرسیون فراوانی برای شیوع و و بروز </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">&nbsp;MS </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">بر حسب سال به طور معنی داری سیر صعودی داشت. </span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"></span></span><br> <strong><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">نتیجه گیری:</span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:13.0pt;">نتایج این مطالعه می تواند یک تصویر کلی اپیدمیولوژیک از </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">MS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> در ایران ارائه دهد.&nbsp; متاآنالیز حاضر نشان می دهد شیوع </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:13.0pt;">MS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:13.0pt;"> در ایران بالا و با گذشت زمان به سرعت در حال افزایش است. </span></span> <strong>Background</strong><br> Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis.<br> <strong>Method</strong><br> &nbsp;A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: <a href="http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018114491">CRD42018114491</a>.<br> <strong>Results</strong><br> According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran&nbsp; was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001).<br> <strong>Conclusions</strong><br> The results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time. اپیدمیولوژی , مولتیپل, اسکلروزیس Multiple Sclerosis, Iran, Systematic Review, Meta-analysis 0 0 http://newresearch.medilam.ac.ir/browse.php?a_code=A-10-2456-15&slc_lang=fa&sid=1 Milad Azami میلاد اعظمی milad98azami@gmail.com 4490248474 100319475328460027782 Yes Ilam University of Medical Sciences, Ilam, Iran دانشگاه علوم پزشکی ایلام، ایلام، ایران Ali Khorshidi علی خورشیدی ali_482002@yahoo.com 3379906670 100319475328460027783 No Psychosocial Injuries Research Center, Ilam University of Medical sciences, Ilam, Iran مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران