在状细胞疾病中,夜间低氧化和中枢神经系统事件
F J Kirkham1, D K Hewes, M Prengler
1Neurosciences Unit, Institute of Child Health, University College London, London, UK. F.kirkham@ich.ucl.ac.uk
Lancet (London, England)
|June 27, 2001
概括
夜间低氧化,而不是传统方法,更好地预测状细胞疾病中中枢神经系统事件. 管理夜间低氧和度可以预防中风和发作.
科学领域:
- 神经学 神经学
- 血液学 血液学 血液学
- 睡眠医学 睡眠医学
背景情况:
- 中枢神经系统 (CNS) 事件,如中风和发作在状细胞疾病中很常见.
- 经骨多普勒超声波可以通过测量高动脉速度来预测中风风险.
- 对于状细胞疾病中中枢神经系统事件的夜间低氧血的预测价值需要进一步研究.
研究的目的:
- 测试这一假设:夜间低氧化是状细胞疾病中中枢神经系统事件的更好的预测因素,而不是临床特征,血液学标记或经多普勒发现.
- 评估一夜间氧气和和中枢神经系统事件的发生率之间的关联.
- 为了比较夜间低血的预测能力与动脉速度测量.
主要方法:
- 对95名患有状细胞病的住院患者 (平均年龄7.7岁) 进行了查,这些患者以前没有中风.
- 患者接受了间多普勒超声波和夜间脉冲氧计.
- 随访时间中位数为6.01年,以监测中枢神经系统事件.
主要成果:
- 19名患者经历了中枢神经系统事件,包括缺血性和出血性中风,过渡性缺血性发作和发作.
- 较低的夜间平均氧和度 (SaO2) 和更高的内动脉或中脑动脉速度独立地与中枢神经系统事件发生的时间有关.
- 高血红蛋白度也与中枢神经系统事件的风险增加相关,独立于SaO2和动脉速度.
结论:
- 夜间缺氧是状细胞疾病中中枢神经系统事件的重要预测因素.
- 查和管理夜间低氧症可能为预防中枢神经系统事件的初级预防提供预防性输血的安全有效替代方案.
- 阻塞性睡眠呼吸暂停指标没有预测中枢神经系统事件,而且腺切除术的影响仍然不确定.
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