成人镰状细胞病的经颅多普勒超声检查
Transcranial Doppler ultrasonography in adults with sickle cell disease.
作者信息
Valadi N, Silva G S, Bowman L S, Ramsingh D, Vicari P, Filho A C, Massaro A R, Kutlar A, Nichols F T, Adams R J
机构信息
Department of Neurology, Medical College of Georgia, 1429 Harper St., HF 1154, Augusta, GA 30912, USA.
出版信息
Neurology. 2006 Aug 22;67(4):572-4. doi: 10.1212/01.wnl.0000230150.39429.8e.
BACKGROUND
Transcranial Doppler (TCD) is used to select children with sickle cell disease (SCD) for primary stroke prevention using regular blood transfusion. Whether it can also identify high stroke risk in adults with SCD is not known.
METHODS
The authors examined 112 adult patients from two convenience population samples with SCD and 53 healthy control subjects to compare velocities in adults to those reported in children with SCD and to evaluate the influence of age and hematocrit on TCD.
RESULTS
Adults with SCD had a higher mean time-averaged maximum mean velocity (110.9 +/- 25.7 cm/s) compared with healthy controls (71.1 +/- 12.0 cm/s), and the difference is approximately proportional to their anemia. No cases with velocities >/=200 cm/s (the threshold used in children for prophylactic treatment) were found in this sample.
CONCLUSIONS
Transcranial Doppler velocities in adults with sickle cell disease (SCD) are lower than those in children with SCD. Velocity criteria used in children cannot be used to stratify risk of stroke in adults.
背景
经颅多普勒（TCD）用于筛选镰状细胞病（SCD）患儿，以便通过定期输血进行原发性卒中预防。目前尚不清楚它是否也能识别SCD成人患者的高卒中风险。
方法
作者检查了来自两个便利人群样本的112例SCD成年患者和53名健康对照者，以比较成人与SCD患儿的血流速度，并评估年龄和血细胞比容对TCD的影响。
结果
与健康对照者（71.1±12.0 cm/s）相比，SCD成年患者的平均时间平均最大平均速度更高（110.9±25.7 cm/s），且差异与他们的贫血程度大致成正比。在该样本中未发现血流速度≥200 cm/s（儿童预防性治疗的阈值）的病例。
结论
镰状细胞病（SCD）成年患者的经颅多普勒血流速度低于SCD患儿。儿童使用的速度标准不能用于对成人卒中风险进行分层。
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