Quinn Charles T, Sargent James W
Center for Cancer and Blood Disorders, Children's Medical Center Dallas, Dallas, TX, USA.
Br J Haematol. 2008 Feb;140(3):336-9. doi: 10.1111/j.1365-2141.2007.06927.x. Epub 2007 Nov 27.
Haemoglobin (Hb) desaturation could increase the risk of stroke in sickle cell anaemia (SS) by perturbing endothelial function and limiting oxygen delivery to the brain. We performed a nested case-control study of the Dallas Newborn Cohort to determine whether daytime steady-state Hb desaturation was associated with overt stroke in children with SS. Cases had SS and overt ischaemic strokes. Controls had comparable genotypes but no overt stroke. Cases had lower prestroke steady-state pulse oximetry values (SpO(2)) than controls, and cases' SpO(2) fell even lower as the time to impending stroke decreased. The odds ratio for stroke was 1.32 for each 1% decrease in SpO(2). In conclusion, steady-state Hb desaturation is a risk factor for overt ischaemic stroke in children with SS. Decline in SpO(2) over time further increases this risk. Hb desaturation is easily measured, potentially modifiable, and could be used to identify children with SS at increased risk of stroke.
血红蛋白（Hb）饱和度降低可能通过扰乱内皮功能和限制大脑的氧气供应，增加镰状细胞贫血（SS）患者中风的风险。我们对达拉斯新生儿队列进行了一项巢式病例对照研究，以确定日间稳态Hb饱和度降低是否与SS患儿的显性中风有关。病例组为患有SS和显性缺血性中风的患儿。对照组具有相似的基因型，但无显性中风。病例组中风前的稳态脉搏血氧饱和度值（SpO₂）低于对照组，且随着即将发生中风的时间缩短，病例组的SpO₂降得更低。SpO₂每降低1%，中风的比值比为1.32。总之，稳态Hb饱和度降低是SS患儿显性缺血性中风的一个危险因素。随着时间推移SpO₂下降会进一步增加这种风险。Hb饱和度降低易于测量，可能具有可调节性，可用于识别中风风险增加的SS患儿。
