Marshall Melanie J, Bucks Romola S, Hogan Alexandra M, Hambleton Ian R, Height Susan E, Dick Moira C, Kirkham Fenella J, Rees David C
Neurosciences Unit, UCL Institute of Child Health, The Wolfson Centre, London, UK.
Haematologica. 2009 Jul;94(7):1006-10. doi: 10.3324/haematol.2008.005215.
Low nocturnal oxygen saturation (SpO(2)) is implicated in complications of Sickle Cell Anemia (SCA). Twenty-four children with SCA were randomized to receive overnight auto-adjusting continuous positive airway pressure (auto-CPAP) with supplemental oxygen, if required, to maintain SpO(2) >or=94% or as controls. We assessed adherence, safety, sleep parameters, cognition and pain. Twelve participants randomized to auto-CPAP (3 with oxygen) showed improvement in Apnea/Hypopnea Index (p<0.001), average desaturation events >3%/hour (p=0.02), mean nocturnal SpO(2) (p=0.02) and cognition. Primary efficacy endpoint (Processing Speed Index) showed no group differences (p=0.67), but a second measure of processing speed and attention (Cancellation) improved in those receiving treatment (p=0.01). No bone marrow suppression, rebound pain or serious adverse event resulting from auto-CPAP use was observed. Six weeks of auto-CPAP therapy is feasible and safe in children with SCA, significantly improving sleep-related breathing disorders and at least one aspect of cognition.
夜间低氧饱和度（SpO₂）与镰状细胞贫血（SCA）的并发症有关。24名SCA患儿被随机分组，若有需要，一组接受夜间自动调节持续气道正压通气（自动CPAP）并补充氧气以维持SpO₂≥94%，另一组作为对照组。我们评估了依从性、安全性、睡眠参数、认知能力和疼痛情况。随机接受自动CPAP治疗的12名参与者（3名补充氧气）在呼吸暂停/低通气指数（p<0.001）、平均每小时血氧饱和度下降超过3%的事件（p=0.02）、夜间平均SpO₂（p=0.02）及认知能力方面均有改善。主要疗效终点（处理速度指数）无组间差异（p=0.67），但接受治疗者的另一项处理速度和注意力指标（划消试验）有所改善（p=0.01）。未观察到因使用自动CPAP导致的骨髓抑制、反跳痛或严重不良事件。对于SCA患儿，六周的自动CPAP治疗是可行且安全的，可显著改善与睡眠相关的呼吸障碍以及认知能力的至少一个方面。
