口服地塞米松递减疗法治疗镰状细胞病的急性胸部综合征。
Tapered oral dexamethasone for the acute chest syndrome of sickle cell disease.
机构信息
Cincinnati Children's Hospital Medical Center, Hematology/Oncology, Cincinnati, OH 45220, USA.
出版信息
Br J Haematol. 2011 Oct;155(2):263-7. doi: 10.1111/j.1365-2141.2011.08827.x. Epub 2011 Aug 16.
Abstract
Tapered oral dexamethasone for acute chest syndrome (ACS) in sickle cell anaemia was studied using a novel ACS assessment tool and investigational biomarkers. Twelve participants were randomized (mean age 17·3 years) before early study termination. Dexamethasone decreased duration of hospitalization for ACS by 20·8 h compared to placebo (P = 0·024). Rebound pain occurred in both groups (3 dexamethasone versus 1 placebo). Overall, dexamethasone decreased the leucocyte activation biomarker, sL-selectin; however, participants with rebound pain had higher sL-selectin within 24 h of treatment (dexamethasone or placebo). This ACS assessment tool was feasibly applied, and sL-selectin is a promising biomarker of ACS therapy.
摘要
在镰状细胞贫血症的急性胸部综合征（ACS）中，使用新型 ACS 评估工具和研究性生物标志物来研究锥形口服地塞米松。在早期研究结束前，对 12 名参与者进行了随机分组（平均年龄 17.3 岁）。与安慰剂相比，地塞米松使 ACS 的住院时间缩短了 20.8 小时（P = 0.024）。两组均出现反弹疼痛（3 例地塞米松与 1 例安慰剂）。总体而言，地塞米松降低了白细胞活化生物标志物 sL-选择素；然而，在治疗后 24 小时内，出现反弹疼痛的参与者的 sL-选择素水平更高（地塞米松或安慰剂）。该 ACS 评估工具具有可行性，并且 sL-选择素是 ACS 治疗的有前途的生物标志物。
相似文献
1
Tapered oral dexamethasone for the acute chest syndrome of sickle cell disease.口服地塞米松递减疗法治疗镰状细胞病的急性胸部综合征。
Br J Haematol. 2011 Oct;155(2):263-7. doi: 10.1111/j.1365-2141.2011.08827.x. Epub 2011 Aug 16.
2
3
Inhaled nitric oxide for acute chest syndrome in adult sickle cell patients: a randomized controlled study.吸入一氧化氮治疗成人镰状细胞病急性胸部综合征：一项随机对照研究。
Intensive Care Med. 2015 Dec;41(12):2121-9. doi: 10.1007/s00134-015-4060-2. Epub 2015 Oct 2.
4
Factors predicting future ACS episodes in children with sickle cell anemia.预测镰状细胞贫血患儿未来急性冠状动脉综合征发作的因素。
Am J Hematol. 2014 Nov;89(11):E212-7. doi: 10.1002/ajh.23819. Epub 2014 Aug 27.
5
Inpatient management of sickle cell pain: a 'snapshot' of current practice.镰状细胞疼痛的住院管理：当前实践的“快照”。
Am J Hematol. 2012 Mar;87(3):333-6. doi: 10.1002/ajh.22265. Epub 2012 Jan 9.
6
Successful Treatment of Acute Chest Syndrome with Manual Exchange Transfusion in a Patient with Sickle Beta-thalassemia.手动换血成功治疗镰状β地中海贫血患者的急性胸部综合征
Intern Med. 2019 Jun 1;58(11):1629-1634. doi: 10.2169/internalmedicine.1753-18. Epub 2019 Feb 1.
7
COVID-19 pneumonia as a cause of acute chest syndrome in an adult sickle cell patient.新冠病毒肺炎作为一名成年镰状细胞病患者急性胸综合征的病因
Am J Hematol. 2020 Jul;95(7):E154-E156. doi: 10.1002/ajh.25809. Epub 2020 Apr 21.
8
Evaluation of the relationship between intravascular hemolysis and clinical manifestations in sickle cell disease: decreased hemopexin during vaso-occlusive crises and increased inflammation in acute chest syndrome.镰状细胞病血管内溶血与临床表现之间关系的评估：血管闭塞性危象期间血红素结合蛋白降低及急性胸综合征时炎症增加。
Ann Hematol. 2022 Jan;101(1):35-41. doi: 10.1007/s00277-021-04667-w. Epub 2021 Sep 25.
9
Adjunctive therapy with inhaled nitric oxide for severe acute chest syndrome in patients with sickle cell disease.吸入一氧化氮辅助治疗镰状细胞病患者的严重急性胸部综合征。
Intensive Care Med. 2015 Dec;41(12):2213-5. doi: 10.1007/s00134-015-4084-7. Epub 2015 Oct 2.
10
A short course of prednisone in the management of acute chest syndrome of sickle cell disease.小剂量泼尼松治疗镰状细胞病急性胸部综合征
J Pediatr Hematol Oncol. 2010 Apr;32(3):e91-4. doi: 10.1097/MPH.0b013e3181c29c52.
引用本文的文献
1
Guidelines for the management of emergencies and critical illness in pediatric and adult patients with sickle cell disease.镰状细胞病儿童及成人患者的急诊与危重症管理指南
Ann Intensive Care. 2025 May 29;15(1):74. doi: 10.1186/s13613-025-01479-3.
2
Systemic Steroids and the Risk of Vasoocclusive Events in Patients with Sickle Cell Disease.全身性类固醇与镰状细胞病患者血管闭塞性事件的风险
Ann Am Thorac Soc. 2023 Jan;20(1):18-20. doi: 10.1513/AnnalsATS.202207-627PS.
3
Effects of corticosteroids in patients with sickle cell disease and acute complications: a systematic review and meta-analysis.镰状细胞病合并急性并发症患者使用皮质类固醇的效果：系统评价和荟萃分析。
Haematologica. 2022 Aug 1;107(8):1914-1921. doi: 10.3324/haematol.2021.280105.
4
How we approach thrombosis risk in children with COVID-19 infection and MIS-C.我们如何应对新冠病毒感染和儿童多系统炎症综合征患儿的血栓形成风险。
Pediatr Blood Cancer. 2021 Jul;68(7):e29049. doi: 10.1002/pbc.29049. Epub 2021 May 6.
5
End points for sickle cell disease clinical trials: renal and cardiopulmonary, cure, and low-resource settings.镰状细胞病临床试验的终点：肾脏和心肺、治愈和资源匮乏环境。
Blood Adv. 2019 Dec 10;3(23):4002-4020. doi: 10.1182/bloodadvances.2019000883.
6
Identifying Clinical and Research Priorities in Sickle Cell Lung Disease. An Official American Thoracic Society Workshop Report.确定镰状细胞肺病的临床和研究重点。美国胸科学会官方研讨会报告。
Ann Am Thorac Soc. 2019 Sep;16(9):e17-e32. doi: 10.1513/AnnalsATS.201906-433ST.
7
Advances in new drug therapies for the management of sickle cell disease.镰状细胞病治疗新药疗法的进展。
Expert Opin Orphan Drugs. 2018;6(5):329-343. doi: 10.1080/21678707.2018.1471983. Epub 2018 May 14.
8
Therapeutic strategies for sickle cell disease: towards a multi-agent approach.镰状细胞病的治疗策略：迈向多药物联合治疗方法。
Nat Rev Drug Discov. 2019 Feb;18(2):139-158. doi: 10.1038/s41573-018-0003-2.
9
The corticosteroid compounds prednisolone and vamorolone do not alter the nociception phenotype and exacerbate liver injury in sickle cell mice.皮质类固醇化合物泼尼松龙和万莫罗龙不会改变镰状细胞小鼠的痛觉表型，并加重肝损伤。
Sci Rep. 2018 Apr 17;8(1):6081. doi: 10.1038/s41598-018-24274-6.
10
Recurrent Acute Chest Syndrome in Pediatric Sickle Cell Disease: Clinical Features and Risk Factors.小儿镰状细胞病复发性急性胸部综合征：临床特征与危险因素
J Pediatr Hematol Oncol. 2018 Jan;40(1):51-55. doi: 10.1097/MPH.0000000000001012.
本文引用的文献
1
A short course of prednisone in the management of acute chest syndrome of sickle cell disease.小剂量泼尼松治疗镰状细胞病急性胸部综合征
J Pediatr Hematol Oncol. 2010 Apr;32(3):e91-4. doi: 10.1097/MPH.0b013e3181c29c52.
2
Increased levels of the inflammatory biomarker C-reactive protein at baseline are associated with childhood sickle cell vasocclusive crises.基线时炎症生物标志物 C 反应蛋白水平升高与儿童镰状细胞血管阻塞性危象有关。
Br J Haematol. 2010 Mar;148(5):797-804. doi: 10.1111/j.1365-2141.2009.08013.x. Epub 2009 Dec 8.
3
A recommitment to sickle cell disease research.对镰状细胞病研究的再次承诺。
Blood. 2008 May 15;111(10):4852-3. doi: 10.1182/blood-2008-03-143685.
4
A single-institution experience with treatment of severe acute chest syndrome: lack of rebound pain with dexamethasone plus transfusion therapy.单机构治疗重症急性胸部综合征的经验：地塞米松加输血疗法无反跳痛。
J Pediatr Hematol Oncol. 2008 Apr;30(4):322-5. doi: 10.1097/MPH.0b013e3181647bb2.
5
Increased von Willebrand factor antigen and high molecular weight multimers in sickle cell disease associated with nocturnal hypoxemia.与夜间低氧血症相关的镰状细胞病中血管性血友病因子抗原及高分子量多聚体增加。
Thromb Res. 2008;122(4):455-8. doi: 10.1016/j.thromres.2007.12.004. Epub 2008 Jan 29.
6
The intriguing contribution of white blood cells to sickle cell disease - a red cell disorder.白细胞对镰状细胞病（一种红细胞疾病）的有趣贡献。
Blood Rev. 2004 Mar;18(1):65-73. doi: 10.1016/s0268-960x(03)00037-7.
7
Hypoxaemia in sickle cell disease: biomarker modulation and relevance to pathophysiology.镰状细胞病中的低氧血症：生物标志物调节及其与病理生理学的相关性。
Lancet. 2003 Nov 1;362(9394):1450-5. doi: 10.1016/S0140-6736(03)14689-2.
8
Sickle cell acute chest syndrome: pathogenesis and rationale for treatment.镰状细胞急性胸综合征：发病机制与治疗原理
Blood. 1999 Sep 1;94(5):1555-60.
9
10
Whole blood tissue factor procoagulant activity is elevated in patients with sickle cell disease.镰状细胞病患者的全血组织因子促凝活性升高。
Blood. 1998 Jun 1;91(11):4216-23.
Zotero 插件