Leite Ana Claudia Celestino Bezerra, de Oliveira Raquel Vasconcellos Carvalhaes, de Moura Patrícia Gomes, Silva Célia Maria, Lobo Clarisse
Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti - Hemorio, Rio de Janeiro, RJ, Brazil ; Instituto de Pesquisa Clínica Evandro Chagas - IPEC, Fundação Oswaldo Cruz - Fiocruz, Rio de Janeiro, RJ, Brazil.
Rev Bras Hematol Hemoter. 2012;34(4):307-10. doi: 10.5581/1516-8484.20120078.
Stroke is a potentially fatal complication of sickle cell disease in children between 2-16 years and transcranial Döppler has been recommended as a screening method in these cases.
The main goal of this study was to correlate transcranial Döppler results to complications related to stroke in sickle cell disease and baseline characteristics of the population.
This was an observational study of children and adolescents with ages between 2-16 years with sickle cell disease who were followed in three centers.
From January 2008 to July 2009, 902 patients were enrolled in this study. The median age was 6.5 years (range: 1.8-15.8), 52.3% were male, 74.4% had hemoglobin SS; 221 (28.6%) had at least one complication associated with sickle cell disease. A total of 773 patients performed transcranial Döppler; in 91.2% this was a method of screening. Conditional or abnormal transcranial Döppler results were more common in patients with sickle cell disease complications versus those without complications (ODDS ratio = 3.18; 95% Confidence interval = 1.92-5.27). There was a significant difference in the frequency of conditional or abnormal transcranial Döppler results in patients with abnormal laboratory results compared to those without abnormalities (OR=4.03); 95% confidence interval = 2.30-7.06.
Conditional or abnormal transcranial Döppler results were significantly more frequent in patients with complications of sickle cell disease confirming the increased risk of stroke in this subgroup of patients. This observation reinforces the recommendation of transcranial Döppler as a screening test for all patients with sickle cell disease with ages between 2 and 16 years.
中风是2至16岁镰状细胞病患儿潜在的致命并发症，经颅多普勒已被推荐作为这些病例的筛查方法。
本研究的主要目的是将经颅多普勒结果与镰状细胞病中风相关并发症及人群基线特征进行关联。
这是一项对2至16岁镰状细胞病儿童和青少年的观察性研究，在三个中心进行随访。
2008年1月至2009年7月，902例患者纳入本研究。中位年龄为6.5岁（范围：1.8 - 15.8岁），52.3%为男性，74.4%为血红蛋白SS型；221例（28.6%）至少有一种与镰状细胞病相关的并发症。共有773例患者进行了经颅多普勒检查；其中91.2%作为筛查方法。与无并发症的镰状细胞病患者相比，有并发症患者的经颅多普勒结果呈条件性或异常更为常见（优势比 = 3.18；95%置信区间 = 1.92 - 5.27）。与实验室结果正常的患者相比，实验室结果异常的患者经颅多普勒结果呈条件性或异常的频率有显著差异（OR = 4.03）；95%置信区间 = 2.30 - 7.06。
镰状细胞病并发症患者经颅多普勒结果呈条件性或异常的频率显著更高，证实该亚组患者中风风险增加。这一观察结果强化了将经颅多普勒作为所有2至16岁镰状细胞病患者筛查试验的建议。
