el-Hazmi M A, Bahakim H M, Babikar M A, al-Swailem A M, Warsy A S
College of Medicine & King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia.
J Trop Pediatr. 1990 Apr;36(2):56-62. doi: 10.1093/tropej/36.2.56.
To investigate the combined effect of pneumococcal vaccination and penicillin prophylaxis on the progress of sickle cell disease, two groups of sickle cell disease patients, presenting with severe clinical manifestations of the disease were selected as cohorts. One group was vaccinated with the polyvalent pneumococcal vaccine and given penicillin prophylaxis, while the other group was not given the vaccine and penicillin. Clinical manifestations, frequency of hospitalization, crises and blood transfusion requirements, haematological parameters, and differential counts were recorded for each patient in the two groups. The 'severity index' of the sickle cell disease was calculated for each patient. No significant differences were encountered in the values of the haematological parameters except for the white cell count which was significantly higher in the non-vaccinated group. However, the frequency of hospitalization, crisis, and blood transfusion were significantly higher in the non-vaccinated group compared to the vaccinated group. Clinical symptoms frequently associated with severe sickle cell disease, were also encountered at a higher frequency in the non-vaccinated group. These results show that pneumococcal vaccination and penicillin prophylaxis increase the crisis-free interval in sickle cell disease patients, and play a significant role in decreasing the morbidity associated with sickle cell disease.
为了研究肺炎球菌疫苗接种和青霉素预防对镰状细胞病进展的联合作用，选择了两组患有该疾病严重临床表现的镰状细胞病患者作为队列。一组接种多价肺炎球菌疫苗并给予青霉素预防，而另一组未接种疫苗和未使用青霉素。记录两组中每位患者的临床表现、住院频率、危象和输血需求、血液学参数以及分类计数。计算每位患者镰状细胞病的“严重程度指数”。除未接种疫苗组的白细胞计数显著较高外，血液学参数值未发现显著差异。然而，与接种疫苗组相比，未接种疫苗组的住院、危象和输血频率显著更高。未接种疫苗组中与严重镰状细胞病经常相关的临床症状出现频率也更高。这些结果表明，肺炎球菌疫苗接种和青霉素预防可增加镰状细胞病患者的无危象间隔，并在降低与镰状细胞病相关的发病率方面发挥重要作用。
