Lagunju I A, Brown B J, Sodeinde O O
Department of Paediatrics College of Medicine, University of Ibadan, Ibadan, Nigeria.
Niger Postgrad Med J. 2013 Sep;20(3):181-7.
To compare the outcome after a first clinical stroke, following treatment with and without hydroxyurea (HU).
A retrospective review of a cohort of Nigerian children with SCD, who had suffered a first stroke, was carried out. Outcomes in the group of children who received and did not receive HU were compared.
Thirty two children presented with stroke and one died of haemorrhagic stroke at presentation. All the children had haemoglobin SS phenotype, and ischaemic stroke was the predominant form seen. Mean age at first clinical stroke was 7 years, 7 months (SD=2 years, 4 months). Thirteen children received HU while 18 declined HU therapy. Maximum dose of HU ranged from 20-25 mg/kg/ day. The secondary stroke incidence of 7/100 person years in the HU group was significantly lower than the 28/100 person years in the non-HU group (P=0.001, OR 3.808, 95% CI 1.556, 9.317). Children who did not receive HU were more likely to drop out of school and to have moderate-severe motor disabilities requiring caregiver assistance for daily living.
In settings where facilities for chronic blood transfusion are not accessible or feasible, HU therapy should be considered for secondary stroke prevention in children with SCD.
比较首次临床中风后接受羟基脲（HU）治疗和未接受HU治疗的结果。
对一组首次中风的尼日利亚镰状细胞病患儿进行回顾性研究。比较接受和未接受HU治疗的儿童组的结果。
32名儿童出现中风，1名在就诊时死于出血性中风。所有儿童均为血红蛋白SS表型，缺血性中风是主要类型。首次临床中风的平均年龄为7岁7个月（标准差=2岁4个月）。13名儿童接受了HU治疗，18名拒绝了HU治疗。HU的最大剂量范围为20 - 25毫克/千克/天。HU组的继发性中风发病率为7/100人年，显著低于非HU组的28/100人年（P = 0.001，比值比3.808，95%置信区间1.556，9.317）。未接受HU治疗的儿童更有可能辍学，并且有中度至重度运动障碍，日常生活需要照顾者协助。
在无法获得或不可行慢性输血设施的情况下，应考虑对镰状细胞病患儿进行HU治疗以预防继发性中风。
