Grady Anthony J, Hankins Jane S, Haberman Brent, Schoumacher Robert, Stocks Rose Mary
Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 420, Memphis, TN, 38163, USA.
Department of Hematology, St. Jude Children's Research Hospital, 262 Danny Thomas place, Memphis, TN, 38105, USA.
Sleep Breath. 2017 Sep;21(3):697-701. doi: 10.1007/s11325-017-1458-9. Epub 2017 Jan 11.
While hydroxyurea is the mainstay of treatment for many of the comorbidities associated with sickle cell disease, its effect on obstructive sleep apnea has not been fully investigated. The purpose of this project is to help characterize the effects of hydroxyurea on obstructive sleep apnea in children with sickle cell disease and determine its therapeutic role in the condition.
Chart review was conducted on two pediatric patients with sickle cell disease who experienced resolution of obstructive sleep apnea following hydroxyurea administration.
After undergoing approximately 11 months of hydroxyurea therapy, sleep apnea symptoms improved and obstructive sleep apnea resolution was confirmed by repeat polysomnography in both cases. This resolution was largely secondary to a reduction in the obstructive component of the apnea hypopnea index, highlighting a previously unreported association.
As adenotonsillectomy is associated with significant risks in patients with sickle cell disease, it appears reasonable to consider a period of observation for improvement of obstructive sleep apnea following hydroxyurea administration rather than directly proceeding with surgery.
虽然羟基脲是治疗镰状细胞病相关多种合并症的主要药物，但其对阻塞性睡眠呼吸暂停的影响尚未得到充分研究。本项目的目的是帮助明确羟基脲对镰状细胞病患儿阻塞性睡眠呼吸暂停的影响，并确定其在该病中的治疗作用。
对两名镰状细胞病儿科患者进行病历回顾，这两名患者在服用羟基脲后阻塞性睡眠呼吸暂停症状得到缓解。
在接受约11个月的羟基脲治疗后，两名患者的睡眠呼吸暂停症状均有改善，重复多导睡眠图检查证实阻塞性睡眠呼吸暂停得到缓解。这种缓解主要是由于呼吸暂停低通气指数的阻塞成分降低，这突出了一种此前未报道的关联。
由于腺样体扁桃体切除术在镰状细胞病患者中存在重大风险，在服用羟基脲后观察一段时间以改善阻塞性睡眠呼吸暂停，而不是直接进行手术，似乎是合理的。
