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对于患有镰状细胞贫血且尽管存在高胆红素血症但MRI或CT血管造影呈阴性的患者，用于检测“黄变症”的脑脊液分光光度法能否用于检测蛛网膜下腔动脉瘤渗漏？

Can CSF spectrophotometry for "Xanthochromia" be used to detect leaking subarachnoid aneurysms in patients with sickle cell anemia with negative MRI or CT angiogram despite hyperbilirubinemia?

作者信息

Siu Wan Yung, Thomas William, Trivedi Rikin, Hogan Alexandra, Siddiqi Umbareen, Sarker Anita, Besser Martin Wolfgang

机构信息

Department of Haematology Addenbrooke's Hospital Cambridge UK.

Department of Neurosurgery Addenbrooke's Hospital Cambridge UK.

出版信息

Clin Case Rep. 2020 Mar 12;8(5):894-899. doi: 10.1002/ccr3.2775. eCollection 2020 May.

DOI:10.1002/ccr3.2775
PMID:32477541
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7250967/
Abstract

CSF (Cerebrospinal Fluid) xanthochromia by spectroscopy should not be dismissed in the context of hyperbilirubinemia in a patient with sickle cell anemia. Xanthochromia detected by spectrophotometry offers a vital clue that further invasive diagnosis is required.

摘要

在镰状细胞贫血患者出现高胆红素血症的情况下，不应忽视通过光谱学检测脑脊液（CSF）黄变症。通过分光光度法检测到的黄变症提供了一个重要线索，表明需要进一步进行侵入性诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/587f065fa449/CCR3-8-894-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/0312272d33b7/CCR3-8-894-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/60491e0e84a4/CCR3-8-894-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/c259864431d5/CCR3-8-894-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/587f065fa449/CCR3-8-894-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/0312272d33b7/CCR3-8-894-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/60491e0e84a4/CCR3-8-894-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/c259864431d5/CCR3-8-894-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b13/7250967/587f065fa449/CCR3-8-894-g004.jpg

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1
Can CSF spectrophotometry for "Xanthochromia" be used to detect leaking subarachnoid aneurysms in patients with sickle cell anemia with negative MRI or CT angiogram despite hyperbilirubinemia?对于患有镰状细胞贫血且尽管存在高胆红素血症但MRI或CT血管造影呈阴性的患者，用于检测“黄变症”的脑脊液分光光度法能否用于检测蛛网膜下腔动脉瘤渗漏？
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Should spectrophotometry be used to identify xanthochromia in the cerebrospinal fluid of alert patients suspected of having subarachnoid hemorrhage?对于疑似蛛网膜下腔出血的清醒患者，是否应使用分光光度法来鉴定脑脊液中的黄变症？
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Spectrophotometry of cerebrospinal fluid for xanthochromia is a sensitive and specific test for subarachnoid bleeding but adds little to computed tomography.脑脊液的分光光度法检测黄变症对于蛛网膜下腔出血是一种敏感且特异的检查方法，但对计算机断层扫描的帮助不大。
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Xanthochromia after subarachnoid haemorrhage needs no revisitation.蛛网膜下腔出血后的黄变无需复查。
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本文引用的文献

1
Intracranial aneurysms in sickle cell disease: Aneurysms characteristics and modalities of endovascular approach to treat these patients.镰状细胞病中的颅内动脉瘤：动脉瘤特征和血管内治疗这些患者的方法。
J Neuroradiol. 2020 May;47(3):221-226. doi: 10.1016/j.neurad.2019.03.001. Epub 2019 Mar 20.
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Screening for intracranial aneurysms in autosomal dominant polycystic kidney disease is cost-effective.在常染色体显性多囊肾病中筛查颅内动脉瘤具有成本效益。
Kidney Int. 2018 Mar;93(3):716-726. doi: 10.1016/j.kint.2017.08.016. Epub 2017 Oct 20.
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Guidelines on red cell transfusion in sickle cell disease. Part I: principles and laboratory aspects.
镰状细胞病红细胞输血指南。第一部分：原则与实验室方面。
Br J Haematol. 2017 Jan;176(2):179-191. doi: 10.1111/bjh.14346. Epub 2016 Nov 7.
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Unruptured intracranial aneurysms in children with sickle cell disease: analysis of 18 aneurysms in 5 patients.镰状细胞病患儿的未破裂颅内动脉瘤：5例患者18个动脉瘤的分析
Neurosurgery. 2015 May;76(5):531-8; discission 538-9; quiz 539. doi: 10.1227/NEU.0000000000000670.
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Likelihood of aneurysmal subarachnoid haemorrhage in patients with normal unenhanced CT, CSF xanthochromia on spectrophotometry and negative CT angiography.未增强CT正常、分光光度法检测脑脊液黄变且CT血管造影阴性的患者发生动脉瘤性蛛网膜下腔出血的可能性
J R Coll Physicians Edinb. 2013;43(3):200-6. doi: 10.4997/JRCPE.2013.303.
6
Extended follow-up of unruptured intracranial aneurysms detected by presymptomatic screening in patients with autosomal dominant polycystic kidney disease.常染色体显性多囊肾病患者无症状筛查检出未破裂颅内动脉瘤的随访研究。
Clin J Am Soc Nephrol. 2011 Jun;6(6):1274-85. doi: 10.2215/CJN.09731110. Epub 2011 May 5.
7
Cranial involvement in sickle cell disease.镰状细胞病的颅部表现。
Eur J Radiol. 2010 Nov;76(2):151-6. doi: 10.1016/j.ejrad.2009.05.032. Epub 2009 Jun 11.
8
CSF spectrophotometry for bilirubin--why and how?脑脊液胆红素分光光度法——为何及如何进行？
Scand J Clin Lab Invest. 2009;69(1):1-7. doi: 10.1080/00365510802651866.
9
Intracranial aneurysms in sickle cell patients: report of 2 cases and review of the literature.镰状细胞病患者的颅内动脉瘤：2例报告并文献复习
Surg Neurol. 2009 Sep;72(3):296-9; discussion 299. doi: 10.1016/j.surneu.2008.03.044. Epub 2008 Jul 9.
10
Revised national guidelines for analysis of cerebrospinal fluid for bilirubin in suspected subarachnoid haemorrhage.疑似蛛网膜下腔出血时脑脊液胆红素分析的修订国家指南。
Ann Clin Biochem. 2008 May;45(Pt 3):238-44. doi: 10.1258/acb.2008.007257.