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镰状细胞病。

Sickle Cell Disease.

机构信息

Johns Hopkins University School of Medicine, Baltimore, Maryland (L.H.P., S.L.).

出版信息

Ann Intern Med. 2021 Jan;174(1):ITC1-ITC16. doi: 10.7326/AITC202101190. Epub 2021 Jan 12.

Abstract

Sickle cell disease is an umbrella term for a group of hemoglobinopathies characterized by the presence of 2 β-globin gene mutations or deletions, at least 1 of which is the point mutation that leads to the production of hemoglobin S. Sickle cell disease is associated with hemolytic anemia, significant chronic end-organ damage, and early death. In high-income countries, at least 95% of children with the disease survive into adulthood, resulting in a growing population of affected adults with significant comorbidities, complex medical issues, and not enough specialists to provide care. Hydroxyurea is the primary therapy, and recent advances in understanding disease pathophysiology have led to new therapies; progress in bone marrow transplant and gene editing has resulted in cure in some patients. The purpose of this review is to provide an overview of the diagnosis, common acute and chronic clinical manifestations, and best practices for management of sickle cell disease.

摘要

镰状细胞病是一组血红蛋白病的总称,其特征为存在 2 个β-珠蛋白基因突变或缺失,至少有 1 种是导致血红蛋白 S 产生的点突变。镰状细胞病与溶血性贫血、严重的慢性终末器官损伤和早逝有关。在高收入国家,至少 95%的患病儿童能存活至成年,导致越来越多的成年患者出现严重的合并症、复杂的医疗问题,并且没有足够的专家来提供护理。羟基脲是主要的治疗方法,而对疾病病理生理学的理解的最新进展导致了新的治疗方法;骨髓移植和基因编辑的进展使一些患者得到治愈。本综述的目的是提供镰状细胞病的诊断、常见急性和慢性临床表现以及最佳管理实践的概述。

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