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镰状细胞病患者肺功能与心肌酶之间的关联

Association between pulmonary function and cardiac enzymes in sickle cell disease.

作者信息

Antwi-Boasiako Charles, Asare Michael M, Baba Ibrahim, Doku Alfred, Adutwum-Ofosu Kevin, Hayfron-Benjamin Charles, Asare Chamila P, Aryee Robert, Dankwah Gifty Boatemaah, Ahenkorah John

机构信息

Department of Physiology, University of Ghana Medical School, University of Ghana Accra, Ghana.

Department of Anaesthesia, 37 Military Hospital Accra, Ghana.

出版信息

Am J Blood Res. 2021 Apr 15;11(2):199-205. eCollection 2021.

Abstract

BACKGROUND

There is scarcity of data on association between lung function and cardiac markers in patients with sickle cell disease (SCD). Meanwhile, SCD affects multi-organs in any one population. There seem to be an association between reduced pulmonary function with cardiac dysfunction. The current study examined the association between pulomanry function with cardiac markers in patients with SCD.

METHODOLOGY

This was a cross-sectional study with cases and controls. The cases (n=117) were made up of patients with SCD. The control subjects (n=58) were voluntary blood donors without SCD. The cellulose acetate electrophoresis was used to determine the genotypes of the study subjects. Blood samples were collected from all the study subjects for full blood count and measurement of cardiac enzymes. The cardiac enzymes measured were lactate dehydrogenase (LDH) and creatine kinase-myocardial band (CK-MB). Lung function test, using the vitalograph was done on all the study subjects. The Global Lung Initiative criteria were used to categorize lung disease as obstruction, restriction, mixed obstruction/restriction and normal.

RESULTS

The prevalence of elevated CK-MB and LDH among the SCD patients was 76.92% and 9.40% respectively, higher than the non-SCD controls (51.72% and 0% for elevated CK-MB and LDH respectively). Of all the impaired lung function, lung restriction was prevalent in all the study groups (30.77% and 15.52% for SCD patients and non-SCD controls respectively). In the fully adjusted model, reduced FEV1 was associated with nearly 3.5-fold higher odds of elevated CK-MB (odds ratio 3.35, 95% CI 1.26-8.90, -value 0.015) in individuals with SCD.

CONCLUSION

Reduced FEV which reflects airflow impairments are associated with CK-MB elevations in patients with SCD, suggesting a possible damage to the cardiomyocytes.

摘要

背景

关于镰状细胞病(SCD)患者肺功能与心脏标志物之间关联的数据稀缺。同时,SCD会影响任何一个人群中的多个器官。肺功能降低与心脏功能障碍之间似乎存在关联。本研究调查了SCD患者肺功能与心脏标志物之间的关联。

方法

这是一项病例对照横断面研究。病例组(n = 117)由SCD患者组成。对照组(n = 58)为无SCD的自愿献血者。采用醋酸纤维素电泳确定研究对象的基因型。采集所有研究对象的血样进行全血细胞计数和心脏酶检测。检测的心脏酶为乳酸脱氢酶(LDH)和肌酸激酶同工酶(CK-MB)。对所有研究对象使用肺活量计进行肺功能测试。采用全球肺部倡议标准将肺部疾病分为阻塞性、限制性、混合性阻塞/限制性和正常。

结果

SCD患者中CK-MB和LDH升高的患病率分别为76.92%和9.40%,高于非SCD对照组(CK-MB和LDH升高分别为51.72%和0%)。在所有肺功能受损情况中,肺限制性在所有研究组中都很普遍(SCD患者和非SCD对照组分别为30.77%和15.52%)。在完全调整模型中,SCD个体中FEV1降低与CK-MB升高的几率高近3.5倍相关(比值比3.35,95%可信区间1.26 - 8.90,P值0.015)。

结论

反映气流受损的FEV降低与SCD患者的CK-MB升高相关,提示可能存在心肌细胞损伤。

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Recent Advances in the Treatment of Sickle Cell Disease.镰状细胞病治疗的最新进展
Front Physiol. 2020 May 20;11:435. doi: 10.3389/fphys.2020.00435. eCollection 2020.
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Lung function and cardiovascular disease: A link.肺功能与心血管病:关联。
Trends Cardiovasc Med. 2021 Feb;31(2):93-98. doi: 10.1016/j.tcm.2019.12.009. Epub 2020 Jan 3.
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Ochsner J. 2018 Winter;18(4):377-389. doi: 10.31486/toj.18.0076.
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