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沙特阿拉伯西部地区一家大型三级医疗中心儿科镰状细胞贫血患者心血管表现的患病率

The Prevalence of Cardiovascular Manifestations in Pediatric Sickle Cell Anemia Patients in a Large Tertiary Care Hospital in the Western Region of Saudi Arabia.

作者信息

Waggass Rahaf, Alhindi Abeer K, Bagabas Inas S, Alsaegh Mawaddah H, Alsharef Noor K, Morya Roaa E, Khan Muhammad A, Jastaniah Wasil

机构信息

Pediatric Cardiology, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.

Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, SAU.

出版信息

Cureus. 2023 Mar 4;15(3):e35751. doi: 10.7759/cureus.35751. eCollection 2023 Mar.

Abstract

Background Sickle cell disease (SCD) is a common hematological disorder with a high prevalence in Saudi Arabia. Despite that, limited studies are available in our region regarding cardiovascular complications. Objectives The objective of the current study was to estimate the prevalence of cardiovascular complications among children with SCD. Design This was a cross-sectional study. Setting The study took place at a single tertiary-care center in Jeddah, Saudi Arabia. Materials and methods The study reviewed 126 electronic records of pediatric patients up to 16 years old diagnosed with SCD between January 2008 and December 2019 in King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Of these, 54 patients had a previous echocardiogram evaluation and were eligible for the study. Main outcomes measures The study identified cardiovascular complications in pediatric sickle cell patients. Sample size The study included a total of 54 pediatric sickle cell patients. Results The mean age was 11.9 (3.48) years, the male-to-female ratio was 2:1, the majority (94.4%) had the HbSS-HbSβ0 genotype, the mean baseline hemoglobin F (fetal hemoglobin) was 20.30 (9.03%), and the clinical severity score was severe in 19 (35.2%) and mild/moderate in 35 (64.8%) patients. Cardiovascular complications occurred in 32 (59.3%) patients. Increased systolic blood pressure was detected in 10 (18.5%) patients. Echocardiography showed left ventricular dilatation in nine (16.7%) patients, tricuspid valve insufficiency in six (11.1%) patients, mitral valve insufficiency in four (7.4%) patients, hyperdynamic left ventricle in one (1.9%) patient, and pulmonary hypertension in one (1.9%) patient. Long QTc interval was noticed in three (5.6%) and cardiomegaly was detected in 18 (33.3%) patients. Conclusion Cardiovascular complications occurred at a high frequency in our pediatric population despite high baseline hemoglobin F levels. Early evaluation and continuous monitoring are important for early intervention.

摘要

背景

镰状细胞病(SCD)是一种常见的血液系统疾病,在沙特阿拉伯患病率很高。尽管如此,我们地区关于心血管并发症的研究有限。

目的

本研究的目的是评估SCD患儿心血管并发症的患病率。

设计

这是一项横断面研究。

地点

研究在沙特阿拉伯吉达的一家三级医疗中心进行。

材料和方法

该研究回顾了2008年1月至2019年12月期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王医疗城(KAMC)诊断为SCD的16岁以下儿科患者的126份电子记录。其中,54例患者曾接受过超声心动图评估,符合研究条件。

主要结局指标

该研究确定了小儿镰状细胞病患者的心血管并发症。

样本量

该研究共纳入54例小儿镰状细胞病患者。

结果

平均年龄为11.9(3.48)岁,男女比例为2:1,大多数(94.4%)具有HbSS-HbSβ0基因型,平均基线血红蛋白F(胎儿血红蛋白)为20.30(9.03%),19例(35.2%)患者临床严重程度评分为重度,35例(64.8%)患者为轻度/中度。32例(59.3%)患者发生心血管并发症。10例(18.5%)患者检测到收缩压升高。超声心动图显示9例(16.7%)患者左心室扩张,6例(11.1%)患者三尖瓣关闭不全,4例(7.4%)患者二尖瓣关闭不全,1例(1.9%)患者左心室高动力,1例(1.9%)患者肺动脉高压。3例(5.6%)患者出现长QTc间期,18例(33.3%)患者检测到心脏扩大。

结论

尽管基线血红蛋白F水平较高,但我们的儿科人群中心血管并发症的发生率仍然很高。早期评估和持续监测对于早期干预很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27ba/10069165/9062cd0a070f/cureus-0015-00000035751-i01.jpg

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