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伊马替尼对降低镰状细胞病患者疼痛危象的影响。

Impact of Imatinib on reducing the painful crisis in patients with sickle cell disease.

作者信息

Karimi Mojtaba, Bahadoram Mohammad, Mafakher Ladan, Rastegar Mohammadhossein

机构信息

Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Hematol Transfus Cell Ther. 2024 Oct-Dec;46(4):387-392. doi: 10.1016/j.htct.2023.06.007. Epub 2023 Aug 10.

Abstract

INTRODUCTION

Sickle cell disease (SCD) is a common hemoglobinopathy worldwide that causes painful crises and hospitalization of patients. These attacks decrease survival and cause chronic end-organ damage in these patients.

HYPOTHESIS

For this reason, finding new treatment approaches could be helpful.

METHOD

In this study, Imatinib was applied as a mast cell inhibitor to reduce pain crises in these patients. Seven patients resistant to hydroxyurea and folic acid treatment and who had at least four painful crises per year with hospitalization were enrolled in this study with treatment with Imatinib (100 mg, twice daily). Subsequently, the number and duration of hospitalizations, analgesic requirement, the severity of chronic pain, and changes in the hematological parameters of these patients were evaluated before and after the treatment.

RESULTS

The data showed that the total number of hospitalizations and the entire duration of hospitalizations were reduced 16 times after treatment with Imatinib, without apparent changes in hematological parameters. Also, the demand for pethidine, tramadol, and nonsteroidal anti-inflammatory drugs (NSAIDs) was reduced in all patients. The average reduction in chronic pain was over 70%.

CONCLUSION

This study demonstrates that treatment with Imatinib in patients with SCD or sickle cell anemia (SCA) may be a suitable therapeutic option for reducing painful crises.

摘要

引言

镰状细胞病(SCD)是一种全球常见的血红蛋白病,可导致患者出现疼痛性危象并住院治疗。这些发作会降低患者的生存率,并导致慢性终末器官损害。

假设

因此,寻找新的治疗方法可能会有所帮助。

方法

在本研究中,伊马替尼作为肥大细胞抑制剂应用于减轻这些患者的疼痛性危象。七名对羟基脲和叶酸治疗耐药且每年至少有四次疼痛性危象并住院的患者纳入本研究,接受伊马替尼治疗(100毫克,每日两次)。随后,评估这些患者治疗前后的住院次数和住院时长、镇痛需求、慢性疼痛的严重程度以及血液学参数的变化。

结果

数据显示,伊马替尼治疗后住院总次数和住院总时长减少了16倍,血液学参数无明显变化。此外,所有患者对哌替啶、曲马多和非甾体抗炎药(NSAIDs)的需求均减少。慢性疼痛平均减轻超过70%。

结论

本研究表明,伊马替尼治疗镰状细胞病(SCD)或镰状细胞贫血(SCA)患者可能是减轻疼痛性危象的合适治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f799/11451392/d0c4a4bf31bb/gr1.jpg

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