Galiba Atipo Tsiba Firmine Olivia, Mikia Clément Pacha, Elira Samba Jennifer Armandine, Nziengui Mboumba Jade Vanessa, Malanda Félix, Mikolele Ahoui Clausina, Elira Dokekias Alexis
National Reference Center for Sickle Cell Disease "Antoinette Sassou Nguesso", Brazzaville, Congo.
Marien Ngouabi University, Brazzaville, Congo.
Anemia. 2023 Sep 27;2023:8887981. doi: 10.1155/2023/8887981. eCollection 2023.
Chronic hemolysis predisposes sickle cell patients to the development of gallstones. Their frequency increases with age, but they may appear early in young children. In the absence of management, they expose the patient to complications that can hinder the quality of life and sometimes even death. This survey aimed to identify the associated factors of the occurrence of cholelithiasis.
It was a case-control study carried out between January 2017 and June 2022 at the National Reference Center for Sickle Cell Disease (SCD) "Antoinette Sassou N'guesso" in Brazzaville. It concerned 37 children with cholelithiasis. Sociodemographic (socioeconomic status and diet) and clinical (body mass index, frequency of vasoocclusive crises and hospitalization for vasoocclusive crises, number of blood transfusion, and chronic complications) as well as hematological examination (type of SCD and blood count in the intercritical period) and hydroxyurea treatment were compared with those of 74 children with no clinical and radiographic signs of cholelithiasis. The chi-squared statistical test and the odds ratio were used for the comparison ( < 0.05).
The average age was 9.70 ± 1.73 years. The 10-12 age group was the most represented (22 cases or 59.45%), followed by 7- to 9-year-olds (12 cases or 32.43%). Three children (8.10%) were 6 years old. The sex ratio was 0.68 1.38. Factors associated with cholelithiasis were low socioeconomic status (83.78% 45.95%; IC 95% 1.46-3.89; ≤ 0.001), a higher number of blood transfusions (5.54 ± 1.22 2.46 ± 1.13; IC 95% 1.55-6.70; ≤ 0.001), and irregular systematic monitoring (5.54 ± 1.22 2.46 ± 1.13; IC 95% 1.55-6.70; ≤ 0.001).
A national strategy to facilitate access to care for patients living with sickle cell disease is imperative. Moreover, emphasis should be placed on the prevention and early management of acute complications of SCD.
慢性溶血使镰状细胞病患者易患胆结石。胆结石的发病率随年龄增长而增加，但也可能在幼儿期就出现。若不加以治疗，会使患者面临可能影响生活质量甚至危及生命的并发症。本调查旨在确定胆结石发生的相关因素。
这是一项病例对照研究，于2017年1月至2022年6月在布拉柴维尔的国家镰状细胞病参考中心“安托瓦内特·萨苏·恩古索”进行。研究对象为37例胆结石患儿。将其社会人口学特征（社会经济状况和饮食）、临床特征（体重指数、血管闭塞性危机发作频率及因血管闭塞性危机住院情况、输血次数、慢性并发症）、血液学检查结果（镰状细胞病类型及病情缓解期血常规）以及羟基脲治疗情况与74例无胆结石临床及影像学征象的患儿进行比较。采用卡方统计检验和比值比进行比较（P＜0.05）。
平均年龄为9.70±1.73岁。10至12岁年龄组占比最高（22例，占59.45%），其次是7至9岁年龄组（12例，占32.43%）。3名患儿（8.10%）为6岁。男女比例为0.68比1.38。与胆结石相关的因素包括社会经济地位低（83.78%比45.95%；95%置信区间1.46 - 3.89；P≤0.001）、输血次数较多（5.54±1.22比2.46±1.13；95%置信区间1.55 - 6.70；P≤0.001）以及缺乏定期系统监测（5.54±1.22比2.46±1.13；95%置信区间1.55 - 6.70；P≤0.001）。
必须制定一项国家战略，以方便镰状细胞病患者获得医疗服务。此外，应重视镰状细胞病急性并发症的预防和早期治疗。
