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镰状细胞贫血与认知功能障碍之间的关联:一项系统综述

The Association Between Sickle Cell Anemia and Cognitive Dysfunction: A Systematic Review.

作者信息

Alpakra Mohammed, Hamed Nazim F, Almakki Zainab E, Al Bakrah Esmaeel

机构信息

Oncology and Hematology, Armed Forces Hospital Southern Region, Khamis Mushayt, SAU.

General Pediatrics, Security Force Hospital, Dammam, SAU.

出版信息

Cureus. 2024 Sep 10;16(9):e69104. doi: 10.7759/cureus.69104. eCollection 2024 Sep.

Abstract

A kind of hemoglobinopathy known as sickle cell anemia (SCA) is characterized by aberrant hemoglobin molecules. The most frequent neurological side effects linked to SCA include neurocognitive dysfunction, asymptomatic cerebral infarction, and ischemic stroke. This study aims to investigate the relationship between SCA and cognitive dysfunction. We systematically searched electronic databases like PubMed, MEDLINE, Science Direct, and Scopus. Two independent reviewers screened and extracted data from eligible studies. Eighteen studies, including 2,457 participants in total and nearly half of them 1,151 (46.8%) were males, were included in our data. The prevalence of cognitive dysfunction in the adult population ranged from 11.5% to 70%. Cognitive dysfunction among adults was significantly associated with poorer educational status, reduced family income, decreased kidney function, older age, stroke history, and vasculopathy. The prevalence of cognitive dysfunction in children ranged from 10.2% to 68.2%. The decline in cognitive function among adults was significantly associated with children over the age of four, abnormal transcranial Doppler and previous stroke, school absence, age beyond 13, and increased BMI. Cognitive function deficiencies are a defining feature of SCA that affects people of all ages. These findings suggest that if cognitive decline is not slowed down, or better still, stopped, medical interventions targeting a variety of sequelae in this population will be ineffective. Future analyses of this population's cognition should evaluate the environmental and other biological variables.

摘要

一种被称为镰状细胞贫血(SCA)的血红蛋白病,其特征是血红蛋白分子异常。与SCA相关的最常见神经学副作用包括神经认知功能障碍、无症状性脑梗死和缺血性中风。本研究旨在探讨SCA与认知功能障碍之间的关系。我们系统地检索了电子数据库,如PubMed、MEDLINE、Science Direct和Scopus。两名独立的评审员对符合条件的研究进行筛选和数据提取。我们的数据纳入了18项研究,总共2457名参与者,其中近一半即1151名(46.8%)为男性。成年人群中认知功能障碍的患病率在11.5%至70%之间。成年人的认知功能障碍与较差的教育程度、家庭收入减少、肾功能下降、年龄较大、中风病史和血管病变显著相关。儿童中认知功能障碍的患病率在10.2%至68.2%之间。成年人认知功能的下降与4岁以上儿童、经颅多普勒异常和既往中风、缺课、13岁以上年龄以及体重指数增加显著相关。认知功能缺陷是SCA的一个决定性特征,影响各年龄段的人群。这些发现表明,如果认知衰退没有减缓,或者更好的情况是停止,针对该人群各种后遗症的医学干预将是无效的。未来对该人群认知的分析应评估环境和其他生物学变量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e98/11466366/36146e53bfeb/cureus-0016-00000069104-i01.jpg

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