经颅多普勒超声筛查对镰状细胞病儿童和青少年卒中预防的影响：一项系统评价和荟萃分析。
Impact of transcranial Doppler screening on stroke prevention in children and adolescents with sickle cell disease: A systematic review and meta-analysis.
作者信息
Guy Danielle, Bagnall Robert, Morgan Rebecca L, Babatunde Ifeoluwa, Nevière Agathe, Friedrich Gabriela, Bennetts Liga, Irfan Omar, Odame Isaac
机构信息
Amaris Heath Economics and Market Access, Barcelona, Catalunya, Spain.
Amaris Heath Economics and Market Access, Barcelona, Catalunya, Spain.
出版信息
Blood Rev. 2025 Jan;69:101253. doi: 10.1016/j.blre.2024.101253. Epub 2024 Dec 12.
BACKGROUND
Children with sickle cell disease (SCD) have increased stroke risk, identifiable by elevated velocities on transcranial Doppler (TCD). This review assessed the impact of TCD screening on stroke, mortality, quality of life and morbidity in children with SCD.
METHODS
A systematic search of MEDLINE, PubMed, Cochrane libraries, and trial registries was conducted from inception to 28th February 2023. Randomised controlled trials (RCTs) and non-randomised studies (NRS) were included. A meta-analysis and narrative synthesis were performed.
FINDINGS
Nine studies were included in the review. In one RCT, initiating chronic blood transfusion in children with abnormal TCD velocities reduced stroke risk by 92 %, while no deaths were reported. Pooled results from three NRS indicated TCD screening leads to four fewer strokes per 1000 patients annually. No studies analysing morbidity nor quality of life were identified.
INTERPRETATION
TCD screening may decrease the risk of stroke in patients with SCD.
背景
镰状细胞病（SCD）患儿的中风风险增加，可通过经颅多普勒（TCD）检测到的速度升高来识别。本综述评估了TCD筛查对SCD患儿中风、死亡率、生活质量和发病率的影响。
方法
从数据库建立至2023年2月28日，对MEDLINE、PubMed、Cochrane图书馆和试验注册库进行了系统检索。纳入随机对照试验（RCT）和非随机研究（NRS）。进行了荟萃分析和叙述性综合分析。
结果
该综述纳入了9项研究。在一项RCT中，对TCD速度异常的儿童开始进行慢性输血可将中风风险降低92%，且未报告死亡病例。三项NRS的汇总结果表明，TCD筛查每年可使每1000名患者的中风病例减少4例。未发现分析发病率和生活质量的研究。
解读
TCD筛查可能会降低SCD患者的中风风险。
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