Wilimas J, Goff J R, Anderson H R, Langston J W, Thompson E
J Pediatr. 1980 Feb;96(2):205-8. doi: 10.1016/s0022-3476(80)80803-1.
Since 1974 we have entered 12 children with sickle cell disease and strokes on a transfusion protocol to maintain hemoglobin S less than 20%. Serial arteriography, EEGs, brain or CT scans, and neuropsychologic testing were also obtained. Transfusion has been stopped in ten patients after one to two years. Seven of these ten patients have had second strokes five weeks to 11 months after cessation of transfusion (median three months). Arteriography was normal at the time of the initial stroke in two patients; one of these had a second stroke. Arteriograms did not improve during transfusion therapy. EEGs and brain and CT scans were occasionally useful at the time of the initial stroke but were of little value in following these patients. Neuropsychologic testing indicated severe impairment of sensory-motor and cognitive processes at the time of the initial stroke and was useful in following improvement or deterioration and in designing remedial education programs. We conclude that short-term transfusion therapy will not prevent second strokes once transfusion is stopped and that arteriography is of limited value in these patients.
自1974年以来，我们已让12名镰状细胞病和中风患儿按照输血方案进行治疗，以将血红蛋白S维持在20%以下。还进行了系列动脉造影、脑电图、脑部或CT扫描以及神经心理学测试。一到两年后，已有10名患者停止输血。这10名患者中有7名在停止输血后5周至11个月（中位时间为3个月）出现了第二次中风。两名患者首次中风时动脉造影正常；其中一人出现了第二次中风。输血治疗期间动脉造影结果并无改善。脑电图以及脑部和CT扫描在首次中风时偶尔有用，但对这些患者的后续跟踪价值不大。神经心理学测试表明，首次中风时感觉运动和认知过程严重受损，有助于跟踪病情改善或恶化情况以及设计补救教育方案。我们得出结论，一旦停止输血，短期输血治疗并不能预防第二次中风，并且动脉造影对这些患者的价值有限。
