Westerman M P, Bailey K, Freels S, Schlegel R, Williamson P
Hematology/Oncology Unit, University of Health Sciences, Chicago Medical School, Illinois 60608, USA.
Am J Hematol. 1997 Mar;54(3):183-8. doi: 10.1002/(sici)1096-8652(199703)54:3<183::aid-ajh2>3.0.co;2-s.
Frequency of painful episodes in sickle-cell disease is considered to be related to clinical severity and possibly to other aspects of the disease. Measurements of frequency often include only hospital-related or more severe, longer-lasting episodes. Since painful episodes, however, may regularly occur in nonhospital settings or be shorter-lasting with possible different pathologic effects, we measured all painful episodes in 10 adults with sickle-cell disease for 1.0-3.8 years, using a daily questionnaire. The results were related to other indices of disease severity and to possible precipitating factors, such as cold weather and menses. Sixty-one percent (on average) of the total number of episodes (243) were nonhospital-related, and 33% (on average) were shorter-lasting. Episode frequencies, whether determined as total, hospital-related, nonhospital-related, or shorter-lasting, were not related to each other or to other indicators of disease severity. The highest incidence of episode frequency occurred in the winter. The association of episodes with menses was moderately close in individual patients. The findings suggest that nonhospital-related painful episodes and shorter-lasting episodes may contribute significantly to episode frequency. Measurement of frequency of all painful episodes would require consideration when evaluating episode frequency and its relationship to disease severity, to possible precipitating factors of episodes, and to treatment of the disease, and for study of the natural course of the disease.
镰状细胞病疼痛发作的频率被认为与临床严重程度有关，可能还与该疾病的其他方面有关。频率的测量通常仅包括与医院相关的或更严重、持续时间更长的发作。然而，由于疼痛发作可能经常在非医院环境中发生，或者持续时间较短且可能有不同的病理影响，我们使用每日问卷对10名成年镰状细胞病患者的所有疼痛发作进行了1.0至3.8年的测量。结果与疾病严重程度的其他指标以及可能的诱发因素，如寒冷天气和月经有关。发作总数（243次）中平均有61%与非医院相关，平均有33%持续时间较短。发作频率，无论是按总数、与医院相关、与非医院相关还是持续时间较短来确定，彼此之间以及与疾病严重程度的其他指标均无关。发作频率的最高发生率出现在冬季。在个体患者中，发作与月经的关联程度适中。研究结果表明，与非医院相关的疼痛发作和持续时间较短的发作可能对发作频率有显著影响。在评估发作频率及其与疾病严重程度、发作可能的诱发因素以及疾病治疗的关系，以及研究疾病的自然病程时，需要考虑对所有疼痛发作频率的测量。
