Emerging biobehavioral factors of fatigue in sickle cell disease.
Emerging biobehavioral factors of fatigue in sickle cell disease.
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DOI：
10.1111/j.1547-5069.2010.01376.x
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发表时间：
2011-03
期刊：
影响因子：
--
通讯作者：
Smith WR
中科院分区：
文献类型：
--
作者：
Ameringer S;Smith WR
与镰状细胞病（SCD）最常见的症状是疼痛，但最近的研究开始表明，疲劳作为这种疾病的一个越来越重要的症状，集中研究工作。本文探讨了可能导致SCD疲劳的生物和行为因素。一个生物行为的框架指导可能导致SCD疲劳的因素的讨论。疾病过程的病理生理学，如严重的溶血性贫血和不可预测的血管闭塞性危象，表明SCD患者有急性和慢性疲劳的风险。例如，低氧血症会导致肌肉无力并产生氧化应激，这反过来又会增加疲劳。镰状红细胞破坏血管内皮并刺激促炎细胞因子，这与睡眠中断有关。疼痛是SCD最臭名昭著的症状，与疲劳有着复杂且机制上知之甚少的关系。对SCD患者的疲劳症状知之甚少。考虑到SCD的生物和行为因素可能导致疲劳，因此非常需要研究SCD中疲劳的性质和潜在机制。SCD患者的疲劳可能会对生活质量产生负面影响。了解可能导致疲劳的因素有助于临床医生识别原因并确定治疗方法。
The symptom most frequently associated with sickle cell disease (SCD) is pain, but recent research is beginning to indicate that fatigue as an increasingly important symptom of this disease upon which to focus research efforts. This article explores biological and behavioral factors that can potentially contribute to fatigue in SCD. A biobehavioral framework guides this discussion of factors that may contribute to SCD fatigue. The pathophysiology of the disease process, such as the profound hemolytic anemia and unpredictable vasoocclusive crises, suggests that individuals with SCD are at risk for both acute and chronic fatigue. For example, hypoxemia can cause muscle weakness and produce oxidative stress, which, in turn, increases fatigue. Sickled erythrocytes disrupt the vascular endothelium and stimulate proinflammatory cytokines, which are linked to sleep disruptions. Pain, the most notorious symptom of SCD, has a complex and mechanistically poorly understood relationship with fatigue. Little is known about the symptom of fatigue in SCD. Considering the biological and behavioral factors of SCD that could potentially contribute to fatigue, there is a great need for research on the nature and potential mechanisms of fatigue in SCD. Fatigue in SCD may negatively affect quality of life. Understanding factors that may contribute to fatigue aids the clinician in identifying causes and determining treatment.
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