Risk Factors for Attention and Behavioral Issues in Pediatric Sickle Cell Disease.
Risk Factors for Attention and Behavioral Issues in Pediatric Sickle Cell Disease.
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DOI：
10.1177/0009922815594356
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发表时间：
2015-10
影响因子：
1.6
通讯作者：
Shapiro BK
中科院分区：
文献类型：
--
作者：
Lance EI;Comi AM;Johnston MV;Casella JF;Shapiro BK
患有镰状细胞病的儿童患神经发育障碍的风险增加，如注意力缺陷多动障碍，智力残疾和特殊学习障碍。很少有研究已经做了镰状细胞病相关的特点与镰状细胞病人群的神经发育障碍。本研究是一项回顾性病历审查，涉及肯尼迪克里格研究所和约翰霍普金斯医院2个医疗中心的门诊记录。该研究的参与者包括59名患有镰状细胞病的儿童，这些儿童有记录在案的神经发育诊断，特别是注意力缺陷多动障碍，注意力问题，行为问题，执行功能障碍，数学，阅读和阅读理解方面的特定学习障碍，智力障碍，发育迟缓，精细运动障碍，语言障碍或自闭症谱系障碍。患有镰状细胞病型血红蛋白S-β地中海贫血+的儿童注意力问题的几率显著高于患有镰状细胞病型血红蛋白SS的儿童（OR = 17.0，95%CI = 1.99-145.00，P <0.02）。在调整性别和镰状细胞病类型后，有哮喘史的镰状细胞病儿童的行为问题发生率显著高于无哮喘史的镰状细胞病儿童（确切OR = 19.53，95%CI = 1.16-1369.72，P <0.04）。根据镰状细胞病儿童的疾病特征和相关合并症，其某些神经发育诊断的风险可能会增加。这些初步研究结果应在更大的数据库中进行探索。
Children with sickle cell disease have an increased risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder, intellectual disability, and specific learning disabilities. Little research has been done to characterize the sickle cell disease–related characteristics associated with neurodevelopmental disorders in the sickle cell disease population. This study was a retrospective chart review involving the outpatient records of 2 medical centers, Kennedy Krieger Institute and Johns Hopkins Hospital. Participants in the study included 59 children with sickle cell disease with a documented neurodevelopmental diagnosis, specifically attention deficit hyperactivity disorder, attention issues, behavioral issues, executive dysfunction, specific learning disabilities in math, reading, and reading comprehension, intellectual disabilities, developmental delay, fine motor disorders, language disorders, or autism spectrum disorders. Children with sickle cell disease type hemoglobin S-β thalassemia plus had significantly higher odds of attention issues than children with sickle cell disease type hemoglobin SS (OR = 17.0, 95% CI = 1.99-145.00, P < .02). Children with sickle cell disease and a reported history of asthma had significantly higher odds of behavioral issues than children with sickle cell disease without a history of asthma, after adjustment for gender and sickle cell disease type (exact OR = 19.53, 95% CI = 1.16-1369.72, P < .04). Children with sickle cell disease may have increased risk for certain neurodevelopmental diagnoses based on their disease characteristics and associated comorbidities. These preliminary study results should be explored in a larger database.