Associated morbidities in children with sickle-cell anaemia presenting with severe anaemia in a malarious area
Associated morbidities in children with sickle-cell anaemia presenting with severe anaemia in a malarious area
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DOI：
10.1177/004947550103100109
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发表时间：
2001-01-01
期刊：
影响因子：
0.6
通讯作者：
Sodeinde, OO
中科院分区：
文献类型：
--
作者：
Ambe, JP;Fatunde, JO;Sodeinde, OO
1991年在伊巴丹大学医院儿童急诊病房对104例表现为严重贫血（红细胞压积小于或等于25%）的镰状细胞贫血（SCA）患者进行了前瞻性研究。其他检查包括疟疾寄生虫血膜检查、血培养、放射学检查和必要时的腰椎穿刺。与SCA患者贫血危象相关的最常见问题是疟疾和细菌感染-分别为68例（66%）和18例（17.3%）。与再生障碍性危象相比，高溶血性和急性脾隔离危象患者的急性胸部综合征发生率明显更高高溶血危象患者的结合性高胆红素血症发生率也明显高于其他贫血危象患者（X-2 = 13.18，p = 0.001）。总病死率为86.5/1000例SCA，再生障碍性危象患者无死亡。9例死亡中有6例有并发症，合并细菌感染和结合型高胆红素血症与贫血危象患者的发病率和死亡率增加有关。对SCA危象患者应早期评估并及时治疗相关感染。
A prospective study of 104 consecutive cases of patients with sickle-cell anaemia (SCA) presenting with severe anaemia (packed cell volume less than or equal to 25%) was carried out in the Children's Emergency Ward of the University College Hospital, Ibadan, in 1991.The patients were classified according to the type of anaemic crisis, by physical findings, serum bilirubin and reticulocyte counts. Other investigations included a blood film for malaria parasites, blood culture, radiological investigation and lumbar puncture when necessary. The most common problems associated with SCA patients in anaemic crisis were malaria and bacterial infections - 68 (66%) and 18 (17.3%) of cases, respectively. Acute chest syndrome was significantly more frequent in patients with hyperhaemolytic and acute splenic sequestration crisis compared with aplastic crisis (P < 0.05).Conjugated hyperbilirubinaemia was also significantly more frequent among patients with hyperhaemolytic crisis compared with all other anaemic crises (X-2 = 13.18, p = 0.001).The overall case fatality was 86.5/1000 SCAs, with no fatalities in those with aplastic crisis. There were complications in six of the nine mortalities.Co-existing bacterial infections and conjugated hyperbilirubinaemia were associated with increased morbidity and mortality in patients with anaemic crisis. Patients with SCA crisis should have early evaluation and prompt treatment for associated infections.