Discontinuing prophylactic transfusions used to prevent stroke in sickle cell disease.
Discontinuing prophylactic transfusions used to prevent stroke in sickle cell disease.
复制标题
停止用于预防镰状细胞病中风的预防性输血。
DOI：
10.1056/nejmoa050460
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
OptimizingPrimaryStrokePreventioninSickleCellAnemia(STOP2)TrialInvestigators
中科院分区：
文献类型：
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作者：
Adams,RobertJ;Brambilla,Donald;OptimizingPrimaryStrokePreventioninSickleCellAnemia(STOP2)TrialInvestigators
研究背景经颅多普勒超声检查有异常的镰状细胞性贫血患儿预防性输血可预防卒中。然而，它是不知道多长时间输血应继续在这些children.MethodsWe研究儿童镰状细胞病谁有中风的高风险的基础上，经颅多普勒筛查检查和谁接受了输血30个月或更长的时间，在此期间，多普勒读数变得正常。这些儿童被随机分配继续输血或不继续输血。排除了脑磁共振血管造影显示有严重狭窄病变的儿童。复合的主要终点是中风或逆转的结果多普勒检查表明中风的高risk.ResultsThe研究停止后，79名儿童的计划招募100进行随机化。在停止输血组的41名儿童中，在末次输血的平均（±SD）4.5±2.6个月（范围，2.1至10.1）内，14名儿童发生高危多普勒结果，2名儿童发生卒中。在38名继续接受输血的儿童中，这些复合终点事件均未发生。输血开始前的最后两个经颅多普勒结果的平均值是复合终点的唯一预测因子（P=0.05）。结论：停止输血预防镰状细胞病儿童卒中的结果是多普勒研究和卒中中血流速度异常的逆转率很高。（ClinicalTrials.gov编号，NCT 00006182。）
BackgroundProphylactic transfusion prevents strokes in children with sickle cell anemia who have abnormalities on transcranial Doppler ultrasonographic examination. However, it is not known how long transfusion should be continued in these children.MethodsWe studied children with sickle cell disease who had a high risk of stroke on the basis of a transcranial Doppler screening examination and who had received transfusions for 30 months or longer, during which time the Doppler readings became normal. The children were randomly assigned to continued transfusion or no continued transfusion. Children with severe stenotic lesions on cerebral magnetic resonance angiography were excluded. The composite primary end point was stroke or reversion to a result on Doppler examination indicative of a high risk of stroke.ResultsThe study was stopped after 79 children of a planned enrollment of 100 underwent randomization. Among the 41 children in the transfusion-halted group, high-risk Doppler results developed in 14 and stroke in 2 others within a mean (±SD) of 4.5±2.6 months (range, 2.1 to 10.1) of the last transfusion. Neither of these events of the composite end point occurred in the 38 children who continued to receive transfusions. The average of the last two transcranial Doppler results before transfusion was started was the only predictor of the composite end point (P=0.05).ConclusionsDiscontinuation of transfusion for the prevention of stroke in children with sickle cell disease results in a high rate of reversion to abnormal blood-flow velocities on Doppler studies and stroke. (ClinicalTrials.gov number, NCT00006182.)