ATTRIBUTES OF SICKLE CELL PAIN IN INFANTS AND YOUNG CHILDREN

这项提案将对 婴幼儿血管闭塞性疼痛体验的特点 儿童镰状细胞病(SCD)。这将是第一项研究 具体描述两者的疼痛强度和持续时间 门诊和住院治疗的痛苦发作，具有前瞻性 设计，在大量的婴幼儿人群中。此外, 这项研究将检查疼痛体验的其他几个方面 这些患者以前没有进行过任何深入的研究， 包括可能的诱发因素，对疼痛的行为反应，以及 止痛药的用法和疗效。与第一项目合作，我们将 全面检视血液学与血液学的关系 这些婴儿的实验室变量和疼痛的发作和频率 和年幼的孩子。我们亦会进行第一次详细研究 现有疼痛评估工具在本研究中的有效性和可靠性 患者群体，并检查疼痛频率之间的关系 婴儿气质或父母应对方式。 虽然这些研究中的每一项都可以单独完成，但 在同一患者群体中进行的这些研究的组合，在 在预期的基础上，将产生丰富的比较信息 将使我们能够评估一套全面的 预测疼痛风险的临床和实验室因素 发作，是SCD最常见和最令人衰弱的并发症。与 通过以上研究获得的知识，我们将能够更好地 通过更有效地减轻这些患者的痛苦和煎熬 疼痛评估和管理。更重要的是，我们将能够 在早期，在主要器官损伤发生之前，识别那些 有频繁临床并发症的儿童可能适合 SCD创新疗法试验的候选人。

This proposal will perform a comprehensive assessment of the characteristics of the vaso-occlusive pain experience in infants and young children with Sickle Cell Disease (SCD). It will be the first study to specifically characterize the pain intensity and duration of both outpatient and hospital-treated painful episodes, with a prospective design, in a large population of infants and young children. In addition, this study will examine several other facets of the pain experience in these patients that have not been previously studied in any depth, including possible precipitating factors, behavioral response to pain, and analgesic usage and efficacy. In collaboration with Project I, we will comprehensively examine the relationship between hematologic and laboratory variables and the onset and frequency of pain in these infants and young children. We will also conduct the first detailed study of the validity and reliability of available pain assessment instruments in this patient population, and examine the relationship between pain frequency and infant temperament or parental coping style. While each one of these studies could be done in isolation, the combination of these studies in the same patient population, on a prospective basis, will yield a wealth of comparative information that will allow us to assess the relative importance of a comprehensive set of clinical and laboratory factors that predict the risk for painful episodes, the most frequent and debilitating complication of SCD. With the knowledge obtained from the above studies, we will be better able to alleviate the pain and suffering of these patients through more effective pain assessment and management. More importantly, we will be able to identify at an early age, prior to the onset of major organ damage, those children with frequent clinical complications who could be appropriate candidates for trials of innovate therapies for SCD.