Associated risk factors for silent cerebral infarcts in sickle cell anemia: low baseline hemoglobin, sex, and relative high systolic blood pressure

被引：159

作者：

DeBaun, Michael R. ^{[1
]}

Sarnaik, Sharada A. ^{[2
]}

Rodeghier, Mark J. ^{[3
]}

Minniti, Caterina P. ^{[4
]}

Howard, Thomas H. ^{[5
]}

Iyer, Rathi V. ^{[6
]}

Inusa, Baba ^{[7
]}

Telfer, Paul T. ^{[8
]}

Kirby-Allen, Melanie ^{[9
]}

Quinn, Charles T. ^{[10
,11
]}

Bernaudin, Francoise ^{[12
]}

Airewele, Gladstone ^{[13
]}

Woods, Gerald M. ^{[14
]}

Panepinto, Julie Ann ^{[15
]}

Fuh, Beng ^{[16
]}

Kwiatkowski, Janet K. ^{[17
]}

King, Allison A. ^{[18
]}

Rhodes, Melissa M. ^{[19
]}

Thompson, Alexis A. ^{[20
]}

Heiny, Mark E. ^{[21
]}

Redding-Lallinger, Rupa C. ^{[22
]}

Kirkham, Fenella J. ^{[23
]}

Sabio, Hernan ^{[24
]}

Gonzalez, Corina E. ^{[25
]}

Saccente, Suzanne L. ^{[26
]}

Kalinyak, Karen A. ^{[10
,11
]}

Strouse, John J. ^{[27
]}

Fixler, Jason M. ^{[28
]}

Gordon, Mae O. ^{[29
]}

Miller, J. Phillip ^{[30
]}

Noetzel, Michael J. ^{[18
,31
]}

Ichord, Rebecca N. ^{[17
]}

Casella, James F. ^{[27
]}

机构：

[1] Vanderbilt Univ, Dept Pediat, Div Hematol Oncol, Nashville, TN 37232 USA

[2] Wayne State Univ, Dept Pediat, Div Hematol Oncol, Detroit, MI 48202 USA

[3] Rodeghier Consultants, Chicago, IL USA

[4] NHLBI, NIH, Bethesda, MD 20892 USA

[5] Univ Alabama Birmingham, Div Hematol Oncol, Dept Pediat, Birmingham, AL 35294 USA

[6] Univ Mississippi, Med Ctr, Dept Pediat, Div Hematol Oncol, Jackson, MS 39216 USA

[7] St Thomas Hosp Natl Hlth Serv Trust, Evelina Childrens Hosp, Dept Paediat, London, England

[8] Royal London Hosp, Dept Pediat Hematol, London E1 1BB, England

[9] Univ Toronto, Hosp Sick Children, Toronto, ON M5G 1X8, Canada

[10] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH USA

[11] Univ Cincinnati, Cincinnati, OH USA

[12] Hop Intercommunal Creteil, Dept Pediat, Creteil, France

[13] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA

[14] Univ Missouri, Dept Pediat, Kansas City, MO 64110 USA

[15] Med Coll Wisconsin, Dept Pediat, Milwaukee, WI 53226 USA

[16] Brody Sch Med, Dept Pediat, Greenville, NC USA

[17] Univ Penn, Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA

[18] Washington Univ, Sch Med, Dept Pediat, St Louis, MO 63110 USA

[19] Ohio State Univ, Dept Pediat, Columbus, OH 43210 USA

[20] Northwestern Univ, Dept Pediat, Chicago, IL 60611 USA

[21] Indiana Univ Purdue Univ, Dept Pediat, Indianapolis, IN 46202 USA

[22] Univ N Carolina, Dept Pediat, Chapel Hill, NC USA

[23] UCL, Inst Child Hlth, Neurosci Unit, London, England

[24] Wake Forest Univ Hlth Sci, Dept Pediat, Winston Salem, NC USA

[25] Georgetown Univ Hosp, Dept Pediat, Washington, DC 20007 USA

[26] Univ Arkansas Med Sci, Dept Pediat, Little Rock, AR 72205 USA

[27] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA

[28] Sinai Hosp, Sch Med, Baltimore, MD 21215 USA

[29] Washington Univ, Sch Med, Dept Ophthalmol & Visual Sci, St Louis, MO 63110 USA

[30] Washington Univ, Sch Med, Div Biostat, St Louis, MO 63110 USA

[31] Washington Univ, Sch Med, Dept Neurol, St Louis, MO 63110 USA

来源：

BLOOD | 2012年 / 119卷 / 16期

基金：

美国国家卫生研究院;

关键词：

CENTRAL-NERVOUS-SYSTEM; TRANSFUSION SIT TRIAL; PULMONARY-HYPERTENSION; YOUNG-CHILDREN; DISEASE; BRAIN; STROKE; ABNORMALITIES; MRI; COMPLICATIONS;

D O I：

10.1182/blood-2011-05-349621

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

The most common form of neurologic injury in sickle cell anemia (SCA) is silent cerebral infarction (SCI). In the Silent Cerebral Infarct Multi-Center Clinical Trial, we sought to identify risk factors associated with SCI. In this cross-sectional study, we evaluated the clinical history and baseline laboratory values and performed magnetic resonance imaging of the brain in participants with SCA (HbSS or HbS beta degrees thalassemia) between the ages of 5 and 15 years with no history of overt stroke or seizures. Neuroradiology and neurology committees adjudicated the presence of SCI. SCIs were diagnosed in 30.8% (251 of 814) participants who completed all evaluations and had valid data on all prespecified demographic and clinical covariates. The mean age of the participants was 9.1 years, with 413 males (50.7%). In a multivariable logistic regression analysis, lower baseline hemoglobin concentration (P < .001), higher baseline systolic blood pressure (P = .018), and male sex (P = .030) were statistically significantly associated with an increased risk of an SCI. Hemoglobin concentration and systolic blood pressure are risk factors for SCI in children with SCA and may be therapeutic targets for decreasing the risk of SCI. This study is registered at www.clinicaltrials.gov as #NCT00072761. (Blood. 2012; 19(16):3684-3690)

引用

页码：3684 / 3690

页数：7

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