重新思考镰状细胞病中血红蛋白阈值指南的时间到了。
Time to rethink haemoglobin threshold guidelines in sickle cell disease.
机构信息
Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Children's Hospital Oakland Research Institute, Oakland, CA, USA.
出版信息
Br J Haematol. 2021 Nov;195(4):518-522. doi: 10.1111/bjh.17578. Epub 2021 Jun 15.
Abstract
Alleviating anaemia in patients with sickle cell disease (SCD) is crucial in managing acute complications, mitigating end-organ damage and preventing early mortality. Some disease-modifying and curative therapies have increased haemoglobin (Hb) levels to exceed 100 g/l, a threshold above which complications from red blood cell (RBC) transfusions have occurred, raising concern about whole-blood viscosity-related complications with these therapies. Here we discuss the rationale behind this limit, the effect of viscosity on blood flow and the applicability of this Hb threshold to therapies for SCD beyond RBC transfusions.
摘要
缓解镰状细胞病（SCD）患者的贫血对于治疗急性并发症、减轻终末器官损伤和预防早期死亡至关重要。一些疾病修正和治愈疗法已将血红蛋白（Hb）水平提高到 100g/l 以上，这一阈值超过了红细胞（RBC）输注引起并发症的水平，引起了人们对这些疗法与全血粘度相关并发症的担忧。在这里，我们讨论了这一限制背后的原理、粘度对血流的影响以及这一 Hb 阈值对 RBC 输注以外的 SCD 治疗的适用性。
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