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首页> 外文期刊>Pediatric blood & cancer >Nocturnal hypertension associated with stroke and silent cerebral infarcts in children with sickle cell disease
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Nocturnal hypertension associated with stroke and silent cerebral infarcts in children with sickle cell disease

机译：与镰状细胞疾病的儿童中风和沉默的脑梗死相关的夜间高血压

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Background: Strokes and silent cerebral infarcts (SCIs) lead to significant morbidity and mortality in children with sickle cell disease (SCD). Higher systolic blood pressures increase risk for stroke and SCIs; however, patients with SCD often have lower clinic blood pressures than the general population. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) allows for more robust examination of blood pressures. This study evaluated associations between abnormal ABPM measurements with stroke and SCIs.Procedure: Across-sectional study was performed. Children with SCD completed 24-hour ABPMs. Children with a documented magnetic resonance imaging (MRI) brain within a year of the ABPM were included in the analysis. Bivariate analyses were performed to identify associations between ABPM parameters with cerebrovascular outcomes.Results: Forty-two children with a median age of 13 years (10, 17) were included in the analysis. Seven (17%) had history of stroke and seven (17%) had SCIs. Nocturnal hypertension, elucidated via 24-hour ABPM, was noted in 25% of subjects. The presence of nocturnal hypertension was significantly higher in the SCI/stroke group (55% vs 12%, P = .01). Sensitivity analyses were performed during which stroke patients were removed from analysis. Nocturnal hypertension remained significantly associated with the presence of SCIs (P = .006).Conclusions: This study reveals an association between nocturnal hypertension and a higher prevalence of SCI and stroke in children with SCD. Larger, prospective studies are needed to confirm these findings and evaluate the contributory nature of blood pressure abnormalities to cerebrovascular events in children with SCD.
机译：背景：在镰状细胞病（SCD）患儿中，中风和无症状性脑梗死（SCI）导致显著的发病率和死亡率。收缩压升高会增加中风和SCI的风险；然而，SCD患者的临床血压通常低于普通人群。24小时动态血压监测（ABPM）允许对血压进行更可靠的检查。这项研究评估了异常ABPM测量与中风和SCIs之间的关联。程序：进行横断面研究。患有SCD的儿童完成了24小时的ABPM。在ABPM后一年内有磁共振成像（MRI）记录的儿童被纳入分析。进行双变量分析，以确定ABPM参数与脑血管结局之间的关联。结果：42名中位年龄为13岁（10,17岁）的儿童被纳入分析。七（17%）有中风史，七（17%）有SCIs。在25%的受试者中发现了通过24小时ABPM阐明的夜间高血压。SCI/卒中组夜间高血压的发生率显著高于对照组（55%对12%，P=0.01）。进行敏感性分析，在此期间将中风患者从分析中剔除。夜间高血压仍然与SCIs的存在显著相关（P=0.006）。结论：本研究揭示了夜间高血压与SCD儿童更高的SCI和中风患病率之间的关联。需要更大规模的前瞻性研究来证实这些发现，并评估SCD儿童血压异常对脑血管事件的影响。

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