Red Blood Cell supports prolong the Survival in Sickle Cell Diseases

Mehmet Rami Helvaci
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Abstract

Background: Hardened red blood cells (RBCs)-induced capillary endothelial damage initiates at birth in sickle cell diseases. Methods: Patients with red blood cells (RBCs) transfusions of less than 50 units in their lives were put into the first and 50 units or higher were put into the second groups. Results: There were 224 cases in the first and 92 cases in the second groups. Mean ages were similar in them (28.9 vs 30.0 years, respectively, p>0.05). Although the lower prevalence of autosplenectomy (56.2% vs 45.6%, p<0.05), male ratio (45.5% vs 64.1%, p<0.001), white blood cells (WBCs) (14.931 vs 15.346/µL, p<0.05) and platelets (PLTs) (435.670 vs 498.310/µL, p= 0.005) counts, painful crises per year (3.8 vs 8.4, p= 0.000), smoking (12.0% vs 17.3%, p<0.05), clubbing (7.1% vs 15.2%, p<0.01), chronic obstructive pulmonary disease (COPD) (6.6% vs 20.6%, p<0.001), leg ulcers (11.6% vs 21.7%, p<0.01), stroke (5.8% vs 11.9%, p<0.05), chronic renal disease (CRD) (4.9% vs 14.1%, p<0.001), coronary heart disease (CHD) (4.0% vs 8.6%, p<0.05), and mean age of mortality (29.5 vs 34.6 years, p<0.05) were all higher in the second group. Conclusion: Although the lower prevalence of autosplenectomy, male ratio, WBCs and PLTs counts, painful crises per year, smoking, clubbing, COPD, leg ulcers, stroke, CRD, CHD, and mean age of mortality were higher in the second group. So autosplenectomy may be a good, and male gender alone may be a bad prognostic feature that can not be explained by smoking alone at the younger age, and RBCs supports prolong the survival. Key words: Sickle cell diseases, hardened red blood cells, capillary endothelial damage, capillary endothelial edema, myocardial infarction, stroke, red blood cell supports
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红细胞支持延长镰状细胞病患者的生存期
背景:硬化红细胞(rbc)诱导的毛细血管内皮损伤始于出生时的镰状细胞病。方法:将一生中红细胞输注量在50单位以下的患者分为第一组,50单位及以上的患者分为第二组。结果:第一组224例,第二组92例。两组患者的平均年龄相似,分别为28.9岁和30.0岁,p < 0.05)。尽管自体脾切除术(56.2%比45.6%,p<0.05)、男性比例(45.5%比64.1%,p<0.001)、白细胞(WBCs)(14.931比15.346/µL, p<0.05)和血小板(PLTs)(435.670比498.310/µL, p= 0.005)计数、每年疼痛危机(3.8比8.4,p= 0.000)、吸烟(12.0%比17.3%,p<0.05)、夜总会(7.1%比15.2%,p<0.01)、慢性阻塞性肺疾病(COPD)(6.6%比20.6%,p<0.001)、腿部溃疡(11.6%比21.7%,p<0.01)、中风(5.8%比11.9%、慢性肾脏疾病(CRD) (4.9% vs 14.1%, p<0.001)、冠心病(CHD) (4.0% vs 8.6%, p<0.05)和平均死亡年龄(29.5 vs 34.6岁,p<0.05)均高于第二组。结论:虽然第二组的自体脾切除术患病率较低,但男性比例、白细胞和血小板计数、每年疼痛危机、吸烟、俱乐部、COPD、腿部溃疡、中风、CRD、冠心病和平均死亡年龄较高。因此自体脾切除术可能是一个好的选择,而男性本身可能是一个不良的预后特征,不能用年轻时吸烟来解释,而红细胞支持延长生存期。关键词:镰状细胞病,硬化红细胞,毛细血管内皮损伤,毛细血管内皮水肿,心肌梗死,中风,红细胞支持
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