在肯尼亚基苏木 Jaramogi Oginga Odinga 教学和转诊医院接受治疗的镰状细胞病儿童和青少年的肺功能

Fredrick O. Olewe, Constance N. Tenge, Irene K. Marete
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背景镰状细胞病是一种遗传性疾病,患者终生伴有贫血、血管收缩危象和器官损伤等症状。肺部并发症和肺功能下降是发病率和死亡率的主要原因。方法和结果 在肯尼亚基苏木的 Jaramogi Oginga Odinga 教学和转诊医院进行了一项横断面研究,以确定确诊镰状细胞病的 6-17 岁儿童和青少年肺功能异常的患病率、模式和相关因素。共招募了 138 名参与者。采用结构化数据收集工具收集社会人口统计学和临床特征。使用 NDD Easy-On PC 肺活量计进行肺活量测定,并将结果输入数据库、进行清理和分析,以 95% 的置信水平计算比例、频率、平均值、范围和几率。共有 79 人(57%)来自农村,使用的燃料为木柴,占 41%。在过去 12 个月中,84 人(61%)入院治疗,104 人(75%)出现血管收缩危象,61 人(44%)出现急性胸部综合征,56 人(40%)输血。肺功能异常发生率为 28%(39 例),限制型 26 例(67%),阻塞型 13 例(33%)。城市(OR 24.101,P 值 0.163)、女性(OR 18.911,P 值 0.069)和输血(OR 11.683,P 值 0.195)的几率较高,而稳定使用羟基脲(OR 0.525,P 值 0.678)和入院(OR 0.048,P 值 0.121)的几率较低,但无统计学意义。居住在城市、女性和输血的几率较高,而稳定使用羟基脲和入院的几率较低,但无统计学意义。
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Lung functions among children and adolescents with sickle cell disease receiving care at Jaramogi Oginga Odinga Teaching and Referral Hospital Kisumu, Kenya
Background Sickle cell disease is a genetic disorder associated with lifelong symptoms of anemia, vaso-oclusive crisis and organ damage. Pulmonary complications and declining lung functions are contributors to morbidity and mortality. Determination of lung functions can enable early diagnosis and institution of appropriate intervention. Methods and findings A cross sectional study done at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, Kenya, to determine the prevalence, patterns, and the factors associated with abnormal lung functions in children and adolescents aged 6-17 years with confirmed diagnosis Sickle Cell Disease. A total of 138 participants were recruited. A structured data collection tool was used to collect Socio-demographics and clinical characteristics. The spirometry was done using NDD Easy-On PC spirometer and results entered into database, cleaned and analyzed for proportions, frequency, mean, range and odds ratio at 95% confidence level. Females were 65(47%), males 73(53%), and the mean age was 10.99 years with SD of 3.15. A total of 79(57%) were from rural and fuel used was fired wood 41%. Hospital admission were 84(61%), vaso-oclusive crisis 104 (75%), acute chest syndrome 61(44%) and blood transfusions 56(40%) in the last 12 months. Prevalence of abnormal lung functions was 28 % (39), restrictive pattern 26(67%) and obstructive pattern 13(33%). Urban setting (OR 24.101 p value 0.163), being female (OR 18.911 p value 0.069), and blood transfusion (OR 11.683 p value 0.195) had high odds ratio while, stable hydroxyurea use (OR 0.525 p value 0.678) and hospital admission (OR 0.048 p value 0.121) had low odds ratio, but not statistically significant. Conclusion One third had abnormal lung function mostly restrictive followed by obstructive pattern. Residence in urban setting, being female and blood transfusion had high odds ratio, while stable hydroxyurea use and hospital admission had low odds ratio but no statistically significant
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