血清阳离子和阴离子变化对镰状细胞病临床严重程度的临床意义:三级中心的病例对照研究

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-04-12 DOI:10.1055/s-0043-1772684
S. Patel, Diksha Chandrakar, P. Wasnik, R. Nanda, E. Mohapatra
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引用次数: 0

摘要

镰状细胞病(SCD)的血管闭塞危象与不成比例的血清离子分布有关。目的是评估血清阳离子和阴离子的变化对SCD患者临床严重程度的影响。材料与方法病例-对照研究纳入SCD病例26例和表面健康对照27例。将病例进一步分为危机状态和稳定状态。每个参与者都被分配了一个疾病严重程度评分。对所有研究参与者进行血清电解质、渗透压、钙、镁、磷、总蛋白和白蛋白的评估。结果患者血清钠(135.65 mmol/L)、氯(99.88 mmol/L)、钙(2.28 mmol/L)、镁(0.76 mmol/L)、渗透压(285.19 mOsm/kg)、白蛋白(0.59 mmol/L)均较对照组显著降低。SCD危重组血清钠(p = 0.01)、钙(p = 0.011)、总阳离子(p = 0.023)、阴离子(p = 0.008)、正负离子比(p = 0.041)均较低。在所有阳离子中,血清钙与疾病严重程度评分呈负相关(r = -0.367, p = 0.033),而血清阴离子中的血清白蛋白对疾病严重程度影响最大(r = -0.338, p = 0.046)。血清钙和白蛋白的临界值分别为2.41和0.63 mmol/L,敏感性分别为83.3和88.9%。计算出的血清钠-白蛋白比值与严重程度评分呈正相关(r = 0.328, p = 0.05),敏感性为94.4%,临界值为208.45。结论低钠、低钙、低白蛋白及钠白蛋白比升高与危重状态有关,常规评估这些参数有助于早期评估临床严重程度并进行适当的输液处理。
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Clinical Implication of Changes in Serum Cations and Anions on Clinical Severity in Sickle Cell Disease: A Case–Control Study in a Tertiary Center
Abstract Introduction  Vaso-occlusive crisis in sickle cell disease (SCD) is related to disproportionate serum ions distribution. The objective was to evaluate the influence of changes in serum cations and anions on clinical severity in SCD patients. Materials and Methods  The case–control study included 26 SCD cases and 27 apparently healthy control individuals. The cases were further grouped as crisis state and steady state cases. Each participant was assigned a disease severity score. All study participants were evaluated for serum electrolytes, osmolality, calcium, magnesium, phosphorus, total protein, and albumin. Results  The mean serum sodium (135.65 mmol/L), chloride (99.88 mmol/L), calcium (2.28 mmol/L), magnesium (0.76 mmol/L), osmolality (285.19 mOsm/kg), and albumin (0.59 mmol/L) were grossly reduced in cases than the control group. The SCD crisis group recorded low serum sodium ( p  = 0.01), calcium ( p  = 0.011), total cations ( p  = 0.023), anions ( p  = 0.008), and cation–anion ratio ( p  = 0.041). Of all the cations, serum calcium correlated inversely with disease severity score ( r  = –0.367, p  = 0.033), whereas serum albumin among the serum anions influenced severity the most ( r  = –0.338, p  = 0.046). The cutoff values for serum calcium and albumin were, respectively, 2.41 and 0.63 mmol/L, with a sensitivity of 83.3 and 88.9%. A calculated ratio of serum sodium–albumin revealed a positive relationship with the severity score ( r  = 0.328, p  = 0.05) with a sensitivity of 94.4% for a cutoff value of 208.45. Conclusion  Low serum sodium, calcium, albumin, and raised sodium–albumin ratio were linked to the crisis state, and routine estimation of these parameters will help in the early assessment of the clinical severity and initiate appropriate fluid management.
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Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
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