血友病女性患者关节健康评估:带菌者超声波项目(CUP)研究。

IF 3 2区 医学 Q2 HEMATOLOGY
Haemophilia Pub Date : 2024-11-27 DOI:10.1111/hae.15128
Fernando F Corrales-Medina, Kelli Fraga, Maria D'Almeida Bastos, Amina Rafique, Christine L Kempton, Pooja Vijayvargia, Joanna A Davis, Rachel S Kronenfeld
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引用次数: 0

摘要

导言:血友病携带者(HC)的需求历来被忽视。现在人们已经认识到,血友病携带者会出现出血症状,包括血液性关节病。目的:一项多机构横断面研究旨在评估 18-40 岁血友病携带者的关节疾病特征,并与年龄匹配的对照组进行比较:方法:带菌者队列包括确诊为HC的女性。对照组无出血性疾病的个人或家族史。所有在 12 个月内有关节外伤或手术史或任何关节置换史的女性均被排除在外。关节健康状况通过临床病史、血友病关节健康评分(HJHS)和护理点肌肉骨骼超声波检查(POC-MSKUS)进行评估:结果:共招募了 30 名血友病患者和 30 名对照组患者。HC的因子活性水平中位数为52%(范围为17%-100%)。无论基线因子活动水平如何,携带者均报告了较高的慢性关节疼痛发生率(p 2),并报告了较多的血性关节炎(p = .037):与年龄匹配的对照组相比,高危人群出现关节相关症状的风险更高,关节健康状况更差。当务之急是对高危人群进行专门的随访,以预防和治疗关节疾病。这项研究还呼吁开展更多调查,以明确因子活动与关节疾病之间是否存在关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of joint health in females with haemophilia: The carriers ultrasound project (CUP) study.

Introduction: The needs of haemophilia carriers (HC) have been historically overlooked. It is now recognised that HC manifests bleeding symptoms, including haemarthrosis. The natural history of joint health in HC is not yet defined.

Aim: A multi-institutional cross-sectional study aimed to evaluate the characteristics of joint disease in HC, aged 18-40 years, compared to age-matched controls.

Methods: The carrier cohort included females with confirmed HC status. Controls had no personal or family history of bleeding disorders. All females with a history of joint trauma or surgery within 12 months or any history of joint replacement were excluded. Joint health was assessed by clinical history, Haemophilia Joint Health Score (HJHS) and point-of-care musculoskeletal ultrasonography (POC-MSKUS).

Results: Thirty HC and 30 controls were enrolled. For HC, the median factor activity level was 52% (range 17%-100%). Carriers, regardless of baseline factor activity levels, reported higher prevalence of chronic joint pain (p < .001) and swelling (p = .002) than controls. Heavy menstrual bleeding, epistaxis, gingival bleeding and easy bruising were also more prevalent in HC (p < .001). Despite HC having a higher median HJHS score (5 vs. 0, p < .001), no differences were observed when using POC-MSKUS. HC with a body mass index ≥25 mg/m2 reported more haemarthrosis (p = .037).

Conclusions: HC are at increased risk of joint-related symptoms and poorer joint health than age-matched controls. Dedicated follow-up to prevent and treat joint disease in HC is imperative. This study is also a call for additional investigation to clarify the association, or lack thereof, between factor activity and joint disease.

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来源期刊
Haemophilia
Haemophilia 医学-血液学
CiteScore
6.50
自引率
28.20%
发文量
226
审稿时长
3-6 weeks
期刊介绍: Haemophilia is an international journal dedicated to the exchange of information regarding the comprehensive care of haemophilia. The Journal contains review articles, original scientific papers and case reports related to haemophilia care, with frequent supplements. Subjects covered include: clotting factor deficiencies, both inherited and acquired: haemophilia A, B, von Willebrand''s disease, deficiencies of factor V, VII, X and XI replacement therapy for clotting factor deficiencies component therapy in the developing world transfusion transmitted disease haemophilia care and paediatrics, orthopaedics, gynaecology and obstetrics nursing laboratory diagnosis carrier detection psycho-social concerns economic issues audit inherited platelet disorders.
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