Primary and secondary stroke prophylaxis in children with sickle cell anemia: a meta-analysis.

We compared the interventions with no therapy for primary and secondary stroke prevention.

我们将这些干预措施与无治疗情况进行了比较，以评估它们在预防首次和继发性中风方面的效果。

The Medline and EMBASE databases were searched for articles that included ≥6 patients published before January 2025.

在2025年1月之前发表的、包含≥6名患者的文献被检索自Medline和EMBASE数据库。

Four reviewers reviewed all studies to arrive at a consensus assessment.

四名评审员审查了所有研究，以达成共识评估。

The stroke rates (per 100 person-year) for primary stroke prevention in children with transcranial Doppler measurement ≥200 cm/s were as follows: no therapy, 10.7; after initial HU, 1.0; and after initial CBT, 1.0.

在经颅多普勒测量≥200 cm/s的儿童中，原发性中风预防的中风率（每100人年）如下：未治疗组为10.7；初始使用羟基脲后为1.0；初始使用慢性输血治疗后为1.0。

The stroke recurrence rates for secondary stroke prevention per 100 person-years were 19.6 after no therapy, 3.5 after initial HU, 2.7 after initial CBT, 1.0 after HCT, and 3.3 after RVS.

在二次中风预防中，每100人年的中风复发率如下：未治疗组为19.6；初始使用羟基脲后为3.5；初始使用慢性输血治疗后为2.7；使用羟基脲治疗后为1.0；使用红细胞生成素刺激治疗后为3.3。

Neither the HCT nor the RVS study adjusted for the time-dependent stroke recurrence rate, resulting in an overestimation of their therapeutic benefit compared to the stroke recurrence rates before the intervention.

HCT和RVS研究均未对时间依赖性中风复发率进行调整，导致其治疗效益相对于干预前的中风复发率被高估。

In low- and middle-income countries (LMICs), where ∼99% of all children with SCA are born, the stroke recurrence rate in untreated children in the first year was 36.4 to 51.4 strokes per 100 person-years, in 2 studies; in the only randomized controlled trialfor secondary stroke prevention with initial HU (SPRING trial n = 101), 38% (5 of 13) of the deaths occurred within the first year.

在低收入和中等收入国家（LMICs），约99%的SCA儿童出生于此，两项研究显示，未经治疗的儿童在第一年的中风复发率为每100人年36.4至51.4次中风；在唯一一个针对二次中风预防的随机对照试验中，初始使用HU（SPRING试验n=101），38%（13人中的5人）的死亡发生在第一年。

For children in LMICs where local HU costs <$0.20 per day, HU is a practical, inexpensive option for primary and secondary stroke prevention.

对于低收入和中等收入国家（LMICs）的儿童，如果当地羟基脲（HU）的成本每天低于0.20美元，HU是用于初级和二级中风预防的一个实用且经济的选择。