PDF(Pubmed)
Abstract：
Kawasaki disease (KD) is an acute febrile vasculitis. Patients with previous KD have increased risk of coronary arterial aneurysms (CAA) and early-onset arteriosclerosis. Endothelial dysfunction is the earliest manifestation of arteriosclerosis. We aimed to explore the endothelial function and clinical characteristics of patients with previous KD.
In this case-control study, we investigated childhood KD patients, with and without CAA, and a group of healthy controls. We obtained the anthropometric measurements, metabolic markers, vascular ultrasonography evaluating arterial stiffness and flow-mediated dilatation (FMD), and clinical information obtained by reviewing the patients\' charts. Continuous variables were compared using non-parametric analyses and categorical variables, using the chi-square or Fisher\'s exact tests.
Seventy KD patients (median current age, 12.95 years; median follow-up duration, 10.88 years) and 14 healthy controls were recruited. FMD was significantly lower in the CAA group (n = 15) than the control group (FMDs: 5.59% [interquartile range, 3.99-6.86%] vs. 7.49% [5.96-9.42%], p = 0.049; diastolic FMD: 6.48% [4.14-7.32%] vs. 7.87% [6.19-9.98%], p = 0.042). The CAA group had a higher percentage of impaired FMD and the significantly largest coronary segments of the three groups. Other parameters including metabolic markers, carotid intima-media thickness, and arterial stiffness were not statistically different.
KD patients, especially those with CAAs, may have impaired endothelial function. FMD may be a good indicator of endothelial dysfunction for use in long-term follow-up of KD patients.
In this case-control study, we investigated childhood KD patients, with and without CAA, and a group of healthy controls. We obtained the anthropometric measurements, metabolic markers, vascular ultrasonography evaluating arterial stiffness and flow-mediated dilatation (FMD), and clinical information obtained by reviewing the patients\' charts. Continuous variables were compared using non-parametric analyses and categorical variables, using the chi-square or Fisher\'s exact tests.
Seventy KD patients (median current age, 12.95 years; median follow-up duration, 10.88 years) and 14 healthy controls were recruited. FMD was significantly lower in the CAA group (n = 15) than the control group (FMDs: 5.59% [interquartile range, 3.99-6.86%] vs. 7.49% [5.96-9.42%], p = 0.049; diastolic FMD: 6.48% [4.14-7.32%] vs. 7.87% [6.19-9.98%], p = 0.042). The CAA group had a higher percentage of impaired FMD and the significantly largest coronary segments of the three groups. Other parameters including metabolic markers, carotid intima-media thickness, and arterial stiffness were not statistically different.
KD patients, especially those with CAAs, may have impaired endothelial function. FMD may be a good indicator of endothelial dysfunction for use in long-term follow-up of KD patients.
摘要：
背景：川崎病（KD）是一种急性发热性血管炎。先前患有KD的患者患冠状动脉动脉瘤（CAA）和早发性动脉硬化的风险增加。内皮功能障碍是动脉硬化的最早表现。我们旨在探讨既往KD患者的内皮功能和临床特征。
方法：在本病例对照研究中，我们调查了儿童KD患者，有和没有CAA，和一组健康对照。我们获得了人体测量，代谢标志物,血管超声检查评估动脉僵硬度和血流介导的扩张（FMD），以及通过查看患者图表获得的临床信息。使用非参数分析和分类变量比较连续变量，使用卡方或费希尔精确检验。
结果：70名KD患者（中位当前年龄，12.95年；中位随访时间，10.88年），招募了14名健康对照。CAA组（n=15）的FMD显着低于对照组（FMD：5.59％[四分位距，3.99-6.86%]vs.7.49%[5.96-9.42%]，p=0.049；舒张性口蹄疫：6.48%[4.14-7.32%]vs.7.87%[6.19-9.98%]，p=0.042)。CAA组的FMD受损百分比更高，并且三组中冠状动脉节段明显最大。其他参数，包括代谢标志物，颈动脉内膜中层厚度,动脉僵硬度无统计学差异。
结论：KD患者，尤其是那些有CAA的人，血管内皮功能受损.FMD可能是血管内皮功能障碍的良好指标，可用于KD患者的长期随访。
方法：在本病例对照研究中，我们调查了儿童KD患者，有和没有CAA，和一组健康对照。我们获得了人体测量，代谢标志物,血管超声检查评估动脉僵硬度和血流介导的扩张（FMD），以及通过查看患者图表获得的临床信息。使用非参数分析和分类变量比较连续变量，使用卡方或费希尔精确检验。
结果：70名KD患者（中位当前年龄，12.95年；中位随访时间，10.88年），招募了14名健康对照。CAA组（n=15）的FMD显着低于对照组（FMD：5.59％[四分位距，3.99-6.86%]vs.7.49%[5.96-9.42%]，p=0.049；舒张性口蹄疫：6.48%[4.14-7.32%]vs.7.87%[6.19-9.98%]，p=0.042)。CAA组的FMD受损百分比更高，并且三组中冠状动脉节段明显最大。其他参数，包括代谢标志物，颈动脉内膜中层厚度,动脉僵硬度无统计学差异。
结论：KD患者，尤其是那些有CAA的人，血管内皮功能受损.FMD可能是血管内皮功能障碍的良好指标，可用于KD患者的长期随访。
