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.
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。