■川崎病对体内冠状动脉的长期影响尚不清楚。
■这项研究的目的是研究恢复期后期的冠状动脉,我们随访了发生冠状动脉瘤(CAAs)的川崎病患者.
■我们随访了24例患者,并在川崎病发病后的中位数为16.6年使用了光学相干断层扫描。
■在72条冠状动脉中,对61条动脉进行了光学相干断层扫描:17条具有持续性CAA,29与回归的CAA,和15没有CAA。组间比较采用卡方检验或Fisher精确检验,和内膜增厚(17vs29vs15,均为100%,P=NA)和内侧破裂(17[100%]vs29[100%]vs14[93%],P=0.25)通常在所研究的动脉中观察到。动脉粥样硬化的晚期特征在有持续性CAAs的动脉中比在有退化的CAAs和没有CAAs的动脉中更常见:钙化(12[71%]vs5[17%]vs1[7%],P<0.001),微血管(12[71%]对10[35%]对4[27%],P=0.020),胆固醇晶体(6[35%]对2[7%]对0[0%],P=0.009),巨噬细胞积累(11[65%]对4[14%]对4[27%],P=0.002),和分层斑块(8[47%]vs11[38%]vs0[0%],P=0.004)。
■川崎病发作后很久,所有动脉均有病理变化。具有持续性CAA的动脉比具有退化的CAA和没有CAA的动脉具有更高级的动脉粥样硬化特征。
UNASSIGNED: The long-term impact of Kawasaki disease on coronary arteries in vivo is unclear.
UNASSIGNED: The purpose of this study was to investigate coronary arteries in the late convalescent phase, we followed patients with Kawasaki disease who developed coronary artery aneurysms (CAAs).
UNASSIGNED: We followed 24 patients and used optical coherence tomography at a median of 16.6 years after the onset of Kawasaki disease.
UNASSIGNED: Of 72 coronary arteries, optical coherence tomography was performed on 61 arteries: 17 with a persistent CAA, 29 with a regressed CAA, and 15 without a CAA. Between-group comparison was performed by chi-square or Fisher\'s exact test, and intimal thickening (17 vs 29 vs 15, all 100%, P = NA) and medial disruption (17 [100%] vs 29 [100%] vs 14 [93%], P = 0.25) were commonly observed in the investigated arteries. Advanced features of atherosclerosis were more frequently seen in arteries with persistent CAAs than in those with regressed CAAs and in those without CAAs: calcification (12 [71%] vs 5 [17%] vs 1 [7%], P < 0.001), microvessels (12 [71%] vs 10 [35%] vs 4 [27%], P = 0.020), cholesterol crystals (6 [35%] vs 2 [7%] vs 0 [0%], P = 0.009), macrophage accumulation (11 [65%] vs 4 [14%] vs 4 [27%], P = 0.002), and layered plaque (8 [47%] vs 11 [38%] vs 0 [0%], P = 0.004).
UNASSIGNED: Long after onset of Kawasaki disease, all arteries showed pathological changes. Arteries with persistent CAAs had more advanced features of atherosclerosis than those with regressed CAAs and those without CAAs.