川崎病恢复期患儿血管病变的超声研究  

The study of vascular lesion using ultrasound in children with a history of Kawasaki disease

作　　者：刘晓琴[1] 黄国英[1] 梁雪村[1] 陶子喻[1] 陈伟达[1] 林其珊[1] 

机构地区：[1]复旦大学附属儿科医院心超室,上海200032

出　　处：《中华医学杂志》2007年第30期2117-2120,共4页National Medical Journal of China

摘　　要：目的探讨川崎病恢复期的肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度及其之间的关系。方法共204例受试者纳入试验。包括51例川崎病合并冠状动脉病变者(冠状动脉病变组),50例川崎病无冠状动脉病变者(冠状动脉正常组),103名正常儿童(对照组)。观察血压、血脂、肱动脉内皮功能、颈动脉僵硬度指数及颈动脉内-中膜厚度。结果肱动脉内皮功能冠状动脉病变组(5.2%±1.9%)和冠状动脉正常组(6.8%±2.0%)均显著低于对照组(13.2%±4.1%,均P<0.01);颈动脉僵硬度指数在冠状动脉病变组(4.0±0.6)显著高于冠状动脉正常组(3.6±0.6)和对照组(3.4±0.5,P<0.05和 P<0.01)。同样,冠状动脉病变组颈动脉内-中膜厚度(0.447 mm±0.024 mm)显著高于冠状动脉正常组(0.426 mm±0.016 mm)和对照组(0.424 mm±0.016 mm,均P<0.01)。多元回归分析显示,年龄和分组是肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度的显著决定因素。相关性检验分析显示,各组在调整年龄后,肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度两两比较均有显著相关性。结论川崎病恢复期存在血管内皮功能障碍、颈动脉僵硬度增加以及颈动脉内-中膜增厚。综合采用肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度等超声检测指标可更全面评价川崎病恢复期血管病变的预后。Objective To explore the endothelial function, carotid artery stiffness index and carotid intima-media thickness in children with a history of Kawasaki disease （KD） . Methods A cohort of 204 children was studied, which comprised 51 patients with Kawasaki disease with coronary artery lesion （ CAL group） ,50 patients with Kawasaki disease with normal coronary arteries （normal coronary arteries group）, and 103 healthy age matched children （ control group） o Their systemic blood pressure, fasting cholesterol concentrations, flow-mediated dilation （FMD） of the brachial artery , carotid artery stiffness index and carotid intima-media thickness （IMT） were compared. Results FMD of the brachial artery in CAL group （5.2% ± 1.9% ）and normal coronary arteries group （6.8% ± 2.0% ）were significantly lower than that of control group （13.2% ± 4. 1% ,both P 〈 0. 01 ） ; carotid artery stiffness index in CAL group （4.0 ± 0.6 ） was significantly greater than that of normal coronary arteries group （ 3.6 ± 0.6 ） and control group （ 3.4± 0.5 ,P = 0.05, P 〈 0.01 ） ; likewise, IMT in CAL group （ 0. 447 mm± 0. 024 mm） was significantly higher than that of normal coronary arteries group （0.426 mm ±0.016 mm） and control group （0.424 mm± 0. 016 mm, both P 〈 0. 01 ）. In multiple linear regression analysis, age and patient grouping were significant determinants of carotid artery stiffness index, FMD and IMT. There were significant correlations between carotid artery stiffness index, FMD and IMT in both healthy group and KD group after adjustment of age. Conclusion There were endothelial dysfunction and increased systemic arterial stiffness and IMT late after the acute phase of Kawasaki disease, flow-mediated dilation of the brachial artery , carotid artery stiffness index combined carotid intima-media thickness can evaluated completely the prognosis of vascular lesion in convalescence after KD.

关 键 词：血管疾病 超声检查 黏膜皮肤淋巴结综合征 恢复期 

分 类 号：R725.4[医药卫生—儿科]