川崎病冠脉瘤远期血管改变与冠脉粥样硬化关系研究  

The study of circulating endothelial progenitor cells and inflammatory factors in children with coronary aneurysms late after Kawasaki disease

作　　者：段超[1] 杜忠东[1] 张桂荣[1] 万岁桂[2] 孙雪静[2] 

机构地区：[1]首都医科大学附属北京儿童医院,北京100045 [2]首都医科大学宣武医院,北京100053

出　　处：《中国实用儿科杂志》2010年第10期759-762,共4页Chinese Journal of Practical Pediatrics

基　　金：北京"首都医学发展科研基金"重点项目资助(2007-2063);国家自然科学基金面上项目(30973238);北京自然科学基金面上项目(7092032);北京自然科学基金B类/北京教育委员会重大科研项目(KZ201010025024);首都医科大学基础临床联合项目资助(2007JL48)

摘　　要：目的探讨川崎病(KD)冠脉瘤远期血管改变及其与冠脉粥样硬化的关系。方法选择首都医科大学附属北京儿童医院2008年6月至2009年6月病程大于1年且合并中型以上冠脉瘤的KD患儿31例为研究对象(KD冠脉瘤组),以CD34/CD133/KDR+为血管内皮祖细胞(EPC)表面分子标记,用流式细胞仪测定血周血EPC数量;采用酶联免疫法测定血清超敏C反应蛋白(hs-CRP);全自动生化分析仪测定血脂及载脂蛋白。选取年龄、性别匹配的21名健康体检儿童作对照(对照组)。结果 KD冠脉瘤组患儿病程1.0～12.5年,中位病程2.5年;中型冠脉瘤9例,巨大瘤22例,12例存在心肌缺血证据。KD冠脉瘤组血清hs-CRP为(2.77±1.06)mg/L,对照组为(1.60±1.53)mg/L,KD冠脉瘤组显著升高(P<0.01)。外周血EPC及血脂两组比较差异无统计学意义(P>0.05)。结论 KD冠脉瘤组恢复期血清hs-CRP显著升高,提示仍有慢性炎症反应,可能与KD成年后早发动脉粥样硬化有关。Abstract：Objectives To evaluate the circulating endothelial progenitor cells （EPC） numbers as well as the serum lipo- protein levels and high sensitivity C-reactive protein （hs-CRP） in children with coronary aneurysms. Methods Thir- ty-one children with coronary aneurysms due to Kawasaki disease and twenty-one healthy children were enrolled in this study. Circulating EPCs were determined by flow cytometry, defined as CD34, KDR, CD133 possitive cells. Serum lipo- protein levels were measured by using automatic biochemistry analyzer and their matched reagents. Serum hs-CRP levels were determined by enzyme-linked immunosorbent assay. All data were analyzed by using SPSS 12.0 for windows. Re- suits The KD group included 9 children with medium aneurysms and 22 children with gaint aneurysms. The duration from the onset of the disease was 1 - 12.5 years （median 2.53 years）. The hs-CRP levels in KD group was significantly higher than in normal controls[ （2.77 _＋ 1.06）mg/L VS （ 1.60 -＋ 1.53）mg/L, P 〈 0.01 ]. The number of circulating endothe- lial progenitor cells between the two groups had no statistical significance （P 〉 0.05） .The serum levels of TG, TC, HDL-C, LDL-C apo-Al and apo-B between the two groups had no statistical significance （P 〉 0.05）. Conelutions The serum level of hs-CRP is significantly increased in children with KD complicated with medium or giant coronary aneurysm late after the onset of disease, suggesting that children with persistant coronary aneurysms due to Kawasaki disease may have the disposition to premature atherosclerosis in young adulthood. Circulating endothelia progenitor cells and serum lipoprotein levels have no significant changes as compared with normal controls.

关 键 词：黏膜皮肤淋巴结综合征 川崎病 冠状动脉瘤 血管内皮祖细胞 超敏C反应蛋白 血脂 

分 类 号：R72[医药卫生—儿科]