川崎病冠脉瘤患儿远期血管内皮功能的研究  

Late endothelial function in children with coronary aneurysm due to Kawasaki disease

作　　者：段超[1] 杜忠东[1] 王玉[1] 贾立群[1] 

机构地区：[1]首都医科大学附属北京儿童医院心内科,北京100045

出　　处：《中国当代儿科杂志》2011年第5期373-376,共4页Chinese Journal of Contemporary 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)

摘　　要：目的评估川崎病(KD)冠脉瘤患儿远期血管内皮功能。方法选择病程大于1年的合并中型以上冠脉瘤的川崎病患儿31例为研究对象,采用高分辨率超声仪进行肱动脉内皮依赖性和非依赖性舒张功能(FMD)、颈动脉僵硬度指数(SI)和颈动脉内中膜厚度(IMT)的检测。选择年龄相近的正常儿童21例作为对照。结果 31例KD冠脉瘤患儿中,中型冠脉瘤9例,冠脉巨大瘤22例,其中12例有心肌缺血。与对照组比较,KD冠脉瘤组患儿肱动脉血管内皮依赖性FMD减低(P<0.05),颈动脉SI增加(P<0.05),颈动脉IMT增厚(P<0.05)。与无心肌缺血患儿相比,有心肌缺血患儿血管内皮依赖性FMD显著降低(P<0.05)。结论 KD冠脉瘤患儿远期存在血管内皮功能障碍,且合并心肌缺血患儿的血管内皮功能障碍尤为显著。Objective To evaluate the late endothelial function in children with coronary aneurysm due to Kawasaki disease（KD）.Methods Thirty-one children with coronary aneurysms due to KD who had the disease course for more than 1 year and twenty-one age-matched healthy children were enrolled.Brachial artery endothelium-dependent and-independent flow-mediated dilation（FMD）,carotid arterial stiffness index（SI） and intima-media thickness（IMT） were measured by high-frequency ultrasound.Results There were 9 cases of medium and 22 cases of giant coronary aneurysms in the KD group.Twelve KD patients had evidence of myocardial ischemia.Compared to the normal controls,the endothelium-dependent FMD decreased（P〈0.05）,the carotid arterial SI increased（P〈0.05）,and the carotid arterial intima-media thickness increased significantly（P〈0.05） in children with coronary aneurysms due to KD.The endothelium-dependent FMD decreased more significantly in 12 KD patients with myocardial ischemia than in those without any evidence of myocardial ischemia（P〈0.05）.Conclusions Late endothelial dysfunction exists in children with coronary aneurysms due to KD,especially in those with myocardial ischemia.

关 键 词：川崎病 冠脉瘤 血管内皮依赖性舒张功能 儿童 

分 类 号：R725.4[医药卫生—儿科]