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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。
Objective To investigate the long-term vascular changes in patients with Kawasaki disease (KD) and its relationship with coronary atherosclerosis. Methods Thirty-one children with KD who had a disease course of more than 1 year from June 2008 to June 2009 in Beijing Children’s Hospital of Capital University of Medical Sciences were enrolled in this study. KD patients with coronary artery disease (KD) and CD34 / CD133 / KDR + was the surface marker of endothelial progenitor cells (EPC). The number of EPCs in blood was measured by flow cytometry. The serum hs-CRP was detected by enzyme-linked immunosorbent assay Lipids and apolipoproteins. Twenty-one healthy children with age and gender matched were selected as controls (control group). Results The duration of disease in children with KD coronary artery disease ranged from 1.0 to 12.5 years, with a median duration of 2.5 years. There were 9 cases of medium-sized coronary aneurysm, 22 cases of giant tumor and 12 cases of myocardial ischemia. The serum hs-CRP level in KD group was (2.77 ± 1.06) mg / L and in control group was (1.60 ± 1.53) mg / L, and it was significantly higher in KD group (P <0.01). There was no significant difference between the two groups (P> 0.05). Conclusions The serum hs-CRP in convalescent stage of KD coronary aneurysm group is significantly increased, suggesting that there is still a chronic inflammatory reaction, which may be related to the early onset of atherosclerosis in adult KD patients.