Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy.
Angiology. 2014 Sep;65(8):716-22. doi: 10.1177/0003319713502392. Epub 2013 Sep 9.
We investigated whether children with a previous Kawasaki disease (KD) have evidence of abnormal vascular and/or platelet function. We included 14 patients with previous KD and 14 matched controls. We assessed endothelial function by flow-mediated dilation (FMD), carotid intima-media thickness (cIMT), coronary microvascular function by coronary blood flow response (CBFR) to cold pressor test, and platelet reactivity by measuring monocyte-platelet aggregates (MPAs) and CD41-platelet expression by flow cytometry. No differences were found between the groups in FMD, cIMT, or CBFR to cold pressor test. The MPAs were similar in patients with KD and controls. CD41-platelet expression, however, was significantly increased in patients with KD compared with controls, both at rest (14.3 ± 1.9 vs 12.4 ± 1.9 mean fluorescence intensity [mfi], P = .01) and after adenosine diphosphate stimulation (19.3 ± 1.3 vs 17 ± 1.7 mfi, P < .001). In conclusion, children with a previous episode of KD showed increased platelet activation, compared with healthy participants despite no apparent vascular abnormality at follow-up.
我们研究了先前患有川崎病 (KD) 的儿童是否存在血管和/或血小板功能异常的证据。我们纳入了 14 名先前患有 KD 的患者和 14 名匹配的对照。我们通过血流介导的扩张 (FMD)、颈动脉内膜中层厚度 (cIMT)、冷加压试验冠状动脉血流反应 (CBFR)评估内皮功能，并通过流式细胞术测量单核细胞-血小板聚集物 (MPAs)和 CD41-血小板表达来评估血小板反应性。两组间 FMD、cIMT 或冷加压试验 CBFR 无差异。KD 患者和对照组的 MPAs 相似。然而，KD 患者的 CD41-血小板表达与对照组相比明显增加，无论是在静息状态下 (14.3 ± 1.9 与 12.4 ± 1.9 平均荧光强度 [mfi]，P =.01) 还是在二磷酸腺苷刺激后 (19.3 ± 1.3 与 17 ± 1.7 mfi，P <.001)。总之，与健康参与者相比，尽管在随访中没有明显的血管异常，但先前患有 KD 的儿童的血小板活化增加。
