Department of Echocardiology, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China.
Department of Imaging, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China.
Pediatr Res. 2014 Mar;75(3):453-8. doi: 10.1038/pr.2013.240. Epub 2013 Dec 18.
We investigated vascular endothelial dysfunction by sonographic features of flow-mediated dilation (FMD) and circulating endothelial microparticles (EMPs) in Kawasaki disease (KD).
Twenty-eight patients with KD were prospectively grouped according to stage of disease: acute, subacute, and convalescent. In addition, 28 healthy children and 28 febrile children were selected as controls. And cases in the convalescent phase were divided into two subgroups: coronary artery lesion (CAL) and no coronary lesion (NCAL). CD144(+)/CD42b(-), CD62E(+), and CD105(+) EMPs were measured by flow cytometry; FMD was obtained by sonography.
There were significant differences in FMD among the five groups. When compared with healthy controls, there were significantly greater numbers of CD144(+)/CD42b(-), CD62E(+), and CD105(+) EMPs and a higher proportion of CD62E(+) EMPs in KD patients. The proportions and numbers of CD144(+)/CD42b(-), CD62E(+), and CD105(+) EMPs in KD patients were not statistically different than in febrile controls. There were no significant differences in FMD and EMPs between the CAL and NCAL subgroups. There were significantly negative correlations between the values of FMD and EMPs in the three phases of KD.
The increased levels of EMPs have significant correlation with decreased values of FMD, both of which may reflect endothelial dysfunction in child KD.
本研究通过超声检测血流介导的舒张功能(FMD)和循环内皮微颗粒(EMPs)探讨川崎病(KD)患儿血管内皮功能障碍。
前瞻性纳入 28 例 KD 患儿,根据疾病分期分为急性期、亚急性期和恢复期。同时选择 28 例健康儿童和 28 例发热儿童作为对照组。恢复期患儿分为冠状动脉损伤(CAL)组和无冠状动脉损伤(NCAL)组。采用流式细胞术检测 CD144(+)/CD42b(-)、CD62E(+)和 CD105(+) EMPs;超声检测 FMD。
5 组间 FMD 比较差异有统计学意义。与健康对照组相比,KD 患儿 CD144(+)/CD42b(-)、CD62E(+)和 CD105(+) EMPs 数量及 CD62E(+) EMPs 比例明显升高,差异有统计学意义(P 均<0.05)。KD 患儿与发热对照组比较,CD144(+)/CD42b(-)、CD62E(+)和 CD105(+) EMPs 数量及 CD62E(+) EMPs 比例差异无统计学意义(P 均>0.05)。CAL 组与 NCAL 组 FMD 和 EMPs 比较差异无统计学意义(P 均>0.05)。KD 患儿各期 FMD 与 EMPs 均呈显著负相关(P 均<0.05)。
KD 患儿 EMPs 水平升高与 FMD 降低具有显著相关性,二者均可能反映了川崎病患儿的血管内皮功能障碍。