Butbul Aviel Yonatan, Dafna Lotem, Pilar Giora, Brik Riva
Department of Pediatrics B, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.
Pediatric Rheumatology Service, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.
Pediatr Rheumatol Online J. 2017 Jan 14;15(1):3. doi: 10.1186/s12969-016-0135-z.
Although Henoch-Schonlein purpura (HSP) is the most common form of systemic vasculitis in children, the long term effect of HSP on endothelial function is still not clear. The aim of our study was to evaluate the long term effect of HSP on endothelial function in children and adolescents.
This research was an observational prospective study. The study group comprised of 19 children diagnosed with HSP. The minimum interval between the diagnosis with HSP and endothelial testing was 5 months. Endothelial function evaluation was assessed by a noninvasive technology named peripheral arterial tonometry, using an EndoPAT™ device. This method measures blood flow in the limb, in response to arterial occlusion, and calculates a Reactive Hyperemic Index (RHI) as an index of endothelial function. RHI values of the study group were compared to those of a known control group.
Nineteen children and adolescents with HSP underwent endothelial function studies. Endothelial function was compared to that of a known control group comprising of 23 healthy children and adolescents. The two groups had similar characteristics, including age, male to female ratio, height, weight and BMI. Mean RHI was 1.81 in the study group, and 1.87 in the control group (p = 0.18). Linear regression of the study group, showed a positive correlation between the time interval from HSP diagnosis to participation in the study, and between the RHI value (r = 0.542, p = 0.016). RHI levels were significantly higher in patients who had endothelial function measured more than 6 years since the diagnosis of HSP compared with those patients with less than 6 years follow up (1.98 + 0.74 vs. 1.38 ± 0.43 P = 0.037).
These results suggest that HSP causes short term endothelial dysfunction that improves with time.
尽管过敏性紫癜（HSP）是儿童系统性血管炎最常见的形式，但HSP对内皮功能的长期影响仍不明确。我们研究的目的是评估HSP对儿童和青少年内皮功能的长期影响。
本研究为观察性前瞻性研究。研究组由19名诊断为HSP的儿童组成。从HSP诊断到内皮功能检测的最短间隔为5个月。使用EndoPAT™设备，通过一种名为外周动脉张力测量法的非侵入性技术评估内皮功能。该方法测量肢体在动脉闭塞反应中的血流，并计算反应性充血指数（RHI）作为内皮功能指标。将研究组的RHI值与已知对照组的RHI值进行比较。
19名患有HSP的儿童和青少年接受了内皮功能研究。将内皮功能与由23名健康儿童和青少年组成的已知对照组进行比较。两组具有相似的特征，包括年龄、男女比例、身高、体重和BMI。研究组的平均RHI为1.81，对照组为1.87（p = 0.18）。研究组的线性回归显示，从HSP诊断到参与研究的时间间隔与RHI值之间呈正相关（r = 0.542，p = 0.016）。与随访时间少于6年的患者相比，自HSP诊断后6年以上测量内皮功能的患者RHI水平显著更高（1.98 + 0.74 vs. 1.38 ± 0.43，P = 0.037）。
这些结果表明，HSP会导致短期内皮功能障碍，且随着时间推移会有所改善。
