Ishikawa Takamichi, Seki Keigo
Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan.
BMC Cardiovasc Disord. 2018 Feb 9;18(1):30. doi: 10.1186/s12872-018-0765-9.
Oxidative stress has recently been shown to play an important role in the development of arteriosclerosis in patients with Kawasaki disease (KD); however, no study has investigated this association in early childhood patients with KD. In this study, we evaluated prospectively the association between the levels of oxidative stress and the endothelial function in early childhood patients with KD.
We compared the derivatives of reactive oxygen metabolites (ROM), flow-mediated dilatation (FMD), and biological characteristics in a population of 50 children: 10 patients with KD and coronary artery lesions (CAL) (group 1), 15 KD patients without CAL (group 2), and 25 healthy age- and sex-matched children (group 3).
The median age of all KD children at study enrollment was 6.8 (IQR 4.4-8.2) years. ROM levels were significantly higher in group 1 (p < 0.001) and group 2 (p = 0.004) than in group 3. The %FMD of group 1 (p < 0.001) and group 2 (p = 0.026) was significantly lower than that of group 3. There was a significant negative correlation between ROM and %FMD (r = - 0.60, p < 0.001). A multiple linear regression analysis identified ln-ROM (standardized coefficient = - 0.403, p = 0.043) and total fever duration (standardized coefficient = - 0.413, p = 0.038) as significant determinants of %FMD in the patients with KD.
Our study suggests that oxidative stress is strongly associated with endothelial dysfunction in early childhood patients with KD. Furthermore, we found that the longer the fever duration, the higher the risk of oxidative stress-induced endothelial dysfunction in these children.
氧化应激最近被证明在川崎病（KD）患者动脉粥样硬化的发展中起重要作用；然而，尚无研究调查幼儿期KD患者的这种关联。在本研究中，我们前瞻性地评估了幼儿期KD患者氧化应激水平与内皮功能之间的关联。
我们比较了50名儿童的活性氧代谢产物衍生物（ROM）、血流介导的血管舒张（FMD）和生物学特征，其中包括10例患有KD和冠状动脉病变（CAL）的患者（第1组）、15例无CAL的KD患者（第2组）以及25名年龄和性别匹配的健康儿童（第3组）。
所有KD儿童在研究入组时的中位年龄为6.8岁（四分位间距4.4 - 8.2岁）。第1组（p < 0.001）和第2组（p = 0.004）的ROM水平显著高于第3组。第1组（p < 0.001）和第2组（p = 0.026）的FMD百分比显著低于第3组。ROM与FMD百分比之间存在显著负相关（r = -0.60，p < 0.001）。多元线性回归分析确定ln-ROM（标准化系数 = -0.403，p = 0.043）和总发热持续时间（标准化系数 = -0.413，p = 0.038）是KD患者FMD百分比的重要决定因素。
我们的研究表明，氧化应激与幼儿期KD患者的内皮功能障碍密切相关。此外，我们发现发热持续时间越长，这些儿童发生氧化应激诱导的内皮功能障碍的风险越高。
