Yao Yinna, Yang Gunan, Chen Yanling
Department of Pediatrics, Zhuji Hospital Affiliated to Shaoxing University of Arts and Sciences, Zhuji, Zhejiang 311800, China.
Evid Based Complement Alternat Med. 2021 Oct 26;2021:7372424. doi: 10.1155/2021/7372424. eCollection 2021.
To investigate the correlation between carotid intima-media thickness (IMT), ankle-brachial index (ABI), and coronary artery dilatation (CAD) in children with Kawasaki disease (KD) and to evaluate the effectiveness of CAD.
A total of 68 children diagnosed with KD from January 2019 to January 2021 in our hospital were included. According to the results of cardiac color Doppler ultrasound, the children with KD were divided into a noncoronary artery dilation group (NCAD), with 41 children with KD who did not have coronary artery lesions, and a coronary artery dilation group (CAD), with 27 children with KD who had coronary artery dilation. 27 healthy children undergoing physical examination in our hospital at the same time were selected as the normal control group. Laboratory index of all subjects was measured individually. The carotid IMT, ABI, and coronary artery diameter of all subjects were measured and compared. Pearson correlation was used to analyze the correlation between carotid IMT, ABI, and the severity of coronary artery disease. The ROC curve was used to evaluate the efficacy of carotid IMT and ABI in predicting coronary artery disease.
The ALB of children in the CAD group was lower than that in the NCAD group ( < 0.05). The IMT of carotid artery and the diameter of coronary artery in children of the CAD group and the NCAD group were higher than those of the normal control group, and the IMT of the CAD group was higher than that of the NCAD group. The ABI of children in the CAD group and the NCAD group was lower than that of the normal control group, and the ABI of children in the CAD group was lower than that of the NCAD group ( < 0.05). Correlation analysis showed that carotid artery IMT of children with KD was positively correlated with coronary artery diameter, while ABI was negatively correlated with coronary artery diameter. The AUC of carotid IMT for CAD in children with KD was 0.668 (95% CI: 0.538-0.797), that of ABI for CAD in children with KD was 0.646 (95% CI: 0.513-0.780), and that of the combination of carotid IMT and ABI for CAD was 0.874 (95% CI: 0.785-0.963).
The changes of carotid artery IMT and ABI in children with KD have a certain correlation with CAD, and the joint detection of carotid artery IMT and ABI can provide clinical reference value for predicting the degree of coronary artery disease in children with KD.
探讨川崎病（KD）患儿颈动脉内膜中层厚度（IMT）、踝臂指数（ABI）与冠状动脉扩张（CAD）之间的相关性，并评估CAD的有效性。
纳入2019年1月至2021年1月在我院确诊为KD的68例患儿。根据心脏彩色多普勒超声结果，将KD患儿分为非冠状动脉扩张组（NCAD），41例无冠状动脉病变的KD患儿；冠状动脉扩张组（CAD），27例有冠状动脉扩张的KD患儿。选取同期在我院进行体检的27例健康儿童作为正常对照组。分别测量所有受试者的实验室指标。测量并比较所有受试者的颈动脉IMT、ABI及冠状动脉直径。采用Pearson相关性分析颈动脉IMT、ABI与冠状动脉疾病严重程度之间的相关性。采用ROC曲线评估颈动脉IMT和ABI预测冠状动脉疾病的效能。
CAD组患儿的ALB低于NCAD组（<0.05）。CAD组和NCAD组患儿的颈动脉IMT及冠状动脉直径均高于正常对照组，且CAD组的IMT高于NCAD组。CAD组和NCAD组患儿的ABI均低于正常对照组，且CAD组患儿的ABI低于NCAD组（<0.05）。相关性分析显示，KD患儿的颈动脉IMT与冠状动脉直径呈正相关，而ABI与冠状动脉直径呈负相关。KD患儿CAD的颈动脉IMT的AUC为0.668（95%CI：0.538 - 0.797），ABI的AUC为0.646（95%CI：0.513 - 0.780），颈动脉IMT与ABI联合检测的AUC为0.874（95%CI：0.785 - 0.963）。
KD患儿颈动脉IMT和ABI的变化与CAD有一定相关性，联合检测颈动脉IMT和ABI可为预测KD患儿冠状动脉疾病程度提供临床参考价值。
