Amano S, Hazama F, Hamashima Y
Jpn Circ J. 1979 Aug;43(8):741-8. doi: 10.1253/jcj.43.741.
Histopathology, distribution and incidence of vascular changes were studied in tissues obtained at autopsy on thirty-seven children. Elastic and musculoelastic arteries showed a high incidence of arteritic changes, however the degree of the lesions was in general mild to moderate with the exception of the iliac artery, which revealed severe changes and a necrotizing panarteritis which was often accompanied with an aneurysm formation. A high incidence of arteritic changes, of which main histological feature was necrotizing panarteritis, was seen in extravisceral middle sized arteries. The coronary artery in particular was involved in each case and most had an accompanying aneurysm, some of which had ruptured. Intravisceral small sized arteries showed a relatively low incidence of arteritic changes and the degree of inflamation was in general mild. Phlebitis was present in over half the number of patients. The degree of lesions was mild in the small veins and mild to moderate in the large veins. Vascular lesions in Kawasaki disease should be termed systemic vasculitis rather than a systemic arteritis. There was a correlation between the caliber of involved vessels and the degree of vascular lesions. According to the histopathology, distribution and incidence of angitis, Kawasaki disease does resemble infantile periarteritis nodosa with the exception of the different manner of the coronary and iliac involvement.
对37例儿童尸检组织的血管变化进行了组织病理学、分布及发生率的研究。弹性动脉和肌弹性动脉显示动脉炎改变的发生率较高，然而，除髂动脉外，病变程度一般为轻度至中度，髂动脉显示严重改变及坏死性全动脉炎，常伴有动脉瘤形成。在腹腔外中等大小动脉中可见动脉炎改变的高发生率，其主要组织学特征为坏死性全动脉炎。特别是冠状动脉在每例中均有累及，多数伴有动脉瘤，其中一些已破裂。腹腔内小动脉显示动脉炎改变的发生率相对较低，炎症程度一般为轻度。超过半数的患者存在静脉炎。小静脉病变程度为轻度，大静脉病变程度为轻度至中度。川崎病的血管病变应称为系统性血管炎而非系统性动脉炎。受累血管的管径与血管病变程度之间存在相关性。根据血管炎的组织病理学、分布及发生率，川崎病除冠状动脉和髂动脉受累方式不同外，确实类似于婴儿结节性多动脉炎。
