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目的探讨川崎病恢复期的肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度及其之间的关系。方法共204例受试者纳入试验。包括51例川崎病合并冠状动脉病变者(冠状动脉病变组),50例川崎病无冠状动脉病变者(冠状动脉正常组),103名正常儿童(对照组)。观察血压、血脂、肱动脉内皮功能、颈动脉僵硬度指数及颈动脉内-中膜厚度。结果肱动脉内皮功能冠状动脉病变组(5.2%±1.9%)和冠状动脉正常组(6.8%±2.0%)均显著低于对照组(13.2%±4.1%,均P<0.01);颈动脉僵硬度指数在冠状动脉病变组(4.0±0.6)显著高于冠状动脉正常组(3.6±0.6)和对照组(3.4±0.5,P<0.05和 P<0.01)。同样,冠状动脉病变组颈动脉内-中膜厚度(0.447 mm±0.024 mm)显著高于冠状动脉正常组(0.426 mm±0.016 mm)和对照组(0.424 mm±0.016 mm,均P<0.01)。多元回归分析显示,年龄和分组是肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度的显著决定因素。相关性检验分析显示,各组在调整年龄后,肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度两两比较均有显著相关性。结论川崎病恢复期存在血管内皮功能障碍、颈动脉僵硬度增加以及颈动脉内-中膜增厚。综合采用肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度等超声检测指标可更全面评价川崎病恢复期血管病变的预后。
Objective To investigate the relationship between brachial artery endothelium function, carotid artery stiffness index and carotid artery intima-media thickness in the recovery phase of Kawasaki disease. Methods A total of 204 subjects were included in the trial. Including 51 cases of Kawasaki disease with coronary lesions (coronary artery disease group), 50 cases of Kawasaki disease without coronary artery disease (normal coronary artery group), 103 normal children (control group). Blood pressure, blood lipid, endothelial function of brachial artery, carotid artery stiffness index and carotid intima-media thickness were observed. Results Coronary artery disease group (5.2% ± 1.9%) and normal coronary artery group (6.8% ± 2.0%) were significantly lower than those in control group (13.2% ± 4.1%, P <0.01) Degree index was significantly higher in coronary artery disease group (4.0 ± 0.6) than in normal coronary artery group (3.6 ± 0.6) and control group (3.4 ± 0.5, P <0.05 and P <0.01). Similarly, the carotid intima-media thickness (0.447 mm ± 0.024 mm) was significantly higher in patients with coronary artery disease than those in the normal coronary artery group (0.426 mm ± 0.016 mm) and in the control group (0.424 mm ± 0.016 mm, P <0.01). Multivariate regression analysis showed that age and grouping were significant determinants of brachial artery endothelial function, carotid artery stiffness index, and carotid artery intima-media thickness. Correlation analysis showed that after adjusting for age, the brachial artery endothelial function, carotid artery stiffness index and carotid artery intima-media thickness were significantly correlated with each other. Conclusion There are vascular endothelial dysfunction, carotid artery stiffness and carotid intima-media thickening in Kawasaki disease recovery. Comprehensive use of brachial artery endothelial function, carotid artery stiffness index and carotid intima-media thickness and other ultrasonic testing indicators can be more fully evaluated Kawasaki disease recovery of vascular disease prognosis.