高分辨力超声评价川崎病急性期肱动脉内皮功能及维生素C的作用

Brachial endothelial function in potients with acute Kawasaki disease and the effects of intravenous administration of vitamin C

目的研究川崎病(KD)急性期肱动脉内皮依赖性血管舒张(EDD)功能及快速经静脉输注维生素C的作用。方法应用高分辨力超声分别测定KD急性期患者及对照组反应性充血介导的肱动脉内径百分变化率,并测定快速经静脉输注维生素C后反应性充血介导的肱动脉内径百分变化率。结果KD急性期组反应性充血介导肱动脉内径百分变化率明显低于对照组(P<0.01),其中并发冠状动脉扩张者与未并发冠状动脉扩张者间差异无统计学意义(P>0.05)。KD急性期患者快速经静脉输注维生素C后反应性充血介导肱动脉内径百分变化率较前明显增加(P<0.01)。结论KD急性期外周动脉内皮功能减低,经静脉快速输注大剂量维生素C可以改善KD急性期外周动脉内皮功能。

Objective:To investigate brachial endothelial function in patients with acute Kawasaki disease and to evaluate the acute effect of vitamin C on the brachial endothelial function. Method:Using high-resolution ultrasonography, we measured the reactive hyperemia-induced percent change of brachial artery in patients with Kawasaki disease and control subjects before and after the acute administration of vitamin C. Result:The reactive hyperemia-induced percent change of brachial artery in patients with Kawasaki disease was significant less than that in control subjects ( P < 0.01 ). No significant difference was found in percent change of brachial artery induced by reactive hyperemia in patient with and without coronary artery dilation ( P = 0.25 ). Intravenous infusion of vitamin C significantly increased the percent change of brachial artery induced by reactive hyperemia. Conclusion:Our study showed the systemic endothelial dysfunction of patients in acute Kawasaki disease, and it can be restored by acute intravenous administration of vitamin C.