超声评价川崎病肱动脉内皮功能及大剂量VitC的治疗作用

Evaluation of the impaired vascular endothelial function and the effects of intravenous vitamin C in Kawasaki diease by ultrasound

目的通过高分辨力超声检测川崎病(kawasakidisease,KD)患儿肱动脉血流介导的扩张反应(flowmediatedvasodilation,FMD),观察川崎病患儿血管内皮功能变化,并对照大剂量VitC治疗后肱动脉内皮功能变化,以探讨VitC对川崎病血管内皮功能障碍的治疗作用。方法超声评价28例急性期及21例恢复期川崎病患者与20例健康对照者的肱动脉血流介导的扩张反应,并观察KD患者应用大剂量VitC静脉滴注前、后肱动脉反应性充血内径变化率(FMD%)的变化。结果川崎病急性期、恢复期组肱动脉FMD%均显著低于对照组(P<0·01)。川崎病急性期组、恢复期组大剂量VitC静滴后肱动脉FMD%均显著高于静滴前(P均<0·01)。结论川崎病急性期组、恢复期组肱动脉FMD%较健康儿童低,提示川崎病患儿存在着显著的持续性血管内皮功能障碍。大剂量抗氧化剂VitC对KD急性期组、恢复期组的血管内皮功能有明显改善作用。

Objective To evaluate the systemic endothelial function in Kawasaki disease（KD） with high resolution vascular ultrasound and to determine whether the timely administration of VitC could restore systemic endothelial dysfunction in KD. Methods The brachial artery responses to reactive hyperemia （flow mediate vasodilation, FMD） were evaluated in 49 patients of KD and 20 matched healthy subjects. The brachial artery vasodilation was assessed before and after VitC was infused intravenously in patients of KD. Results ①The FMD% of the brachial artery in the patients of KD were significantly lower than that in the control group（ P 〈 0.001 ）. ②Intravenous infusion of VitC significantly increased the FMD% of the brachial artery in the patients of KD（ P 〈 0.01 ）. Conclusion ①Systemic endothelial dysfunction exists in acute stage and convalescence stage of KD. ②The timely administration of VitC could restore systemic endothelial dysfunction in acute stage and convalescence stage of KD.