川崎病冠状动脉损害易患基因研究进展

Susceptibility gene research of coronary artery lesions in Kawasaki disease

川崎病是一种好发于5岁以下儿童的急性全身性中、小血管炎性综合征，该病的病因和发病机制至今尚未明确。流行病学资料显示川崎病的发病存在明显的种族差异，在亚裔人群中的发病率明显高于非亚裔人群。冠状动脉损害是川崎病最为严重的并发症，可导致缺血性心肌病、心肌梗死甚至猝死，未经治疗的患儿约25％会发生冠状动脉损害，而经过治疗的患儿冠状动脉损害发生率仍为5％。近年来该病已取代风湿热成为发达国家儿童获得性心脏病最常见的病因。目前关于冠状动脉损害的研究是川崎病的研究热点，而遗传因素在川崎病及冠状动脉损害的发生过程中起重要作用。研究显示ITPCK、CASP3、TNF-α、CD40、IL—10、PELII、GRIN3A、CTLA-4、SNX24、LRP1B等多种基因易患性与川崎病冠状动脉损害密切相关，该文就川崎病患儿冠状动脉损害易患基因研究进展作一综述。

Kawasaki disease is an acute and systemic vasculitis of small and medium-sized arteries, which often occurs in children under 5 years old. The etiology and pathogenesis of Kawasaki disease remain unclear. Epidemiological data have shown the incidence in Asian population is higer than that in non-Asian population. Coronary artery lesions are the most serious complications in children with Kawasaki disease, which can result in ischemic cardiomyopathy, myocardial infarction or sudden death. Coronary artery lesions occur in about 25% untreated children and in 5% treated children. In recent years, replacing rheumatic fever, it has been the leading cause of acquired heart disease in children in developed countries. Current research on coronary artery lesions is a hotspot of Kawasaki disease, and genetic factors play an important role in the development of the lesions. Studies show that genes such as ITPCK, CASP3, TNF-α, CD40, IL-10, PELI1, GRIN3A, CTLA-4, SNX24, LRP1B are closely related to coronary artery lesions. In this article, we review some susceptibility genes on coronary arterial lesions in Kawasaki disease.