Evaluation Of Arterial Endothelial Function In Children With Kawasaki Disease In Shenzhen Children’s Hospital

Purpose Vascular endothelial function is an important indicator to evaluate the long-term prognosis of children with Kawasaki disease(KD).In this study,two non-invasive detection methods,namely Flow-mediated dilation(FMD)and brachial-ankle pulse wave velocity(baPWV),were used to evaluate Shenzhen Children’ s Hospital.Vascular endothelial function in children with KD recovery period,and to explore related laboratory indicators that affect endothelial function in children.Methods In this study,children with KD diagnosed at Shenzhen Children’s Hospital from January 2014 to February 2018 with an onset of more than one year were selected as the main research subjects,and healthy children with matching age and sex were selected as controls.All subjects excluded the risk factors of endothelial injury such as abnormal lipid levels,diabetes,rheumatic immune diseases.All KD cases met the diagnostic criteria revised for the fifth time by the Japanese Kawasaki Disease Research Committee in 2002,and 2g/Kg intravenous immunoglobulin(IVIG)and oral aspirin were used as the main treatment options in the acute phase.Children in the recovery phase of KD were divided into CAL group and nCAL group according to whether they were combined with Coronary artery lesion(CAL)(including coronary artery dilation(CAD)and coronary artery aneurysm(CAA))in the acute phase of the disease.All the children tested underwent two tests of brachial artery FMD and baPWV and recorded relevant data.At the same time,the age of onset,fever days,and neutrality of these children with KD recovery in the acute phase of the disease were recorded through direct inquiry and the data saved in the clinical data.Laboratory indicators such as granulocyte ratio,platelets,CRP,total bilirubin,erythrocyte sedimentation rate,serum sodium,triglycerides,etc.,respectively,explore their correlation with vascular endothelial function during KD recovery.In this study,SPSS 22.0 software was used to statistically analyze the data.Measurement data are expressed as mean±standard deviation.Paired t-tests are used for those with normal distribution.The correlation analysis between the two variables used Spearman rank correlation analysis.A probability value of p<0.05 is considered statistically significant.Results(1)12 children with CAL in KD recovery period(CAL group,average age 6.67±2.69 years,follow-up period 4.09±1.16 years),30 children without CAL in KD recovery period(nCAL group,average age 6.67±1.49 years old,follow-up period of4.10±1.21 years)and 16 healthy children(HC group,average age 6.75±1.79 years)participated in the study.There was no statistical difference in gender,age of entry,age of onset,follow-up period,BMI,systolic blood pressure,and diastolic blood pressure in the CAL group,nCAL group and the healthy control group.(2)In terms of brachial artery FMD,the CAL group and the nCAL group were significantly lower than the healthy control group(respectively: 9.70±2.19 vs 11.42±2.04;9.88±2.13 vs 11.42±2.04;p<0.05),the CAL group and the nCAL group There is no statistical difference between them;In terms of baPWV,the CAL group was significantly higher than the healthy control group(963.75±140.36 vs 870.63±58.18,p<0.05).There was no statistical difference between the nCAL group and the healthy control group.There was no statistical difference between the CAL group and the nCAL group.There was no statistical difference.(3)The platelet level in the acute phase of KD was significantly negatively correlated with brachial artery FMD(r=-0.34,p<0.05),and the age of onset was significantly negatively correlated with baPWV(r=-0.42,p<0.05).No obvious correlation was found between the number of days of fever,neutrophil ratio,CRP,total bilirubin,serum sodium,erythrocyte sedimentation rate,triglyceride and brachial artery FMD and baPWV.Conclusion Children with KD recovery in Shenzhen Children’s Hospital have endothelial dysfunction,including those who are not accompanied by coronary artery disease.They may be people at high risk of cardiovascular disease in the future and require long-term follow-up.The level of platelet in the acute phase of KD is an important factor that affects the long-term skin function of children.Brachial artery FMD and baPWV can reflect the vascular endothelial function status of children with KD recovery period,and can provide useful information for the diagnosis and treatment of children with KD recovery period.