Pathological study of postcoronary arteritis in adolescents and young adults: With reference to the relationship between sequelae of Kawasaki disease and atherosclerosis
Pathological study of postcoronary arteritis in adolescents and young adults: With reference to the relationship between sequelae of Kawasaki disease and atherosclerosis
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DOI：
10.1007/s002460010180
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发表时间：
2001-03-01
影响因子：
1.6
通讯作者：
Naoe, S
中科院分区：
文献类型：
--
作者：
Takahashi, K;Oharaseki, T;Naoe, S
为明确川崎病（KD）心脏后遗症、冠状动脉炎后病变是否可成为冠状动脉粥样硬化的危险因素，对6例15岁以上儿童时期因动脉炎引起冠状动脉病变的患者尸检病例进行了组织学检查。检查了24条动脉：10条没有动脉瘤形成的证据，7条动脉表现为单纯管腔扩张，7条动脉有动脉瘤并有再通。在没有动脉瘤的组中，除了KD急性期动脉炎引起的先前存在的内膜增厚之外，还观察到“新的内膜增厚”。在第二组动脉瘤动脉的管腔仍然扩张的情况下，6 个动脉瘤中有 4 个发生了血栓闭塞。此外，一名 39 岁的患者发现晚期动脉粥样硬化变化（即复杂病变）。最后，第三组动脉瘤血栓闭塞后管腔再通，内侧可见新的内膜增厚，部分动脉被闭塞。这项研究的结果表明，有川崎病病史的个体冠状动脉中存在的动脉瘤构成了晚年动脉粥样硬化的危险因素。
To clarify whether the cardiac sequelae of Kawasaki disease (KD), postcoronary arteritis lesions can become a risk factor for atherosclerosis of the coronary arteries, six autopsy cases of patients older than 15 years of age with coronary arterial lesions caused by arteritis in childhood were examined histologically. Twenty-four arteries were inspected: 10 had no evidence of aneurysm formation, 7 arteries manifested simple dilatation of the lumen, and in 7 arteries there were aneurysms with recanalization. In the group in which there were no aneurysms, "new intimal thickening" was observed in addition to the preexisting intimal thickening which had been caused by arteritis in the acute phase of KD. In the second group with aneurysmal arteries whose lumen remained dilated, thrombotic occlusion occurred in 4 of 6 aneurysms. In addition, advanced atherosclerotic changes (i.e., complicated lesions) were found in a 39-year-old patient. Finally, in the third group of arteries which manifested recanalized lumens after thrombotic occlusion of the aneurysms, new intimal thickening was seen on the internal side and some of them were occluded. The findings in this study suggest that aneurysms present in coronary arteries in individuals with a history of KD constitute a risk factor for atherosclerosis later in life.