Long-term outcome of coronary artery dilatation in Kawasaki disease.
Long-term outcome of coronary artery dilatation in Kawasaki disease.
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DOI：
10.4103/apc.apc_172_16
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发表时间：
2018-05
影响因子：
0.7
通讯作者：
Uiterwaal CS
中科院分区：
文献类型：
--
作者：
Advani N;Sastroasmoro S;Ontoseno T;Uiterwaal CS
川崎（KD）是一种急性系统性血管炎综合征，在未经治疗的儿童中冠状动脉瘤的发病率很高。已知KD导致的大多数动脉瘤随时间消退。本研究旨在确定KD患者冠状动脉扩张的过程和结果，并确定不同分支的结果是否存在差异。这是一项在诊断为KD的患者中进行的回顾性队列研究，具有中期随访数据。所有KD患者冠状动脉扩张1-10½年，进行了系列超声心动图检查。Kaplan-Meier曲线用于统计分析。共研究了154例冠状动脉扩张患者。急性期冠状动脉扩张率为33.3%，6-8周后降至7.9%。每例患者可能在一个以上的分支发生血管扩张，因此血管扩张总数为245例。中位消退时间为2.6个月（平均10.5个月），中位随访时间为41个月（平均23个月）。与大型企业相比，中小型企业的结果更有利。扩张的位置不影响结果。大多数（77.4%）中小型动脉瘤在2年内消退，但巨大动脉瘤往往会持续存在。冠状动脉扩张的结果取决于直径而不是位置。回归率在较小的范围内更快。左冠状动脉主干是最常见的扩张部位。
Kawasaki disease (KD) is an acute systemic vasculitis syndrome with a high incidence of coronary aneurysms in untreated children. The majority of aneurysms resulting from KD are known to regress with time. This study aimed to determine the course and outcome of coronary artery dilatation in patients with KD and ascertain whether there are any differences in the outcomes in the different branches. This is a retrospective cohort study of patients diagnosed with KD with midterm follow-up data. Serial echocardiography was performed in all KD patients with coronary dilatation for 1–10½ years. The Kaplan–Meier curve was used for statistical analysis. There were 154 patients with coronary dilatation studied. The frequency of coronary dilatation in acute phase was 33.3% and decreased to 7.9% 6–8 weeks later. Each patient could have dilatations at more than one branch, so the total number of dilatations was 245. The median time needed for regression was 2.6 months (mean: 10.5 months) while the median of follow-up duration was 41 months (mean: 23 months). Small- and medium-sized dilatations had more favorable outcomes compared to the giant ones. Location of dilatation did not influence the outcome. The majority (77.4%) of small- and medium-sized dilatations regress within 2 years, but giant aneurysms tend to persist. The outcome of coronary dilatation is determined by the diameter and not by the location. Regression rate is faster in smaller dilatations. Left main coronary artery is the most frequent location for dilatation.