Evidence of Microvascular Changes in the Retina following Kawasaki Disease.
Evidence of Microvascular Changes in the Retina following Kawasaki Disease.
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DOI：
10.1038/srep40513
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发表时间：
2017-01-17
影响因子：
4.6
通讯作者：
Lim TC
中科院分区：
文献类型：
--
作者：
Chen KY;Burgner DP;Wong TY;Saw SM;Quek SC;Pang AY;Leo SW;Wong IB;Zannino D;Curtis N;Cheung M;Cheung CY;Lim TC
目前尚不清楚是否所有患有川崎病(KD)的儿童后来都增加了心血管风险。视网膜微血管系统反映了微循环的变化，与传统的心血管危险因素和事件有关。这项研究的目的是调查两组既往KD患者和对照组患者的视网膜微血管参数。我们对116名(57名患者和59名对照参与者)澳大利亚人和156名(78名患者和78名对照参与者)新加坡人进行了病例对照研究，他们的急性疾病至少有两年。标准化的视网膜照片由训练有素的技术人员使用半自动软件进行分级，该软件量化视网膜微血管(口径、分支角度、分维和曲折)。在校正了传统的心血管危险因素后，新加坡KD患者的视网膜小静脉比对照组大9.67 μm(95%可信区间为4.87~14.51，p <； 0.001)。观察到冠状动脉异常患者视网膜小静脉的大小逐渐增大。有限的证据表明，与对照组相比，有冠状动脉异常的澳大利亚KD患者的视网膜小静脉较大(7.34 μm，95%可信区间1.30~15.99，p = 0.10)。在新加坡KD患者中，视网膜微血管的差异尤其明显。较大的视网膜小静脉可能反映慢性炎症和内皮功能障碍，并与成年人的冠状动脉疾病有关。
It is unclear whether all children with Kawasaki disease (KD) have increased later cardiovascular risk. The retinal microvasculature reflects changes in the microcirculation and is associated with traditional cardiovascular risk factors and events. The aim of this study was to investigate retinal microvascular parameters in two populations of patients with previous KD and control participants. We performed case-control studies of 116 (57 patients and 59 control participants) Australian and 156 (78 patients and 78 control participants) Singaporean individuals, at least two years since their acute illness. Standardised retinal photographs were graded by trained technicians using a semi-automated software, which quantifies the retinal microvasculature (calibre, branching angle, fractal dimensions, and tortuosity). Retinal venules of Singaporean KD patients were 9.67 μm (95% CI 4.87 to 14.51, p < 0.001) larger than control participants following correction for traditional cardiovascular risk factors. An incremental increase in the size of retinal venules in those with coronary artery abnormalities was observed. There was limited evidence that retinal venules were larger in Australian KD patients with coronary artery abnormalities compared to control participants (7.34 μm, 95% CI 1.30 to 15.99, p = 0.10). Differences in retinal microvasculature were particularly evident in Singaporean KD patients. Larger retinal venules may reflect chronic inflammation and endothelial dysfunction, and are associated with coronary artery disease in adults.