Coronary Artery Dilation in Sickle Cell Disease
Coronary Artery Dilation in Sickle Cell Disease
复制标题
DOI：
10.1016/j.jpeds.2011.05.013
复制
发表时间：
2011-11-01
影响因子：
5.1
通讯作者：
Lopez, Leo
中科院分区：
文献类型：
--
作者：
Nicholson, George T.;Hsu, Daphne T.;Lopez, Leo
目的 评估镰状细胞病 (SCD) 儿童冠状动脉扩张的患病率。研究设计 这是一项对 10 至 19 岁 SCD 患者进行的回顾性分析，这些患者接受了 20 个月的常规经胸超声心动图评估。收集左主干、左前降支和右冠状动脉近端直径，以及临床和实验室变量和其他超声心动图结果。通过使用大量正常儿童对照人群的信息，将超声心动图测量结果转换为 z 分数。冠状动脉扩张(CAE)定义为冠状动脉直径z评分>=2。通过单因素和多因素分析将有CAE的患者与无CAE的患者进行比较。结果96例SCD患者中17例(17.7%)患有CAE。患有和未患有CAE的人在性别、年龄、身高、体重、体表面积或基因型上没有差异。 CAE患者的左心室舒张末期内径、缩短分数、室间隔厚度、后壁厚度、质量、质量体积比和白细胞计数较大。多变量分析显示质量体积比和白细胞计数升高与CAE相关。结论CAE在SCD中常见，并与左心室肥厚和炎症相关。 （儿科杂志 2011；159：789-94）。
Objective To evaluate the prevalence of coronary artery dilation in children with sickle cell disease (SCD).Study design This is a retrospective analysis performed in patients, between 10 and 19 years old, with SCD who underwent a routine transthoracic echocardiographic evaluation over a 20-month period. The left main, left anterior descending, and proximal right coronary artery diameters, as well as clinical and laboratory variables and other echocardiographic results were collected. Echocardiographic measurements were converted to z scores by using information from a large control population of normal children. Coronary artery ectasia (CAE) was defined as a coronary artery diameter z score >= 2. The patients with CAE were compared with those without CAE by using univariate and multivariate analyses.Results Seventeen of 96 patients with SCD (17.7%) had CAE. There were no differences in sex, age, height, weight, body surface area, or genotype between those with and those without CAE. Patients with CAE had larger left ventricular end-diastolic dimension, shortening fraction, septal thickness, posterior wall thickness, mass, mass-to-volume ratio, and white blood cell count. Multivariate analysis revealed that the mass-to-volume ratio and elevated white blood cell count were associated with CAE.Conclusion CAE is common in SCD and is associated with left ventricular hypertrophy and inflammation. (J Pediatr 2011;159:789-94).