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《Journal of Applied Clinical Pediatrics》 2009-18
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Clinical Intervention on Vascular Endothelial Injury in Children with Kawasaki Disease

PI Guang-huan1,TIAN Xiao-bing2,WANG Mei1,WU Chun1,HUANG Yue1,SUN Qun-ying1,HE Yun1(1.Department of Pediatrics,the Affiliated Hospital of North Sichuan Medical College;2.Department of Epidemiology,North Sichuan Medical College,Nanchong 637000,Sichuan Province,China)  
Objective To investigate the relationship between coronary artery lesions and circulation endothelial cells(CEC) in perip-heral blood and level of blood plasma von Willebrand factor(vWF) in Kawasaki disease(KD) patients,and influence of immunoglobulin intravenous(IVIG) and low molecular heparin treatment on them.Methods There were 45 children with KD in the study.According to with or without coronary artery lesions they were divided into 2 groups.The first group had 30 children without coronary artery lesions,the other had 15 children with coronary artery lesions.Twenty healthy children were served as healthy control group.All patients with KD were treated with IVIG,2 g/kg in a single infusion on days 5 to 10 of illness and begun treatment of low molecular heparin in the first 4 days after IVIG therapy,100 IU/kg,one time every 12 hours,hypodermic,continuous use for 7 days.CEC were isolated from peripheral blood with immunomagnetic Dynabeads and were counted by using microscopy.Level of blood plasma vWF was determined by double antibody sandwich enzyme linked immunosorbent assay.Results CEC count in peripheral blood in coronary artery lesions group was higher than that in without coronary artery lesions group,and higher in both groups than that in healthy control group(F=151.7 P0.001).Level of blood plasma vWF in the coronary artery lesions group was higher than that in without coronary artery lesions group and higher in both groups than that in healthy control group(F=16.2 P0.001).There were significant differences of CEC quantity and level of blood plasma vWF before and after IVIG treatment in coronary artery lesions group(t=9.31,4.43 Pa0.001) or without coronary artery lesions group(t=8.92 P0.001,t=2.97 P0.01)].There were significant differences also of CEC quantity and level of blood plasma vWF before and after low molecular heparin treatment in coronary artery lesions group(t=3.45 P0.001,t=2.28 P0.05) or without coronary artery lesions group(t=3.51 P0.001,t=2.61 P0.01).Conclusions There is obvious blood vessel endothelium injury in KD and endothelium injury of patients with coronary artery lesions is even worse.Treatment with IVIG and low molecular heparin appeared to significantly improve endothelium injury.
【Fund】: 四川省卫生厅课题资助[川卫办发(2006)437号]
【CateGory Index】: R725.4
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