川崎病并发冠状动脉损伤危险因素及诊治的最新进展
The Latest Progress of Risk Factors, Diagnosis and Treatment of Kawasaki Disease Complicated with Coronary Artery Lesions
DOI: 10.12677/ACM.2024.142437, PDF,   
作者: 甘陈园:右江民族医学院研究生学院,广西 百色;廖传德*:右江民族医学院附属梧州医院儿科,广西 梧州
关键词: 川崎病冠状动脉损伤危险因素Kawasaki Disease Coronary Artery Lesions Risk Factors
摘要: 川崎病是一类由免疫介导的病因不明的急性全身性血管炎症性病变,主要并发症是冠状动脉病变(CALs)和冠状动脉瘤(CAA),这些可能随后导致长期后遗症,例如冠状动脉狭窄、冠状动脉阻塞和心肌梗塞。近年来KD的发病率一直上升,已经成为发达国家及发展中国家儿童获得性心脏病的最常见原因。此外,川崎病缺乏特异性及灵敏度高的实验室检查指标,故不能及时早期诊断和治疗。本文将对川崎病并发冠状动脉损伤的危险因素及诊治的最新进展进行综述。
Abstract: Kawasaki disease is an immune-mediated acute systemic vascular inflammatory disease of un-known etiology. The major complications are coronary artery lesions (CALs) and coronary artery aneurysm (CAA), which may subsequently lead to long-term sequelae such as coronary artery ste-nosis, coronary artery occlusion and myocardial infarction. The incidence of KD has been increasing in recent years and has become the most common cause of acquired heart disease in children in developed and developing countries. In addition, Kawasaki disease lacks specific and sensitive la-boratory examination indicators, so it cannot be diagnosed and treated early in time. This article will review the latest progress in the risk factors, diagnosis and treatment of Kawasaki disease complicated with coronary artery injury.
文章引用:甘陈园, 廖传德. 川崎病并发冠状动脉损伤危险因素及诊治的最新进展[J]. 临床医学进展, 2024, 14(2): 3089-3095. https://doi.org/10.12677/ACM.2024.142437

参考文献

[1] Menahem, S. and Lefkovits, J. (2021) Major Complication Following Kawasaki Disease in an Infant—The Development of Apical Infarction and Aneurysm Formation. Children, 8, Article 981. [Google Scholar] [CrossRef] [PubMed]
[2] Hamwi, S., Alebaji, M.B., Mahboub, A.E., et al. (2023) Multiple Systemic Arterial Aneurysms in Kawasaki Disease. Cureus, 15, e42714. [Google Scholar] [CrossRef] [PubMed]
[3] Garg, T., Kearns, C., Kim, E., et al. (2022) Multiple Systemic Arterial Aneurysms in Kawasaki Disease. Radiographics, 42, E88-E89. [Google Scholar] [CrossRef] [PubMed]
[4] 王程浩, 梁雪村, 储晨, 等. 川崎病所致严重冠状动脉病变单中心队列研究[J]. 中国循证儿科杂志, 2023, 18(1): 32-36.
[5] 钱翠平, 黄晓碧, 赵胜, 等. 儿童川崎病冠状动脉损伤危险因素Logistic回归分析[J]. 安徽医科大学学报, 2023, 58(3): 490-494.
[6] 熊祎, 张永兰, 杜忠东. 川崎病合并巨大冠状动脉瘤101例中长期随访[J]. 中华儿科杂志, 2021, 59(2): 101-106.
[7] O’Brien, K. (2020) Australian Hospitalisations for Kawasaki Disease, 1993-1994 to 2017-2018. Journal of Paediatrics and Child Health, 56, 1126-1133. [Google Scholar] [CrossRef] [PubMed]
[8] Türkuçar, S., Yıldız, K., Acarı, C., et al. (2020) Risk Factors of Intravenous Immunoglobulin Resistance and Coronary Arterial Lesions in Turkish Children with Kawasaki Disease. The Turkish Journal of Pediatrics, 62, 1-9. [Google Scholar] [CrossRef] [PubMed]
[9] 王良军, 张海瑛, 朱铖. 超声心动图检测川崎病患儿冠状动脉损害及与年龄的相关性[J]. 中华医学超声杂志(电子版), 2018, 15(6): 450-451.
[10] Kuwabara, M., Yashiro, M., Kotani, K., et al. (2015) Cardiac Lesions and Initial Laboratory Data in Kawasaki Disease: A Nationwide Survey in Japan. Journal of Epidemiology, 25, 189-193. [Google Scholar] [CrossRef
[11] Ruan, Y., Ye, B. and Zhao, X. (2013) Clinical Characteristics of Kawasaki Syndrome and the Risk Factors for Coronary Artery Lesions in China. Pediatric Infectious Disease Journal, 32, e397-e402. [Google Scholar] [CrossRef
[12] 潘晶莹. 我国川崎病的流行病学特征[J]. 国际儿科学杂志, 2013, 40(5): 466-469.
[13] Tsujii, N., Nogami, K., Matsumoto, M., et al. (2019) Involvement of the ADAMTS13-VWF Axis in Acute Kawasaki Disease and Effects of Intravenous Immunoglobulin. Thrombosis Research, 179, 1-10. [Google Scholar] [CrossRef] [PubMed]
[14] 陈小洁, 桂珍, 吴梦, 等. D-二聚体联合脑钠肽检测用于预测儿童川崎病急性期并发冠状动脉损害的价值[J]. 浙江医学, 2020, 42(10): 1051-1054.
[15] 李晓伟, 黄先玫. 川崎病患儿血浆纤维蛋白原、D-二聚体及CRP水平变化及与冠状动脉病变的关系[J]. 中国生化药物杂志, 2016(7): 176-178.
[16] Bañón, R., Hernández-Romero, D., Navarro, E., et al. (2019) Combined Determination of B-Type Natri-uretic Peptide and High-Sensitivity Troponin I in the Postmortem Diagnosis of Cardiac Disease. Forensic Science, Medi-cine and Pathology, 15, 528-535. [Google Scholar] [CrossRef] [PubMed]
[17] Takeuchi, D., Saji, T., Ta-katsuki, S., et al. (2007) Abnormal Tissue Doppler Images Are Associated with Elevated Plasma Brain Natriuretic Pep-tide and Increased Oxidative Stress in Acute Kawasaki Disease. Circulation Journal, 71, 357-362. [Google Scholar] [CrossRef] [PubMed]
[18] 杨芳, 王晓莉, 欧宓, 等. N端脑钠肽前体与超声心动图对川崎病的早期诊断对比研究[J]. 中华实用儿科临床杂志, 2019, 34(23): 1803-1806.
[19] 范江花, 段蔚, 罗海燕, 等. 血浆N端脑利钠肽前体和降钙素原对早期川崎病冠状动脉损害的预测价值[J]. 儿科药学杂志, 2018, 24(9): 1-5.
[20] 刘亚萍, 杨婷婷, 胡秀芬, 等. N末端脑钠肽前体诊断不完全川崎病急性期临床意义[J]. 中国实用儿科杂志, 2016, 31(5): 365-368.
[21] 王祥, 陈智, 肖云彬, 等. 血N末端脑利钠肽原和降钙素原在川崎病诊断中的价值[J]. 中国中西医结合儿科学, 2017, 9(4): 301-303.
[22] Ji, K., Qian, L., Nan, J., et al. (2015) Ox-LDL Induces Dysfunc-tion of Endothelial Progenitor Cells via Activation of NF-κB. BioMed Research International, 2015, Article ID: 175291. [Google Scholar] [CrossRef] [PubMed]
[23] 陈圆玲, 王佳佩, 沈梦娇, 等. 血LDL-C、NT-proBNP在川崎病合并冠状动脉损害患儿中的临床意义[J]. 现代实用医学, 2017, 29(11): 1510-1512.
[24] Sekine, K., Mochizuki, H., In-oue, Y., et al. (2012) Regulation of Oxidative Stress in Patients with Kawasaki Disease. Inflammation, 35, 952-958. [Google Scholar] [CrossRef] [PubMed]
[25] 吴嘉, 韦伟市, 李卓玲, 等. 血清小而密低密度脂蛋白胆固醇水平对冠心病患者心血管不良事件的预测价值[J]. 临床检验杂志, 2020, 38(2): 99-103.
[26] 吴丽平, 青秀, 李刚, 等. 低密度脂蛋白胆固醇对川崎病患儿丙种球蛋白耐药的预测价值[J]. 实用医院临床杂志, 2022, 19(2): 65-68.
[27] Shao, S., Zhou, K., Liu, X., et al. (2021) Predictive Value of Serum Lipid for Intravenous Immunoglobulin Resistance and Coronary Artery Lesion in Kawasaki Disease. The Journal of Clinical Endocrinology & Metabolism, 106, e4210-e4220. [Google Scholar] [CrossRef] [PubMed]
[28] Maierean, S., Webb, R., Banach, M., et al. (2022) The Role of In-flammation and the Possibilities of Inflammation Reduction to Prevent Cardiovascular Events. European Heart Journal Open, 2, oeac039. [Google Scholar] [CrossRef] [PubMed]
[29] 张晓慧, 李光韬, 张卓莉. C反应蛋白与超敏C反应蛋白的检测及其临床意义[J]. 中华临床免疫和变态反应杂志, 2011, 5(1): 74-79.
[30] 程红革, 贺望娇. 超敏C反应蛋白与心血管疾病的预防[J]. 国际检验医学杂志, 2010, 31(11): 1291-1293.
[31] 鲍宽烨, 张瀚迟, 盛玮. 101例川崎病患儿急性期CRP、PLT水平与肝功能的相关性分析[J]. 国际检验医学杂志, 2020, 41(24): 2982-2985.
[32] Shuai, S., Zhang, H., Zhang, R., et al. (2023) Prediction of Coronary Artery Lesions Based on C-Reactive Protein Levels in Chil-dren with Kawasaki Disease: A Retrospective Cohort Study. The Journal of Pediatrics, 99, 406-412. [Google Scholar] [CrossRef] [PubMed]
[33] 李雪莲, 朱绪亮, 张俊, 等. 超敏C反应蛋白和血小板生成素对川崎病的临床意义[J]. 中国现代药物应用, 2017, 11(19): 74-75.
[34] Yang, Y. and Hu, X. (2022) The Predictive Values of MMP-9, PLTs, ESR, and CRP Levels in Kawasaki Disease with Cardiovascular Injury. Evidence-Based Com-plementary and Alternative Medicine, 2022, Article ID: 6913315. [Google Scholar] [CrossRef] [PubMed]
[35] 王坤, 孔小行, 成芳芳, 等. 川崎病患儿并发冠状动脉扩张的临床特点及危险因素分析[J]. 临床医学研究与实践, 2020, 5(29): 7-9.
[36] Wu, R., Jiang, W., Sun, Y., et al. (2023) In-dicators of Oxidative Stress in the Prediction of Coronary Artery Lesions in Patients with Kawasaki Disease. JCR: Jour-nal of Clinical Rheumatology, 29, 126-131. [Google Scholar] [CrossRef
[37] Ae, R., Abrams, J.Y., Maddox, R.A., et al. (2020) Platelet Count Variation and Risk for Coronary Artery Abnormalities in Kawasaki Disease. Pediatric Infectious Disease Journal, 39, 197-203. [Google Scholar] [CrossRef
[38] Jeon, S., Kim, G., Ko, H., et al. (2019) Risk Factors for the Occurrence and Persistence of Coronary Aneurysms in Kawasaki Disease. Korean Journal of Pediatrics, 62, 138-143. [Google Scholar] [CrossRef] [PubMed]
[39] Uehara, R. and Belay, E.D. (2012) Epidemiology of Kawasaki Disease in Asia, Europe, and the United States. Journal of Epidemiology, 22, 79-85. [Google Scholar] [CrossRef
[40] Kuo, H., Li, S., Guo, M.M., et al. (2016) Genome-Wide Association Study Identifies Novel Susceptibility Genes Associated with Coronary Artery Aneurysm Formation in Kawasaki Disease. PLOS ONE, 11, e154943. [Google Scholar] [CrossRef] [PubMed]
[41] 朱丹颖, 等. 靶向捕获测序技术检测川崎病冠状动脉损害易感基因研究[J]. 中华儿科杂志, 2017, 55(7): 529-533.
[42] 朱丹颖. 川崎病冠状动脉损害易患基因研究进展[J]. 国际儿科学杂志, 2017, 44(5): 297-300.
[43] 陈丽琴, 宋思瑞, 张晗, 等. 川崎病丙种球蛋白无反应型易感基因研究[J]. 临床儿科杂志, 2019, 37(10): 721-726.
[44] 穆志龙, 焦富勇, 谢凯生. 《川崎病心血管后遗症的诊断和管理指南(JCS/JSCS 2020)》解读[J]. 中国当代儿科杂志, 2021, 23(3): 213-220.
[45] 谭朝中, 刘芳. 川崎病严重冠状动脉病变的治疗和长期管理[J]. 中国小儿急救医学, 2020, 27(9): 661-665.
[46] Seki, M. and Minami, T. (2022) Kawasaki Disease: Pathology, Risks, and Management. Vascular Health and Risk Management, 18, 407-416. [Google Scholar] [CrossRef
[47] Rife, E. and Gedalia, A. (2020) Kawasaki Disease: An Update. Current Rheumatology Reports, 22, Article No. 75. [Google Scholar] [CrossRef] [PubMed]