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目的观察大剂量维生素C(VitC)对川崎病(KD)急性期肱动脉血流介导的扩张反应(FMD)的影响,探讨VitC对KD急性期血管内皮功能障碍是否有改善作用。方法采用高分辨率多普勒超声仪测定2001年1月至2002年12月在华中科技大学同济医学院附属同济医院儿科住院的36例KD急性期患儿(KD组)及15名健康儿童(正常对照组)肱动脉FMD,并比较KD组静脉滴注大剂量VitC(200mg/kg,最大量为4g)和安慰剂(10%葡萄糖)前后肱动脉FMD的变化。结果KD组肱动脉FMD明显低于正常对照组(P<0.001);KD组静滴大剂量VitC后肱动脉FMD明显增加(P<0.01),静滴安慰剂后肱动脉FMD无明显增加(P>0.05)。结论大剂量VitC能明显改善KD急性期肱动脉FMD,其对KD急性期血管内皮功能障碍可能有显著改善作用。

Effect of high dose vitamin C on flow mediated vasodilation of brachial artery in acute phase of Kawasaki disease

??Abstract Objective To observe the effect of high dose vitamin C on flow mediated vasodilation(FMD) of brachial artery in acute phase of Kawasaki disease(KD) and investigate whether high dose vitamin C could improve vascular endothelial dysfunction in KD.Methods Using high resolution vascular ultrasound,we measured FMD of the brachial artery of 36 patients who were admitted to our hospital from Jan.2001 to Dec.2002. in acute phase of KD and 15 matched healthy subjects as controls.Studies were performed before and after intravenous infusion of high dose vitamin C (200mg/kg??max??4g) or placebo in KD group.Results The FMD of the brachial artery in KD group was significantly lower than that in the control group (3.55??3.00% vs 10.34??4.29%??P<0.001).Intravenous infusion of vitamin C significantly increase the FMD of the brachial artery in 18 KD patients (6.97??2.93% vs 3.51??2.01%??P<0.01),while after administration of placebo in the other 18 patients,there was no significantly increased in the FMD(4.12??2.21% vs 3.75??3.00%??P>0.05).Conclusion Intravenous infusion of high dose vitamin C can increase the FMD of the brachial artery,and it can improve vascular endothelial dysfunction in KD.