背景︰川崎病主要侵犯小於五歲的兒童，導致冠狀動脈損害，甚至造成心肌梗塞。從1976年後，在台灣已經造成無數小孩罹患川崎病。過去的研究顯示發炎對於動脈硬化佔有重要的角色。有許多的報導顯示高敏感度C反應性蛋白濃度、白血球和高密度膽固醇和冠狀動脈損害有密切的相關性。這個研究的主要目的就是利用發炎指數中高敏感度C反應性蛋白、白血球和高密度膽固醇來偵測罹患川崎病小孩中恢復期併發冠狀動脈損害時，血液數值變化。
方法和材料︰在2005年7月至2006年6月間，共有97位病患已經在2001年及2004年間已經診斷出川崎病的小孩參加實驗。這些病童在參加實驗一年前不同時間已經被診斷出罹患川崎病。診斷川崎病的基準根據1984年經過日本實驗委員會修正診斷標準。45個罹患川崎病併發冠狀動脈瘤的病人為第一組，52位罹患川崎病沒有併發冠狀動脈瘤的病人為第二組。另外選50位健康年紀和第一組和第二組相似的健康小孩當作第三組。實驗中的三組都記載他們參與實驗當時的白血球數值、收縮和舒張血壓，身體質量指數、年紀、性別、膽固醇、三酸甘油酯、高密度脂蛋白、低密度脂蛋白、血清中高敏感度C反應性蛋白濃度和經由超音波檢查後紀錄的冠狀動脈損害。我們分析罹患川崎病小孩，影響高敏感度C反應性蛋白濃度、白血球及高密度膽固醇和冠狀動脈損害之間的相關性。
結果︰第一組的兒童裡(平均值0.264 mg/dl)血中高敏感度C反應性蛋白濃度明顯的高於第二組(平均值0.155 mg/dl)和對照組第三組(平均值0.116 mg/dl)，且p值是有意義的(p=0.006和p=0.017)。同樣的，第一組的小孩裡(平均值6,543.11/mm3)血中白血球數值明顯的高於第二組(平均值5,720.19/mm3)和對照組第三組(平均值5,611.27/mm3)，且p值是有意義的(p=0.029和p=0.012)。而第一組的小孩裡(平均值41.42 mg/dl)血中高密度膽固醇數值低於第二組(平均值44.79 mg/dl)和對照組第三組(平均值46.58 mg/dl)，且p值是有意義的( p=0.035和p=0.027)。血中高敏感度C反應性蛋白濃度和白血球數值之間有正相關性(r = 0.641, p < 0.05)。但血中高敏感度C反應性蛋白濃度和高密度膽固醇數值之間沒有相關性。
結論：我們的實驗證實了罹患川崎病併發冠狀動脈瘤的小孩在經過恢復期後與發炎反應相關。另外，發炎反應對於造成漸進的冠狀動脈瘤形成佔有一定的角色。這個實驗也證實利用血中高敏感度C反應性蛋白濃度、白血球和高密度膽固醇可用來預測罹患川崎病的小孩預期形成冠狀動脈瘤存在大小的一個因素。

Background: Kawasaki disease (KD) affects mainly children younger than five years of age, leading to coronary artery lesions, and even to life-threatening myocardial infarctions. Since 1976, Kawasaki disease has occurred among thousands of children in Taiwan. Evidence suggests that inflammation plays a key role in the pathogenesis of atherosclerosis. Significant determinants of high sensitivity C-reactive protein (hs-CRP), which is a sensitive indicator of inflammation, as well as white blood cell (WBC) count, and high-density lipoprotein cholesterol (HDLc) and coronary artery lesion were identified. The relationships between these factors’ concentration and arterial lesion were likewise investigated and had reported. The aim of this study was to determine the serum levels of the hs-CRP, WBC count, and plasma HDLc levels in patients with later phase of KD.
Methods and Materials: From July 2005 to June 2006, 97 children with Kawasaki disease at least 1 year after diagnosis were recruited in this study. These participated children had been diagnosed as KD and collected at the interval of 2001 to 2004. Diagnosis was based on the 1984 revised by the KD Research Committee in Japan. The participants were grouped into 45 patients with KD and coronary aneurysms (Group I), 52 patients with KD and normal coronary arteries (Group II), and 50 healthy age-matched children (Control Group III). Their WBC count, systemic and diastolic blood pressures, body mass index, age, sex, fasting total cholesterol concentrations, triglyceride, high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol, serum hs-CRP levels, and coronary artery lesion by cardioechography were recorded and compared. The analytical differences between hs-CRP, WBC count, and plasma HDLc levels and the coronary artery events in KD were examined.
Results: Serum hs-CRP levels of Group I patients (mean 0.264 mg/dl) was significantly greater than that of Group II (mean 0.155 mg/dl, p=0.006) and Group III patients (mean 0.116 mg/dl, p =0.017). Similarly, the WBC count of Group I patients (mean 6,543.11/mm3) was significantly greater than that of Group II (mean 5,720.19/mm3, p=0.029), and Group III patients (mean 5,611.27/mm3, p =0.012). However, plasma HDLc levels of Group I patients (mean 41.42 mg/dl) was significantly lesser than that of Group II (mean 44.79 mg/dl, p=0.035), and Control Group III patients (mean 46.58 mg/dl, p=0.027). There was a positive association between hs-CRP and WBC count levels (r = 0.641, p < 0.05), but none between hs-CRP and plasma HDLc levels.
Conclusions: There is the possibility of ongoing low-grade inflammation late after the convalescent phase of Kawasaki disease in children with coronary aneurysms, which may have a role in increasing coronary artery dysfunction. These results also suggest that hs-CRP, WBC count, and plasma HDLc levels are useful parameters for predicting formation of coronary artery lesion even in children after onset of KD.

中文摘要------------------------------------------------- i
英文摘要------------------------------------------------iii
英文縮寫表----------------------------------------------v
論文內文:
序言（背景介紹）------------------------------------1
材料與方法----------------------------------------------5
結果--------------------------------------------------------8
討論------------------------------------------------------10
參考文獻------------------------------------------------16
表----------------------------------------------------------24
圖----------------------------------------------------------25
附錄-------------------------------------------------------30

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