三磷酸腺苷-阿托品负荷超声心动图Tei指数评价儿童川崎病左心室功能  

Evaluation of left ventricular function in children with Kawasaki disease by Tel index of adenosine triphosphate- atropine stress echocardiography

作　　者：刘力[1] 夏焙[1] 李成荣[2] 邱宝明[3] 李姝娜[1] 杜秀明[1] 

机构地区：[1]深圳市儿童医院超声科,518026 [2]深圳市儿童医院免疫科,518026 [3]深圳市儿童医院心内科,518026

出　　处：《中华超声影像学杂志》2009年第8期672-674,共3页Chinese Journal of Ultrasonography

基　　金：深圳市科技计划项目资助（200304187）

摘　　要：目的探讨应用三磷酸腺苷-阿托品负荷超声心动图Tei指数评价川崎病患儿恢复期左心室功能的临床意义。方法对60例川崎病恢复期患儿行三磷酸腺苷-阿托品负荷超声心动图检查，测量冠状动脉左前降支静息状态下及注射三磷酸腺苷5min后峰值血流速度，计算冠状动脉血流储备指数（coronary flow reserve，CFR）。同步测量左室射血分数（LVEF）、二尖瓣口舒张期血流E峰、A峰及E／A值，左室等容收缩时间、等容舒张时间、射血时间，计算Tei指数，比较CFR降低对左室功能的影响。结果川崎病CFR下降组患儿在负荷状态下的Tei指数较CFR正常组显著增高（0．46±0．09对0．33±0．06，P〈0．05）。负荷状态下两组患儿的心率血压乘积均显著增加，差异有统计学意义（P〈0．05）。LVEF、E／A值两组差异均无统计学意义。结论三磷酸腺苷-阿托品负荷超声心动图Tei指数可检测出川崎病恢复期患儿无症状的左室功能损伤，这种心功能损伤与CFR有关，提示川崎病冠状动脉病变对心脏功能有影响。Objective To study the left ventricular function in children with Kawasaki disease（KD） by Tel index of adenosine triphosphate（ATP）-atropine stress echocardiography. Methods ATP-atropine stress echocardiography was performed in 60 patients with KD at convalescent stage. The diastolic peak velocity（DPV） was measured at rest（DPVrest） and during the 5th minute of ATP infusion（DPVATP ） in the left anterior descending artery, Coronary flow reserve （CFR） was calculated as DPVATP/DPVrest The left ventricular ejection fraction （LVEF）, peak E, peak A, E/A, isovolumetric contraction time （ICT）, isovolumetric relaxation time（IRT） ,ejection time（ET） were also measured at rest and during peak heart rate and Tel index was calculated. Results Tel index was more significantly increased in KD with CFR decreased group than in CFR normal group （0.46 ± 0.09 vs 0.33± 0.06, P d0.05）. The rate-pressure product （RPP） was increased （ P d0.05） stress compared with values at rest in both groups. There were no significant difference between the two groups in LVEF,E/A. Conclusions Tel index of ATP-atropine stress echocardiography is feasible diagnostic method to detect the asymptomatic left ventricular dysfunction in children with KD in convalescent stage. The impairment which related to CFR prognosticate the lesion of coronary artery in KD has influence on left ventricular function.

关 键 词：超声心动描记术 压力 黏膜皮肤淋巴结综合征 心室功能 左 

分 类 号：R686[医药卫生—骨科学]