超声心动图对小儿川崎病冠状动脉病变早期诊断及防治作用  

Echocardiography in diagnosis and pervention of the coronary artery lesions in kawasaki disease

作　　者：潘宝全[1] 许宗羿 郑曼蕾[1] 冯泽康[1] 

机构地区：[1]澳门镜湖医院儿科

出　　处：《岭南心血管病杂志》1998年第2期109-110,99-139,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨超声心动图在早期诊断及防治川崎病冠状动脉的应用。方法采用彩色多普勒超声显像仪，取大血管短轴切面扫描主动脉根纳左、右冠状动脉，测其宽度。结果本组23例中，男15例、女8例，＜4岁者20例，发现冠状动脉病变9例，6例为左冠状动脉扩张，双支病变并动脉瘤形成3例。本组被发现冠状动脉病变距开始发热时间平均为11．5天，冠状动脉回复正常6例，回复时间最早2个月，平均4．9个月。动脉瘤3例中2例消失，动脉瘤消失最早4．5个月。结论超声心动图检查川崎病冠状动脉具有无创、准确、便于随访追踪的优点。它能进一步明确诊断、指导治疗和评价预后。我们建议临床诊断川崎病或原因不明发热超过5天，另有川崎病2项主要表现，尤其是血小板计数增高者常规及时进行超声心动图检查。Objective Because the maincomplication of Kawasaki disease (KD) is coronary artery lesion, to evaluate the function of echocardiography (ECHO) in KD for diagnosis and preventingthese lesions. Method Coronary arteries were examined at the short axis of the great alienes by usingthe ultramark 9 echo set. If abnormalities of coronary artery were found, follow- up with ECHO wasarranged in 1,3,6 and 12 months. From Aug. 1994tO Jun. 1997, there were 23 cases to be diagnosedas KD and Undergone ECHO examination in KiangWu Hospital. Twenty of them (87.6% ) were < 4years old and nine (39. l%) were found to havecoronary artery lesions. Four cases with the lesionshad atypical clinical features but platelets count increased. Result The average period between thebeginning of fever and the finding of the lesions ofcoronary arteries was 11. 5 days. The diameter ofcoroner artery retumed to norrmal range in six cases(75% ), and aneurysm disappeared in two cases.The earliest recovery appeared in about two monthsafter treatment and the mean time of complete recovery was 4.9 months. Conclusion ECHO is a noninvasive, accurate and convenient technique in detection of coronary lesions in Kawasaki disease andis, therefore, very helpful in terms of early diagnosis, treatment planning, coronary damage assessment and prognosis prediction. We suggest ECHOshould be regularly used in the Patients who are diagnosed as KD or have fever of unknown origin over5 days and two main clinical manifestations of KD,espeialy with increase of plateletS count.[

关 键 词：川崎病 超声心动图 冠状动脉 

分 类 号：R540.45[医药卫生—心血管疾病]