川崎病患儿左心室扭转与冠状动脉损害相关性分析  

Correlation between left ventricular torsion and coronary artery lesion in children with Kawasaki disease

作　　者：王智培 狄浩然 

机构地区：[1]沧州市人民医院妇产超声科,河北沧州061000

出　　处：《中华实用诊断与治疗杂志》2015年第4期385-387,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：沧州市科技局基金项目(131302108)

摘　　要：目的分析川崎病患儿左心室扭转与冠状动脉损害的相关性。方法 852例川崎病患儿(观察组)行冠状动脉造影,跟据是否有冠状动脉损害分为发生组107例和未发生组745例;同期300例正常儿童为对照组。各组均行超声检查,比较冠状动脉损害发生率及左心室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左心室收缩末期内径(left ventricular end-systolic dimension,LVESD)、左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume,LVESV)和左室射血分数(left ventricular ejection fraction,LVEF)。结果 (1)本组冠状动脉损害发生率为12.56%;(2)发生组LVEDD、LVESD、LVEDV、LVESV分别为(59.04±6.82)mm、(42.08±9.05)mm、(176.28±48.51)mL、(88.52±41.09)mL,均高于未发生组((49.16±4.52)mm、(31.29±7.31)mm、(125.09±29.64)mL、(37.69±15.09)mL)及对照组((48.36±3.37)mm、(28.16±4.05)mm、(116.25±26.81)mL、(33.91±11.70)mL),而LVEF((48.91±11.49)%)低于未发生组((65.08±12.19)%)及正常组((70.71±9.52)%)(P<0.05),未发生组以上指标与对照组比较差异无统计学意义(P>0.05);(3)发生组左心室扭转角度、扭转率、旋转角度、心尖旋转率分别为(6.83±2.95)°、(44.19±18.1)°/s、(-4.19±3.08)°、(-48.11±17.53)°/s,均低于未发生组((11.50±3.16)°、(71.53±19.50)°/s、(-6.69±2.54)°、(-53.69±17.50)°/s)及对照组((17.29±6.10)°、(96.08±31.07)°/s、(-8.28±4.01)°、(-71.96±17.07)°/s)(P<0.05),未发生组上述指标与对照组比较差异有统计学意义(P<0.05);(4)左心室扭转角度、扭转率与LVEF呈正相关(r=0.629,P=0.032;r=0.533,P=0.041)与LVEDV(r=-0.763,P=0.013;r=-0.653,P=0.023)、LVESV(r=-0.691,P=0.033;r=-0.763,P=-0.027)均呈负相关。结论川崎病合并左心室扭转时冠状动脉损害发生率高,患者LVEF下降,LVEDV、LVESV则代偿性上升,可致左心室扭转运动减低。Objective To analyze the correlation between left ventricular torsion and coronary artery lesion（CAL）in children with Kawasaki disease.Methods A total of 852 children with Kawasaki disease（observation group）were divided into CAL group（n=107）and non-CAL（n=745）,and another 300 normal children in the same period were selected as controls（control group）.All patients received ultrasound to compare the incidence of CAL,left ventricular end-diastolic dimension（LVEDD）,left ventricular end-systolic dimension（LVESD）,left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）and left ventricular ejection fraction（LVEF）.Results The incidence of CAL was 12.56%.LVEDD,LVESD,LVEDV and LVESV were larger in CAL group（（59.04±6.82）mm,（42.08±9.05）mm,（176.28±48.51）mL,（88.52±41.09）mL）than those in non-CAL group（（49.16±4.52）mm,（31.29±7.31）mm,（125.09±29.64）mL,（37.69±15.09）mL）and control group（（48.36±3.37）mm,（28.16±4.05）mm,（116.25±26.81）mL and（33.91±11.70）mL）（P〈0.05）,and LVEF was lower in CAL group（（48.91±11.49）%）than that in non-CAL group（（65.08±12.19）%）and control group（（70.71±9.52）%）（P〈0.05）.There were no significant differences in the above indicators between non-CAL group and control group（P〉0.05）.The left ventricular torsion angle and rate,and rotation angle and rate were（6.83±2.95）°,（44.19±18.1）°/s,（-4.19±3.08）°and（-48.11±17.53）°/s in CAL group,significantly lower than those in non-CAL group（（11.50±3.16）°,（71.53±19.50）°/s,（-6.69±2.54）°,（-53.69±17.50）°/s）and control group（（17.29±6.10）°,（96.08±31.07）°/s,（-8.28±4.01）°,（-71.96±17.07）°/s）（P〈0.05）,and showed significant differences between non-CAL group and control group（P〈0.05）.The left ventricular torsion angle and rate were positively correlated with LVEF（r=0.629,P=0.032;r=0.533,P=0.041）,and were negatively

关 键 词：川崎病 左室扭转 冠状动脉损害 相关性 

分 类 号：R725.4[医药卫生—儿科] R445.1[医药卫生—临床医学]