应用组织多普勒成像评价低月龄婴儿川崎病左室功能变化  

The evaluation of left ventricular function change in younger infants with Kawasaki disease by Tissue doppler imaging

作　　者：王海永[1] 童明辉[1] 吴婷婷[1] 雷海燕[1] 王佳冰[1] 

机构地区：[1]兰州大学第二医院儿童医院超声科,甘肃兰州730030

出　　处：《心脏杂志》2017年第6期696-700,共5页Chinese Heart Journal

摘　　要：目的探讨组织多普勒成像(tissue doppler imaging,TDI)在评价低月龄婴儿川崎病(Kawasaki disease,KD)左室功能变化的特点。方法连续选取住院KD患者125例,分为≤6个月组(n=28)和>6个月组(n=97)。于静脉注射免疫球蛋白(intravenous immunoglobulin,IVIG)前、IVIG后6周、IVIG后12周用TDI分别获得二尖瓣瓣环室间隔侧及左室侧壁处舒张早期运动速度e’sep、e’lat;室间隔处TDI-Tei指数,并对不同时期二组之间及同组间不同时间点参数做比较。结果≤6个月组冠状动脉损伤发生率高于>6个月组(32%vs.24%),且损伤程度较重。IVIG前≤6个月组e’lat、e’sep均显著低于>6个月组,E/e’lat、E/e’sep均显著高于>6个月组(均P<0.01)。IVIG后6周≤6个月组e’lat、e’sep略有恢复,但仍低于>6个月组,E/e’lat、E/e’sep下降但仍高于>6个月组(均P<0.05),IVIG后12周≤6个月组e’lat、e’sep与>6个月组相比无显著差别,E/e’sep进一步减低但仍高于>6个月组(P<0.05)。IVIG前、IVIG后6周≤6个月组TDI-Tei指数均高于>6个月组(均P<0.05),而在IVIG后12周,该指标两组间无显著差别。≤6个月组与IVIG前相比,IVIG后12周e’lat、e’sep及E/A显著升高,E/e’sep及TDI-Tei指数显著下降(均P<0.05)。与IVIG后6周相比,IVIG后12周e’sep进一步显著升高,TDI-Tei指数进一步显著下降(均P<0.05),但IVIG前与IVIG后6周相比,各参数未见显著差异,>6月组各时间点参数未见显著差异。结论与大龄KD患者相比,低月龄KD婴儿冠状动脉损伤发生率较高且程度较重,左室舒张功能减低明显,且恢复时间长。AIM To observe the characteristics in younger infants with KD by TDI. METHODS 125 KD patients were consecutively selected, and divided into two groups, 〈6 months group and 〉 6 months group. 28 cases were included in the 〈6 months group, while 97 cases were in the 〉6 months group. The e＇sept （ the mitral annular velocity of septal during early diastolic period）, e＇lat （ the mitral annular velocity of lateral left ventricle during early diastolic period） and septal TDI-Tei index （ the sum of the isovolumetric contraction and relaxation times divided by the ejection time） in before IVIG administration, 6 weeks after IVIG administration, and 12 weeks after IVIG administration were measured by TDI, and were compared with each other during different phases. RESULTS ≤ 6 months group had a higher incidence of coronary artery lesions than 〉6 months group （32% vs. 24% ）, and the damage degree wasmore serious. ≤6 months group had a much lower value of e＇lat and e＇sep and a much higher value of E/e＇lat and E/e＇sep than group B in the first two phases （P 〈0. 05）. There were no significant differences in e＇lat and e＇sep between the two groups in the last phase, but a higher value of E/e＇sep in ≤ 6 months group （P 〈0. 05 ）. There was a higher TDI-Tei index in ≤6 months group than 〉6 months group during the first two phases （P 〈 0. 05 ）, and no signficant difference in the last phase. In ≤ 6 months group, compared to before IVIG administration, e＇lat, e＇sep, E/A, E/e＇ lat, E/e＇sep and TDI-Tei index of 12 weeks after IVIG administration begun to recover （ P 〈 0.05 ） , but there was no significant difference between the time before IVIG administration and the time of 12 weeks after IVIG administration. In 〉 6 months group, there were no significant differences among the three phases. CONLUSION There is a high incidence of coronary artery lesions in younger infants, and the degree of injury can be more serious. The left ventricular diastolic f

关 键 词：组织多普勒成像 川崎病 低月龄婴儿 左室功能 

分 类 号：R541.1[医药卫生—心血管疾病]