川崎病肠道受累与腹型紫癜的超声鉴别诊断  

Ultrasonographic differential diagnosis of intestinal involvement in Kawasaki disease and abdominal type allergic purpura

作　　者：徐魏军 魏玺 夏爽[3] 裴广华[1] Xu Weijun;Wei Xi;Xia Shuang;Pei Guanghua(Department of Ultrasound,Tianjin Children′s Hospital,Tianjin 300134,China;Department of Ultrasound Diagnosis and Treatment,Cancer Hospital,Tianjin Medical University,Tianjin 300060,China;Department of Radiology,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市儿童医院超声科,300134 [2]天津医科大学肿瘤医院超声诊疗科,300060 [3]天津市第一中心医院放射科,300192

出　　处：《中华超声影像学杂志》2021年第4期294-298,共5页Chinese Journal of Ultrasonography

摘　　要：目的通过对比分析川崎病肠道受累(intestinal involvement in Kawasaki disease,IIKD)与腹型紫癜(abdominal type allergic purpura,ATAP)的超声图像,提高对IIKD的认识。方法收集2014年7月至2020年1月在天津市儿童医院就诊、经临床诊断为川崎病(Kawasaki disease,KD)且腹部超声有阳性发现的21例KD患儿(IIKD组)及24例经临床诊断为ATAP患儿(ATAP组)的超声图像,并进行对比分析。结果单因素分析显示,IIKD组与ATAP组在肠壁非分层增厚、浆膜和相邻肠系膜回声减低(形态不规则)、周围脂肪组织增厚及相邻淋巴结形态异常方面差异有统计学意义(均P<0.05);多因素分析显示,浆膜和相邻肠系膜回声减低(形态不规则)为IIKD的独立影响因素,ROC曲线下面积为0.914(95%CI=0.819~1.000,P<0.001),其诊断IIKD的敏感性和特异性分别为95.2%、87.5%。结论IIKD和ATAP的超声图像具有一定的特异性,浆膜和相邻肠系膜回声减低(形态不规则)可有效鉴别二者。Objective To compare and analyze the ultrasonic images between intestinal involvement in Kawasaki disease(IIKD)and abdominal type allergic purpura(ATAP),so as to improve the understanding of IIKD.Methods From July 2014 to January 2020,the ultrasonographic images of 21 children with IIKD and 24 children with ATAP in Tianjin Children′s Hospital were collected and analyzed.Results Univariate analysis showed that there were significant differences between IIKD group and ATAP group in non stratified thickening of intestinal wall,decreased echo of serosa and adjacent mesentery(irregular shape),thickening of peripheral fat tissue and abnormal shape of adjacent lymph nodes(all P<0.05);Multivariate analysis showed that decreased echo of serosa and adjacent mesentery(irregular shape)were independent influencing factors of IIKD.The area under ROC curve was 0.914(95%CI=0.819-1.000,P<0.001).The sensitivity and specificity of IIKD were 95.2%and 87.5%,respectively.Conclusions The ultrasonographic images of intestinal involvement in IIKD and ATAP have certain specificity.Decreased echo of serosa and adjacent mesentery(irregular shape)can effectively distinguish IIKD and ATAP.

关 键 词：超声检查 儿童 川崎病肠道受累 腹型过敏性紫癜 

分 类 号：R725.4[医药卫生—儿科] R725.5[医药卫生—临床医学] R445.1