儿童冠状动脉异常主动脉起源的超声评估分析  

The evaluation of anomalous aortic origin of coronary arteries by echocardiography in children

作　　者：刘媛媛 包敏[1] 刘波[1] 任军[1] 郭婧慧 曹爱梅[1] 刘艳[1] 郑彤[1] 石琳[1] 郑春华[1] LIU Yuan-yuan;BAO Min;LIU Bo;REN Jun;GUO Jing-hui;CAO Ai-mei;LIU Yan;ZHENG Tong;SHI Lin;ZHENG Chun-hua(Department of Pediatric Heart,Capital Institute of Pediatrics Affiliated Children's Hospital,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院心血管内科,北京市100020

出　　处：《中国心血管病研究》2021年第12期1125-1129,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的探究经胸超声心动图诊断冠状动脉异常主动脉起源的超声影像学特点及方法,提高对儿童冠状动脉异常主动脉起源的认识和早期诊断。方法回顾性分析2014年1月到2020年12月首都儿科研究所附属儿童医院心功能室诊断的60例冠状动脉异常起源主动脉患儿,分析患儿的临床症状、心电图及超声心动图检查结果。结果冠状动脉异常起源总检出率为0.2%。其中男40例,女20例,年龄(49.1±39.4)月,体重(22.7±15.9)kg,因可疑川崎病经冠状动脉检查者27例,心律失常4例,晕厥2例,胸痛1例,余病例均为偶然发现。所有病例中右冠状动脉起源于左冠窦有54例(90.0%),右冠状动脉起源于左右冠窦交界处为4例(6.6%),右冠状动脉起源于左主干1例(1.7%),左冠状动脉起源于右冠窦1例(1.7%)。其中1例左冠状动脉异常起源于右冠窦患儿,有晕厥病史并伴有左心增大及心功能下降;另1例为右冠状动脉异常起源于左冠窦伴开口狭窄,后行手术治疗。结论经胸超声心动图可筛查出冠状动脉异常主动脉起源。超声医师需认识到该病可能引起的恶性后果,建议在婴幼儿期普及经胸超声冠状动脉检查,尽早诊断出冠状动脉异常主动脉起源。Objective To explore the methods and features of the origin of abnormal coronary artery by transthoracic echocardiography so as to improve the understanding and early diagnosis in children. Methods The clinical symptoms, ECG and echocardiography of 60 children who were diagnosed as anomalous aortic origin of a coronary artery in the Department of Pediatric Heart, Capital Institute of Pediatrics Affiliated Children’s Hospital were recorded and analyzed retrospectively from January 2014 to December 2020. Results The positive rate of anomalous aortic origin of the coronary artery in the study was 0.2%. There were 40 males and 20 females, patient age ranging from 1 month to 14 years and weight ranging from 5.2 kg to 70 kg. Among the patients, 27 underwent coronary examination due to Kawasaki disease, 4 with arrhythmia, 2 with syncope and 1 with chest pain. The prevalence of anomalous aortic origin of the right coronary artery was 98.3%(59/60) and that anomalous aortic origin of the left main coronary artery was 1.7%(1/60). Two patients were treated by surgery, of which, one had a history of syncope with left ventricular enlargement and decreased cardiac function with anomalous aortic origin of the left main coronary artery, and the other had a stenosis in anomalous aortic origin of the right coronary artery.Conclusion Transthoracic echocardiography could be a properly and sensitively screening method of abnormal aortic origin of coronary artery. It should be carried out as basic examination in infants and young children for the early diagnosis and treatments.

关 键 词：冠状动脉异常主动脉起源 经胸超声心动图 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学]