基于超声随访结果四种冠脉损伤评估方法诊断效能分析  

Analysis of Diagnostic Efficacy of Four Coronary Artery Injury Assessment Methods Based on Ultrasound Follow-up Results

作　　者：刘昊旻 刘崇海[1] 何云[1] 李小林 陈雨露 陈怡[1] LIU Hao-min;LIU Chong-hai;HE Yun(Department of Pediatrics,Affiliatted Hospital of North Sichuan Medical College,Nanchong,Sichuan,637000,China)

机构地区：[1]川北医学院附属医院儿科,四川南充637000

出　　处：《黑龙江医学》2022年第11期1285-1287,1291,共4页Heilongjiang Medical Journal

基　　金：四川省卫健委科研课题(20PJ148)。

摘　　要：目的:以川崎病(KD)患儿出院后随访超声心动图结果为参照分析四种冠脉病变评价指标的诊断效能。方法:选取2018年1月—2020年4月川北医学院附属医院儿科住院治疗的133例KD患儿作为研究对象。以患儿出院后心脏超声冠脉随访结果为参照,探讨1995年第6版《诸福棠实用儿科学》标准及目前国内外三种不同的Z值法(郑淋Z值法、Kobayashi法、Dallaire法),针对KD患儿合并冠状动脉病变的检出率,并进行分析。结果:1995标准分别与郑淋Z值法、Kobayashi法、Dallaire法比较,差异有统计学意义(χ^(2)=6.560,P<0.05)。随访病例中缩小者73例,与1995标准检出率比较,差异有统计学意义(χ^(2)=6.032、0.136、0.015、0.964,P<0.05),而与三种Z值法相比,差异无统计学意义(P>0.05)。在四种评估方法中,Kobayashi法的准确性、灵敏度及特异度分别是85.0%、86.5%、83.1%。结论:1995标准相对于郑淋Z值法、Kobayshi法、Dallaire法值检测检出率偏低。Kobayashi法在几种评估方法中拥有最好的检出率、准确性、灵敏度及特异度。Objective:To analyze the diagnostic efficacy of four coronary artery disease evaluation indicators based on the follow-up echocardiographic results of children with Kawasaki disease(KD)after discharge from the hospital.Methods:A total of 133 children with KD who were hospitalized in the hospital from January 2018 to April 2020 were selected.Taking the results of echocardiography and coronary follow-up of children after discharge as reference,the standard of Zhu Futang Textbook of Pediatrics(1995 standard)of the sixth edition in 1995 and three different Z-value methods at home and abroad(Zhenglin Z-value Law,Kobayashi Law,Dallaire Law)were discussed.The detection rate of coronary artery lesions in children with Kawasaki disease was analyzed.Results:There was statistically significant difference between the 1995 standard and Zhenglin Z-value method,Kobayashi method and Dallaire method(χ^(2)=6.560,P<0.05).Among the follow-up cases,there were 73 cases of shrinkage,and the difference was statistically significant compared with the 1995 standard detection rate(χ^(2)=6.032,0.136,0.015,0.964,P<0.05),while compared with the three Z-value methods,the difference was not statistically significant(P>0.05).Among the four evaluation methods,the accuracy,sensitivity and specificity of the Kobayashi method were 85.0%,86.5%and 83.1%.Conclusion:Compared with Zhenglin Z value method,Kobayshi method and Dallaire method,the detection rate of 1995 standard is relatively low.The Kobayashi method has the best detection rate,accuracy,sensitivity and specificity among several evaluation methods.

关 键 词：川崎病 冠状动脉病变 超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学]