超声LCA/AoA RCA/AoA值在川崎病不同时期的变化及对预后的预测价值分析  

Changes of Ultrasound LCA/AoA and RCA/AoA Values in Self-Limited Recovery of Kawasaki Disease and Analysis of Their Predictive Value for Prognosis

作　　者：黄蓓 夏晓辉[1] 谢娟娟[1] 敖琨[1] 颜晶 HUANG Bei;XIA Xiaohui;XIE Juanjuan(Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University,Hunan Changsha 410005,China)

机构地区：[1]湖南省人民医院/湖南师范大学附属第一医院超声科,湖南长沙410005

出　　处：《河北医学》2022年第10期1719-1726,共8页Hebei Medicine

基　　金：湖南省自然科学基金项目,(编号:2020JJ8013)。

摘　　要：目的:采用超声检测川崎病(KD)患儿左冠状动脉总干(LCA)、右冠状动脉总干(RCA)内径、主动脉瓣环(AOA)内径,计算LCA/AoA、RCA/AoA值,分析二者在KD患儿自限性恢复中的变化及对预后的预测价值。方法:选取2020年1月至2021年12月在我院就诊的KD患儿126例为观察组,选取同期健康体检儿童63例为对照组。比较观察组急性期、亚急性期、恢复期及对照组LCA/AoA、RCA/AoA值。统计观察组急性期及发病3个月后冠状动脉病变(CAL)发生情况。分析患儿预后的影响因素,评估LCA/AoA、RCA/AoA值预测预后的价值。结果:观察组急性期、亚急性期、恢复期LCA/AoA、RCA/AoA值均高于对照组(P<0.05);观察组亚急性期LCA/AoA、RCA/AoA值较急性期升高,但恢复期较急性期、亚急性期降低(P<0.05);观察组发病3个月后CAL发生率较急性期降低(P<0.05);校正血小板计数、C反应蛋白水平后,恢复期LCA/AoA、RCA/AoA值均为KD患儿预后的影响因素(P<0.05);恢复期LCA/AoA预测左冠状动脉病变的AUC值为0.902,RCA/AoA值预测右冠状动脉病变的AUC值为0.850。结论:超声LCA/AoA、RCA/AoA值在KD自限性恢复中变化明显,尤其是恢复期LCA/AoA、RCA/AoA值可有效预测患儿预后,可为临床治疗方案的调整提供参考依据。Objective:To detect the left common coronary artery(LCA)and right common coronary artery(RCA)internal diameters and aortic annulus(AoA)internal diameters in children with Kawasaki disease(KD)using ultrasound,calculate LCA/AoA and RCA/AoA values,and analyse the changes in their self-limiting recovery and their predictive value for prognosis in children with KD.Methods:A total of 126 KD children who were treated in our hospital from January 2020 to December 2021 were selected as the observation group,and 63 healthy children who underwent physical examination during the same period were selected as the control group.The LCA/AoA and RCA/AoA values of the observation group in the acute phase,subacute phase and recovery phase were compared with those in the control group.The incidence of coronary artery lesion(CAL)in the acute phase and 3 months after the onset of the observation group was counted.The influencing factors of prognosis of children were analyzed,and the value of LCA/AoA and RCA/AoA values in predicting prognosis was evaluated.Results:The LCA/AoA and RCA/AoA values of the observation group in the acute stage,subacute stage and recovery stage were higher than those in the control group(P<0.05).The LCA/AoA and RCA/AoA values in the subacute phase of the observation group were higher than those in the acute phase,but were lower in the recovery phase than those in the acute and subacute phases(P<0.05).The incidence of CAL in the observation group was lower than that in the acute stage after 3 months of onset(P<0.05).After correction of platelet count and C-reactive protein level,LCA/AoA and RCA/AoA values in the recovery period were the prognostic factors for children with KD(P<0.05).The AUC value of LCA/AoA for predicting left coronary artery disease during the recovery period was 0.902,and the AUC value for RCA/AoA for predicting right coronary artery disease was 0.850.Conclusion:Ultrasound LCA/AoA and RCA/AoA values change significantly during the self-limited recovery of KD,especially in the recovery perio

关 键 词：超声 LCA/AoA RCA/AoA值 川崎病 自限性恢复 预后 

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