超声心动图分析冠状动脉损伤评估方法在川崎病冠状动脉病变的诊断价值  

Analysis of the diagnostic value of coronary artery injury assessment method in coronary artery lesions in Kawasaki disease based on echocardiography

作　　者：马平 刘崇海[1] 唐庆 吴玲 陈怡[1] 陈雨露 MA Ping;LIU Chonghai;TANG Qing;WU Ling;CHEN Yi;CHEN Yulu(Department of Pediatrics,Affiliated 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：《重庆医学》2023年第11期1702-1706,共5页Chongqing medicine

摘　　要：目的探讨不同冠状动脉损伤评估方法在川崎病(KD)患儿使用丙种球蛋白治疗前检测冠状动脉病变的能力,且以超声随访结果为参照分析各评估方法的诊断价值。方法收集2018年1月至2021年6月于川北医学院附属医院儿科住院治疗的KD确诊患儿,根据1995年第6版《诸福棠实用儿科学》标准(简称1995年标准)、1984年日本卫生部所制定的标准(简称1984年标准)、2017年美国心脏协会(AHA)推荐的Kobayashi和Dallaire及目前国内外5种不同的Z值法(郑淋Z值法、McCrindle、Lopez、Kurotobi、Olivieri),分别计算KD患儿合并冠状动脉病变的检出率。结果有220例纳入本研究,1995年标准、1984年标准、Kobayashi、Dallaire、McCrindle、Kurotobi、Lopez、郑淋Z值法、Olivieri冠状动脉病变检出率分别为38.2%、9.55%、38.2%、28.6%、26.4%、21.8%、18.6%、17.3%、16.4%,其中1995年标准、Kobayashi检出率较高,二者差异无统计学意义(P>0.05),且更加符合随访的实际冠状动脉损伤结果。结论1995年标准和Kobayashi在KD治疗前对冠状动脉损伤诊断与后期超声随访结果一致。Objective To investigate the ability of different coronary artery injury assessment methods based on ultrasound detection to evaluate coronary artery lesions in children with Kawasaki disease(KD)before using gamma globulin therapy,and to analyze the diagnostic efficacy of each assessment method by follow-up echocardiography results.Methods The children diagnosed with KD who were hospitalized in the Pediatrics Department of the Affiliated Hospital of North Sichuan Medical College from January 2018 to June 2021 were collected.The standard formulated by the 6th edition in 1995 of"Practical pediatrics of Zhu Futang"(1995 Standard),the"Japanese Ministry of Health"(1984 Standard),Kobayashi and Dallaire recommended by the American Heart Association(AHA)in 2017,and five different Z-value methods at home and abroad(Zheng Lin Z-value method,McCrindle,Lopez,Kurotobi,Olivieri),respectively,to calculate the detection rate of KD children complicated with coronary artery disease.Results A total of 220 cases were included in this study.The detection rates of coronary artery lesions in 1995 Standard,1984 Standard,Kobayashi,Dallaire,McCrindle,Kurotobi,Lopez,Zheng Lin z-score method and Olivieri were 38.2%,9.55%,38.2%,28.6%,26.4%,21.8%,18.6%,17.3%and 16.4%,respectively.Among them,the detection rate of 1995 Standard and Kobayashi were higher,and the difference between them was not statistically significant(P>0.05),which was more in line with the actual results of coronary artery injury in follow-up.Conclusion The 1995 Standard and Kobayashi diagnosis of coronary artery injury before treatment for KD was consistent with follow-up echocardiography results.

关 键 词：川崎病 冠状动脉 超声心动图 Z值 儿童 

分 类 号：R725.9[医药卫生—儿科]