超声心动图对伴冠状动脉扩张的急性川崎病患儿的诊断价值  

The Diagnostic Value of Echocardiography in Children with Acute Kawasaki Disease Accompanied by Coronary Artery Dilation

作　　者：郭映斯 陶宇飞 姚非非 GUO Ying-si;TAO Yu-fei;YAO Fei-fei(Medical Technology Department of Nanyang Traditional Chinese Medicine Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中医院医技科,河南南阳473000

出　　处：《罕少疾病杂志》2024年第7期63-65,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探究急性川崎病伴冠状动脉扩张患儿采用超声心动图的诊断价值。方法回顾分析我院2020年1月到2022年6月110例确诊的川崎病患儿超声心动图表现,重点观察冠状动脉改变,其中冠状动脉内径恢复正常的为A组(n=61),未恢复的为B组(n=49),对比两组急性期受累冠脉的分类、比例及扩张冠脉内径的评估值。结果首次超声心动图显示,仅为单纯性冠脉扩张的A组23例,B组21例,为冠状动脉瘤的A组33例,B组26例,冠脉内径狭窄的共有4例,分别是A组3例和B组1例,合并血栓形成分别有A组2例,B组1例;首次超声检查后,两组患儿EF值均正常,差异无统计学意义(P>0.05);急性期冠脉内径(LAD、RCA、LMCA)Z值大(P<0.05);随访超声结果显示,两组患儿发热时长、CPR、ESR水平均有明显改善;110例KD患儿冠脉恢复中,以急性期单纯性冠脉扩张和小型冠脉瘤居多。结论超声心动图简单方便,可无创伤性诊断观察急性期KD患儿冠脉扩张,准确观察冠脉内径情况,了解扩张冠脉内径有无钙化、狭窄及血栓形成,用于随访复查对明确川崎病患儿后期有无冠脉损害和预后情况价值重大。Objective To explore the diagnostic value of echocardiography in children with acute Kawasaki disease accompanied by coronary artery dilation.Method A retrospective analysis was conducted on the echocardiographic manifestations of 110 children with Kawasaki disease diagnosed in our hospital from January 2020 to June 2022,with a focus on observing coronary artery changes.Among them,group A(n=61)showed normal coronary artery diameter and group B(n=49)showed no recovery.The classification,proportion,and evaluation values of dilated coronary artery diameter of the affected coronary arteries in the acute phase were compared between the two groups.Result The first echocardiography showed that there were only 23 cases of simple coronary artery dilation in Group A,21 cases in Group B,33 cases in Group A with coronary artery aneurysm,26 cases in Group B.There were a total of 4 cases of coronary artery stenosis,3 cases in Group A and 1 case in Group B.There were 2 cases in Group A and 1 case in Group B with concomitant thrombosis,respectively;After the first ultrasound examination,the EF values of both groups of children were normal,and the difference was not statistically significant(P>0.05);The Z-value of coronary artery diameter(LAD,RCA,LMCA)in the acute phase is large(P<0.05);The follow-up ultrasound results showed that the duration of fever,CPR,and ESR levels in both groups of children were significantly improved;Among 110 pediatric patients with KD,the majority were acute stage simple coronary artery dilation and small coronary artery tumors.Conclusion Echocardiography is simple and convenient,and can be used for non-invasive diagnosis and observation of coronary dilation in children with acute KD.It accurately observes the diameter of the coronary artery,and understands whether there is calcification,stenosis,and thrombosis in the dilated diameter of the coronary artery.It is of great value for follow-up and re examination to determine whether there is coronary damage and prognosis in children with Kawasaki disease

关 键 词：川崎病 冠状动脉扩张 超声心动图 冠状动脉损害 

分 类 号：R725.4[医药卫生—儿科]