小儿川崎病心脏功能变化与冠状动脉损伤的相关性分析  

Analysis on correlation between cardiac functional changes and coronary artery lesions in Kawasaki disease in children

作　　者：赵俊山 马莹莹 王丽君 辛丽 ZHAO Junshan;MA Yingying;WANG Lijun;XIN Li(Second Department of Intensive Care Medicine,Hebei Provincial Children’s Hospital,Shijiazhuang,Hebei 050031,China)

机构地区：[1]河北省儿童医院重症医学二科,石家庄050031

出　　处：《重庆医学》2024年第23期3602-3607,共6页Chongqing Medical Journal

基　　金：河北省2023年度医学科学研究课题计划项目(20231174)。

摘　　要：目的探讨川崎病患儿急性期及恢复期心脏功能变化与冠状动脉损伤(CAL)的相关性。方法选取2021年6月至2023年12月就诊于该院的74例典型川崎病患儿为研究对象,所有研究对象入院后行超声心动图检查,根据冠状动脉有无扩张分为无CAL的川崎病患儿(CAL^(-)组,n=44)和合并CAL的川崎病患儿(CAL^(+)组,n=30),CAL^(+)组治疗2个月再根据冠状动脉扩张情况分为CAL^(+)恢复组(n=17)和CAL^(+)持续扩张组(n=13)。比较3组室间隔舒张末期厚度与左心室后壁舒张末期厚度比值(IVST/LVPWT)、主动脉根部内径与主肺动脉内径比值(AORD/MPAD)、冠状动脉内径与主动脉根部比值、冠状动脉内径与体表面积比值、主动脉与肺动脉最大压力比值、左心室短轴缩短百分率(FS)、射血分数(EF)和左心室质量指数(LVMI)的差异。结果与CAL^(-)组、CAL^(+)恢复组比较,CAL^(+)持续扩张组急性期、临床痊愈1个月时IVST/LVPWT明显增大(P<0.05)。与CAL^(-)组、CAL^(+)持续扩张组比较,CAL^(+)恢复组急性期、临床痊愈期AORD/MPAD更小(P<0.05)。与CAL^(-)组比较,CAL^(+)持续扩张组临床痊愈期AORD/MPAD更小(P<0.05)。与CAL^(+)持续扩张组比较,CAL^(+)恢复组急性期、临床痊愈期及临床痊愈1、2个月左、右冠状动脉内径与主动脉根部比值和左、右冠状动脉与体表面积比值更大,差异有统计学意义(P<0.05)。在临床痊愈期,与CAL^(-)组比较,CAL^(+)持续扩张组主动脉与肺动脉最大压力比值更低,差异有统计学意义(P<0.05)。3组急性期、临床痊愈期、临床痊愈1、2个月EF、FS、LVMI比较,差异无统计学意义(P>0.05)。结论川崎病患儿心脏功能检测可作为CAL预后评估指标。Objective To investigate the correlation between the cardiac function change and coronary artery lesions(CAL)in acute stage and convalescent stage of children patients with Kawasaki disease.Methods A total of 74 children patients with typical Kawasaki disease visiting to this hospital from June 2021 to December 2023 were selected as the study subjects.All study subjects conducted the echocardiographic examination after admission.The patients were divided into the non-CAL group(CAL^(-)group,n=44)and complicating CAL group(CAL^(+)group,n=30)according to whether or not coronary artery having dilation.After 2-month treatment,the CAL^(+)group was divided into the CAL^(+)recovery group(n=17)and CAL^(+)persistent dilation group(n=13).The differences in the ratio of interventricular septal thickness at end-diastole to left ventricular posterior wall thickness(IVST/LVPWT),ratio of aortic root diameter to main pulmonary artery diameter(AORD/MPAD),ratio of coronary artery diameter to aortic root,ratio of coronary artery diameter to body surface area,maximum aortic to pulmonary pressure ratio,percentage of left ventricular brachyaxis shortening and ejection fraction(EF)were compared among 3 groups.Results Compared with the CAL^(-)group and CAL^(+)recovery group,IVST/LVPWT in the acute stage and 1 month of clinical recovery in the CAL^(+)persistent dilation group was significantly increased(P<0.05).Compared with the CAL^(-)group and CAL^(+)persistent dilation group,AORD/MPAD in the acute stage and clinical recovery stage in the CAL^(+)recovery group was smaller(P<0.05).Compared with the CAL^(-)group,AORD/MPAD in the clinical recovery stage in the CAL^(+)persistent dilation group was smaller(P<0.05).Compared with the CAL^(+)persistent dilation group,the ratio of left and right coronary artery internal diameter to aortic root and ratio of left and right coronary artery to body surface area in the acute stage,clinical recovery stage and in 1,2 months after clinical recovery were greater,and the differences were statistically sig

关 键 词：川崎病 心脏功能 冠状动脉 损伤 相关性 

分 类 号：R725.4[医药卫生—儿科]