川崎病34例冠状动脉病变的诊断与治疗  

Diagnosis and Therapy of Coronary Arterial Lesions of Kawasaki Disease

作　　者：陈茂荣[1] 杨运刚[1] 

机构地区：[1]福建医科大学附属厦门第一医院儿科,福建厦门361003

出　　处：《临床军医杂志》2003年第6期51-53,共3页Clinical Journal of Medical Officers

摘　　要：目的　探讨川崎病 (KD)冠状动脉病变的诊断和治疗。方法　对 3 4例有冠状动脉病变的川崎病进行回顾分析。结果　轻、中度冠脉扩张及心包积液均能在 1～ 2年内恢复 ,而重度冠脉扩张成巨大冠脉瘤 (CAA)者则不易恢复 ,留下永久性冠状动脉病变 ,预后不良。另外 ,发现采用ASA +IVIG +IVMP治疗 ,患儿的临床症状较ASA +IVIG治疗的症状更易得到改善 ,而且冠状动脉扩张的发生率 ( 4 4 4%)较ASA +IVIG治疗者 ( 61 .5 %)为低 ,扩张的程度也轻。结论　 ( 1 )小儿川崎病 (KD)虽然是全身中小血管内膜的炎症 ,但以心脏冠状动脉最易受累 ,特别是左侧冠状动脉(LCA) ,为小儿时期后天性冠状动脉心脏病的重要原因。 ( 2 )KD急性期在用ASA +IVIG治疗的基础上加用IVMP对临床症状的改善有肯定的疗效 ,而在预防CAA方面可能是有效的。Objective To discuss the diagnosis and therapy of coronary arterial lesions of Kawasaki Disease (KD). Methods Retrospective analysis was carried out in 34 patients with KD.Results Slight or moderate coronary dilatation and hydropericardium could return to normal within 1 to 2 years, while large coronary artery aneurysm (CAA) resulting from severe coronary dilatation left behind permanent coronary arterial lesions, which stood for bad prognosis. Aspirin (ASA) + intravenous immunoglobulin (IVIG) + intravenous methylprednisolone (IVMP) was more effective on relieving the symptoms and lowing the rate and the degree of coronary dilatation than ASA + IVIG. Conclusion (1) KD is characteristic of the involvement in the coronary artery especially the left coronary artery, which accounts for an important cause of coronary heart disease in childhood. (2) It is suggested that IVMP, in addition to ASA+IVIG, be effective on relieving clinical symptoms, and may be effective on preventing CAA.

关 键 词：川崎病 冠状动脉病变 诊断 治疗 KD 心包积液 

分 类 号：R541.4[医药卫生—心血管疾病] R72[医药卫生—内科学]