超声心动图联合ANCA、Cys-C在川崎病冠状动脉病变早期诊断中的价值研究

Value of echocardiography combined with ANCA and Cys-C in early diagnosis of Kawasaki disease coronary artery lesions

目的分析超声心动图联合抗中性粒细胞抗体(ANCA)、胱抑素C(Cys-C)在川崎病冠状动脉病变早期诊断中的价值研究。方法选取2020年5月至2021年5月南阳市镇平县人民医院收治的90例川崎病患儿设为川崎病组,其中无冠状动脉病变61例,冠状动脉病变29例,另选取同时段内100例健康体检儿童为对照组。两组均进行超声心电图、ANCA、Cys-C检查,详细记录检查结果,根据冠状动脉是否发生病变对超声心动图联合ANCA、Cys-C在早期川崎病冠状动脉病变中的诊断价值进行分析。结果相比对照组,川崎病组患儿左心室射血分数(LVEF)、舒张早期峰值速度与舒张晚期的比值(Em/Am)水平降低,左心室舒张末期内径(LVEDD)、ANCA、Cys-C水平升高(P<0.05);冠状动脉病变组患儿LVEF、Em/Am水平低于无冠状动脉病变组,LVEDD、ANCA、Cys-C水平高于无冠状动脉病变组(P<0.05),与超声心动图、ANCA、Cys-C单项检查相比,三项联合对川崎病冠状动脉病变的诊断价值较高(P<0.05)。结论超声心动图及ANCA、Cys-C变化与川崎病冠状动脉病变发生存在关联,临床中可利用超声心动图、ANCA、Cys-C联合检查对疾病病变作出有效评估,值得临床推广与应用。

Objective To analyze the value of echocardiography combined with antineutrophil cytoplasmic antibody(ANCA)and cystatin C(Cys-C)in the early diagnosis of Kawasaki disease coronary artery lesions.Methods 90 children with Kawasaki disease treated in Zhenping County People's Hospital of Nanyang city from May 2020 to may 2021 were selected as Kawasaki disease group,including 61 cases without coronary artery disease and 29 cases with coronary artery disease,and 100 healthy children in the same period were selected as the control group.Both groups were examined by ultrasonic electrocardiogram,ANCA and Cys-C,and the examination results were recorded in detail.The diagnostic value of echocardiography combined with ANCA and Cys-C in early Kawasaki disease coronary artery lesions was analyzed according to whether coronary artery lesions occurred.Results Compared with the control group,the levels of left ventricular ejection fraction(LVEF),the ratio of early diastolic peak velocity to late diastolic peak velocity(Em/Am)in Kawasaki disease group decreased,and the levels of left ventricular end diastolic diameter(LVEDD),ANCA,Cys-C increased(P<0.05);The levels of LVEF and Em/Am in the coronary artery disease group were lower than those in the non coronary artery disease group,and the levels of LVEDD,ANCA and Cys-C were higher than those in the non coronary artery disease group(P<0.05).Compared with single examination of echocardiography,ANCA and Cys-C,the combination of the three items has higher diagnostic value for coronary artery lesions of Kawasaki disease(P<0.05).Conclusion Echocardiography,ANCA and Cys-C changes are associated with coronary artery lesions in Kawasaki disease.The combined examination of echocardiography,ANCA and Cys-C can be used to effectively evaluate the disease in clinic,which is worthy of clinical promotion and application.