超声心动图对小儿川崎病冠状动脉病变的检出情况

Ultrasonocardiography in detecting kawasaki disease coronary artery disease in children

目的探讨超声心动图(UCG)对小儿川崎病冠状动脉病变(CAL)的检出情况。方法选取2016年1月至2018年8月郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院收治的120例川崎病患儿。静脉丙种球蛋白联合阿司匹林治疗后1个月采用UCG观察冠状动脉的开口、内径、走行、管壁及管腔情况,并对临床治疗结果进行随访,观察患儿超声诊断及随访结果。结果120例川崎病患儿中,共检出78例CAL,检出率65.0%。其中无冠状动脉扩张(CAD)且Z值<2占28.2%;CAD且2≤Z值<2.5占43.6%;冠状动脉瘤(CAA)占25.6%;巨大冠状动脉瘤(GCAA)占2.6%。随访患儿56例,其中22例冠状动脉内径不规则病变均恢复正常;15例CAD改善,2例CAA改善,6例CAA合并血栓者持续存在;2例GCAA患儿改善但血栓仍持续存在。上述患儿均未发现冠状动脉明显狭窄及猝死者。结论UCG能有效检测出川崎病患儿冠状动脉变化,且能精确定位,对于临床治疗起到一定的指导作用。

Objective To investigate the detection of coronary artery lesions(CAL)in children with Kawasaki disease by ultrasonocardiography(UCG).Method From January 2016 to August 2018,120 children with Kawasaki disease were selected from Children’s Hospital Affiliated to Zhengzhou University,He’nan Children’s Hospital and Zhengzhou Children’s Hospital.One month after intravenous immune globulin combined with aspirin,UCG was used to observe the opening,diameter,course,wall and lumen of coronary artery,and the clinical treatment results were followed up to observe the ultrasonic diagnosis and follow-up results of the children.Result In 120 cases of Kawasaki disease,78 cases of CAL were detected,the detection rate was 65.0%.Among them,28.2%had no coronary artery dilatation(CAD)and Z value<2;43.6%had CAD and 2≤Z value<2.5;25.6%had coronary artery aneurysm(CAA)and 2.6%had GCAA.56 cases were followed up,22 cases of irregular coronary artery diameter lesions recovered to normal,15 cases of CAD improved,2 cases of CAA were improved,6 cases of CAA with thrombus were persistent;2 cases of GCAA improved,but thrombus still existed.No obvious coronary artery stenosis or sudden death was found in the above children.Conclusion UCG can effectively detect the changes of coronary artery in children with kawasaki disease,and can accurately locate,which plays a guiding role in clinical treatment.