彩色多普勒超声心动图在川崎病心脏病变中的应用价值

Value of Doppler color echocardiography in diagnosis of Kawasaki disease with cardiac involvement

目的探讨彩色多普超声心动图在川崎病心脏病变中的应用价值。方法彩色多普超声心动图检查58例川崎病患儿,测量冠状动脉直径,测量房室大小,计算心功能(EF%),观察各瓣膜有否返流及心包有无积液。结果58例川崎病患儿中发生心脏异常改变有31例(53.45%),冠状动脉病变28例,其中单纯左冠状动脉主干病变17例,右冠状动脉主干3例,左右冠状动脉同时累及8例,2例发生冠状动脉瘤,左室增大9例,右室增大6例,全心增大4例,二尖瓣关闭不全18例,三尖瓣关闭不全16例,心包积液13例,2例有短期内心功能减低。结论彩色多普勒超声心动图能动态观察冠状动脉的病理改变、进展及估计预后,是无创评价和随访川崎病心脏改变的最具价值的应用工具。

Objective To assess the diagnostic value of Doppler color echocardiography for Kawasaki disease (KD) with cardiac involvement. Methods Doppler color echocardiography was performed in 58 KD cases for measurement of the diameter of the coronary artery and the dimensions of the ventricles. The ejection fraction (EF) of the heart was also calculated and the presence of pericardial effusion and valvular regurgitation examined. Results Cardiac involvement was identified in 31 (53.45%) of the total 58 patients, and 28 patients were found to have coronary artery lesions. Uncomplicated left and right main stem coronary artery lesions were detected in 17 and 3 patients, respectively, lesions involving both two coronary arteries in 8, coronary aneurysms in 2, left ventricle enlargement in 9, right ventricle enlargement in 6, and enlargement of the whole heart in 4 patients. Eighteen patients had mitral regurgitation, 16 had tricuspid regurgitation, 13 had pericardial effusion, and 2 developed temporary cardiac dysfunction. Conclusions Doppler color echocardiography is capable of depicting dynamically the pathological changes and progression of the coronary artery lesions with prognostic indications, to serve as the most valuable non-invasive modality for diagnosis of KD with cardiac involvement.