川崎病患儿二尖瓣环运动特征及临床意义

Character and significance of mitral annulus motion in patients with kawasaki disease

目的应用组织多普勒成像技术(TDI)测量二尖瓣环运动,评价川崎病患儿左心功能变化及其与冠状动脉损害程度的关系。方法超声心动图常规测量46例川崎病患儿左右冠状动脉内径和心功能,并根据冠状动脉损害程度分组。DTI检测二尖瓣环六个点的收缩期峰值速度(Vs)、舒张早期峰值速度(Ve),舒张晚期峰值速度(Va),并计算二尖瓣瓣环运动e、a峰的e/a值,取六个点的平均值。同样方法检测20例正常儿童作为对照。结果川崎病患儿左心功能指标中左室短轴缩短率(FS)、射血分数(EF)、Ve、Vs和e峰较正常对照组有不同程度减低,Va、a峰较正常对照组有不同程度增高,Ve/Va和e/a比值均较正常对照组减低。心脏功能下降程度与冠状动脉损害呈正相关。结论川崎病患儿心脏功能均较正常儿童下降,其程度与冠状动脉损害相关。

Objeetive To measure the motion of mitral annulus in patients with Kawasaki disease by Tissue Doppler imaging （TDI）, and to evaluate the relationship between change of left ventricular（LV） function and lesion of coronary artery. Methods Echo- cardiography was used to examine 46 KD children, and 20 health children as control. The internal diameter of proximal part coronary artery（CA） ,shortening fraction（FS） of LV, ejection fraction（EF）,mitral inflow velocity Ve, Va, and Ve/Va were measured routinely. All patients were divided into five groups according to CA lesion. DTI was applied to measure mitral annulus velocity .e, a and e/a ,6 points in each patients were selected to calculate average value of each index.Results Compared to control group, FS, EF, Ve, Vs and e decreased, Va and a increased , Ve/Va and e/a decreased in KD group. The systolic and diastolic function of LV decreased in patients with coronary aneurysm, while only diastolic function decreased in those groups which hadn＇ t developed coronary aneurysm yet. Conclusion Heart function , especially diastolic function, decreases in children with kawasaki disease, and the decreasing level is positively related to the damage level of coronary artery.