彩色多普勒超声诊断川崎病冠状动脉损害及远期随访

Diagnosis of coronary artery lesions and long-term follow-up in patients with Kawasaki disease by echocardiogram

目的探讨川崎病(KD)患儿冠状动脉损害的发生及恢复期变化特点。方法采用彩色多普勒超声心动图检查川崎病患儿388例,对伴冠状动脉损害者进行远期随访。结果冠状动脉损害168例(43.3%),随访6个月～5年,超声心动图显示冠状动脉扩张组106例冠状动脉全部恢复正常;中小型冠状动脉瘤组82.4%(42/51例)冠状动脉恢复正常;巨大型冠状动脉瘤组11例无一恢复正常。不同年龄组间冠状动脉损害率差异有统计学意义(P<0.05)。结论川崎病急性期冠状动脉扩张多可恢复;大部分中小型冠状动脉瘤改变可恢复;但巨大型冠状动脉瘤可长期存在。<1岁年龄组冠状动脉瘤发生率较高。

Objectives To explore the characteristics of coronary artery lesions in Kawasaki disease and the changes in convalescence. Methods Color Doppler echocardiography was performed on 388 patients with Kawasaki disease and long-term follow-up were completed for patients with coronary artery lesions. Results The coronary artery lesions were found in 168 patients （43.3%, 168/388） by eehocardiography. During six months to five years follow-up, the coronary artery were found recovered by cchocardiography examination in all patients （106） with coronary artery dilatation and 82.4% （42/51） patients with medium or small coronary aneurysm group, however, none had recovered in giant coronary aneurysm group. The incidence of coronary artery lesions in patients younger than one year old was significantly higher than those older than five years old （P 〈 0.05） . Conclusions Most of coronary artery lesions found during acute stage in patients with Kawasaki disease were transient. The giant coronary aneurysms may exist longer. A high incidence of coronary artery lesions appeared in patients younger than one year old.