超声心动图随访小儿川崎病冠状动脉的变化

Echocardiography follow-up of coronary artery change in children with Kawasaki disease

目的探讨超声心动图在小儿川崎病冠状动脉病变随访中的应用价值。方法对47例川崎病患儿的冠状动脉进行超声检查,并对伴有冠状动脉损害者进行随访。结果 47例川崎病患儿中,冠状动脉损害19例(19/47,40.4%),其中左冠状动脉扩张10例(10/19,52.6%),左、右冠状动脉均扩张4例(4/19,21.1%),右冠状动脉扩张2例(2/19,10.5%),冠状动脉瘤3例(3/19,15.8%)。经治疗后随访发现18例患儿冠状动脉内径能恢复正常,其中2例冠状动脉瘤患儿均为1岁以下婴儿,瘤体较小,瘤径分别为4.2mm和4.6mm,前者随访18个月恢复正常,后者随访2年恢复正常。结论超声心动图能动态观察冠状动脉病变,是目前随访川崎病患儿冠状动脉损害最具价值的手段,但对冠状动脉远端损害的检出有一定的困难。

To explore the application value of echocardiography followup of coronary artery change in children with Kawasaki disease. Methods The coronary artery of 47 children with Kawasaki disease were examined by ultrasonography, then the children with coronary arterial lesions were followed-up. Results In 47 children, there were 19 cases of coronary arterial lesions（ 19/47,40.4% ） , including 10 cases with left coronary artery dilation（ 10/19,52.6% ） ,4 cases with left and right coronary artery dilation （4/19,21.1%） ,2 cases with right coronary artery dilation（2/19,10.5% ） , and 3 cases with coronary artery aneurysms （3/19,15.8%）. After clinical treatment, the coronary artery diameter in 18 children returned to normal, two cases of coronary artery aneurysms in children were younger than 1-yearold, the tumor size was 4.2 mm and 4.6 mm, respectively. The followup showed coronary artery aneurysm returned to normal after 18 months in former, while returned to normal after 2 years in latter. Conclusion Eehocardiography can dynamically observe the coronary arterial lesions, it can serve as the most valuable noninvasive means and followup for the diagnosis of coronary artery change in children with Kawasaki disease, but it is difficult to find out the distal coronary artery lesions.