对川崎病并发冠状动脉扩张的诊断

Diagnose of Kawasaki Disease Complicated with Coronary Artery Dilatation

目的 :探讨如何早期诊断川崎病并发冠状动脉扩张 ,并对其进行随访。方法 :收集 2 3例川崎病 ,其中并发冠状动脉扩张5例 (2 1.7% ) ,依据日本MCLS研究会制订的标准确定诊断 ,超声心动图主要测量左、右冠状动脉起始部内径及左心室收缩 /舒张末内径 ,计算EF、FS值。并利用超声心动图进行常规随访 ,间隔时间为 3～ 6个月。结果 :一般的实验室检查及X线在有无合并冠状动脉扩张间无明显差别 ;EKG异常与超声心动图得到的EF、FS之间关系一致 ;超声心动图多在发病 1～ 4周发现冠状动脉扩张。结论 :发现EKG可能对并发心肌炎等心肌收缩功能受损的诊断及随访有帮助 ,而超声心动图检查仍是川崎病并发冠脉扩张诊断及随访的最佳手段。

Objective: To investigate the methods of early diagnosis and follow up for coronary artery dilatation of Kawasaki disease. Methods: 23 cases of Kawasaki disease were studied, 5 cases of them were complicated with coronary artery dilatation. According to the standard of Japanese MCLS, measuring the inside diameter of origination of coronary artery, and the inside diameter of left ventricle in the end of contraction or stretching by echo,and counting EF and FS. Following them with echo in general every three to six months. Results: General examination of lab and X-ray had no significant difference, whether uniting coronary artery dilatation or not. Abnormity in EKG was consistent with EF and FS gained from echo. It often happened coronary artery dilatation after the first to fourth week. Conclusion: EKG may be helpful to diagnose and follow the cardiac muscle function of contraction, echo is the best facility in diagnosing and following the coronary artery dilatation of Kawasaki disease.