川崎病冠状动脉病变心肌缺血的诊断方法

Diagnostic methods of myocardial ischemia in Kawasaki disease with coronary artery lesions

川崎病（KD）未经适当治疗,冠状动脉病变的发生率可达25％.其中部分发展为冠状动脉瘤（CAA）及冠状动脉阻塞性病变（狭窄、闭塞或血栓形成）.对KD合并CAA的患儿需进行长期随访.目前仍以心电图（ECG）和二维超声心动图（2DE）为基本检查手段,对KD合并CAA者,应首选磁共振成像检查,ECG和2DE提示有心肌缺血可能时可行多巴酚丁胺负荷超声心动图检查或直接行冠状动脉造影检查,及时发现冠状动脉狭窄,评估心肌缺血程度,为进一步治疗提供依据.

Kawasaki disease （KD） without proper treatment,the incidence of coronary artery lesions is up to 25％.Some of them develope of coronary artery aneurysms （CAA）,obstructive coronary artery disease（stenosis,occlusion or thrombosis）.KD with CAA in children need long term follow-up.Electrocardiogram（ECG） and two-dimensional echocardiography（2DE） are still the basic means of checking for follow-up.KD with CAA who should be preferred magnetic resonance imaging examination.Dobutamine stress echocardiography or coronary angiography should be done with suggestive of myocardial ischemia in ECG or 2DE.