实时三维超声心动图联合Tei指数评价川崎病恢复期左心功能

Evaluation of the left ventricular function by real-time three-dimensional echocardiography and Tei index in patients with Kawasaki disease in convalescence phase

目的应用实时三维超声心动图(RT-3DE)和多普勒超声Tei指数评价恢复期川崎病(KD)患儿的左心功能。方法选择KD恢复期患儿80例(冠脉损害组38例,冠脉正常组42例)及正常对照组儿童40例,常规M型Teichholtz校正公式及实时三维超声分别检测左室射血分数(EF,3D-EF);多普勒超声检测二尖瓣口舒张期E/A比值及左心Tei指数;对以上各指标进行组间对比及相关性分析。结果恢复期KD患儿冠脉损害组常规EF明显低于冠脉正常组和对照组(P<0.05);但冠脉正常组EF与正常对照组相比无明显差异(P<0.05)。冠脉损害组3D-EF明显低于冠脉正常组(P<0.05);冠脉正常组3D-EF明显低于正常对照组(P<0.05)。冠脉损害组左心Tei指数较冠脉正常组相比明显延长(P>0.05);冠脉正常组Tei指数较对照组明显延长(P<0.05)。3D-EF与Tei指数呈明显负相关(r=-0.75,P<0.05)。结论恢复期KD患儿左心收缩功能受损,有冠脉损害者为著。RT-3DE可以准确评价恢复期KD患儿左心收缩功能,与Tei指数有较好的相关性。

Objective To explore the clinical value of real-time three-dimensional echocardiography and Doppler Tei index for evalua- ting the left ventricular function of patients with Kawasaki disease（KD） in convalescence phase. Methods Eighty patients with Ka- wasaki disease in convalescence phase （ 38 cases of coronary lesions and 42 cases of non-coronary lesions） and 40 normal children were analyzed with echocardiography. Left ventricular ejection fraction was measured with M-mode Teichholtz and real-time three-dimensional echocardiography （ EF , 3 D - EF ） . E/A ratio and the Tel index of the left ventriclular were measured and compared between the three groups. Results The EF was significantly lower in KD patients with coronary artery lesions than in KD patients without coronary ar- tery lesions and normal control children（P 〈 0. 05） ,while there was no significant difference between KD patients without coronary ar- tery lesions and control children. 3D-EF was significantly lower in coronary artery lesion group than in non-coronary lesion group（ P〈 0. 05 ）, and 3D-EF was also lower in non-coronary lesion group than in normal group（P 〈 0. 05）. Tei index was higher in coronary artery lesion group than in non-coronary lesion group （P 〈 0. 05 ）, and higher in non-coronary lesion group than in normal group （P 〈 0. 05）. 3D-EF was negatively correlated with Tei index（r = -O. 75,P 〈 O. 05）. Conclusion The left ventricular systolic function is impaired in KD patients in convalescence phase. RT-3DE can accurately evaluate the left ventricular systolic function of KD in convalescence phase and has a good correlation with Tel index.