超声心动图检查对川崎病合并心力衰竭患儿心脏形态及功能的评价价值

Value of echocardiographic evaluation on Kawasaki disease of heart morphology and function

目的 探讨超声心动图对川崎病合并心力衰竭患儿心脏形态及功能评价价值.方法 选择2014年1月至2017年1月于忻州市人民医院超声科接受心脏检查的30例川崎病合并心力衰竭患儿为观察组,同时段健康儿童30例为对照组,均接受心脏超声检查.观察观察组与对照组心脏超声测量指标的差异,并比较观察组治疗前后心脏超声测量指标.结果 与对照组比较,观察组患儿左心房内径（LA）[（20.3±2.5）mm比（13.7 ±2.8）mm]、右心室内径（RV）[（13.8±2.3）mm比（10.5±1.9）mm]及左室舒张末期内径（LVDd）[（41.9 ±5.8）mm比（27.2±2.6） mm]指标显著升高,左室射血分数（LEVF）[（45.6±6.4）％比（70.3±8.4）％]、左心室短轴缩短率（LVFS）[（19.8±2.2）mL比（35.9±4.1）mL]及二尖瓣舒张早期峰值速度/舒张晚期峰值速度（E/A）（1.38±0.22比1.92±0.43）指标均显著降低,差异均有统计学意义（t=9.879、7.365、12.125、12.254、16.567、5.923,均P＜0.05）.治疗后,观察组超声测量指标均明显改善,其中结构参数LA[（20.3±2.5）mm比（16.5±2.2）]、RV[（13.8±2.3）mm比（11.4±1.3）]及LVDd[（41.9±5.8） mm比（33.7±3.3）]均明显降低,功能指标LVEF[（45.6±6.4）％比（59.9±7.1）％]、LVFS[（19.8±2.2）mL比（28.5±3.7） mL]及E/A[（1.38±0.22）比（1.73±0.31）]均明显升高,差异均有统计学意义（t=5.125、4.035、10.915、7.828、9.864、4.194,均P＜0.05）.结论 超声心动图能够客观地对川崎病合并心力衰竭患儿心脏形态学指标、功能指标以及治疗效果进行评价,临床应用价值高.

Objective To study value of the echocardiographic evaluation on Kawasaki disease of heart morphology and function.Methods From January 2014 to January 2017,30 cases of heart failure children with Kawasaki in the People＇s Hospital of Xinzhou were selected as observation group,at the same time 30 healthy volunteers were selected as control group,and they were all detected with echocardiography.The differences in cardiac ultrasound measurement were observed and compared between the observation group and normal control group,and before and after treatment,the heart ultrasonic measurement differences were compared between the two groups.Results Compared with those of the control group,the LA [（20.3 ± 2.5） mm vs.（13.7 ± 2.8） mm],RV [（13.8 ±2.3） mm vs.（10.5 ± 1.9） mm] and LVDd [（41.9 ± 5.8） mm vs.（27.2 ± 2.6） mm] index of the observation group were significantly increased,LVEF [（45.6 ± 6.4） % vs.（70.3 ± 8.4） %],LVFS [（19.8 ± 2.2） mL vs.（35.9 ±4.1） mL] and E/A [（1.38 ± 0.22） vs.（1.92 ± 0.43）] index of the observation group decreased significantly,the differences were statistically significant （t =9.879,7.365,12.125,12.254,16.567,5.923,all P 〈 0.05）.Compared with those of the control group,the ultrasonic measurement indexes of the observation group were significantly improved,the structure parameters ofLA [（20.3±2.5）mm vs.（16.5±2.2）mm],RV[（13.8±2.3）mm vs.（11.4±1.3）mm] and LVDd[（41.9 ± 5.8）mm vs.（33.7 ± 3.3）mm] decreased obviously,function index of LVEF[（45.6 ± 6.4）% vs.（59.9 ±7.1）%],LVFS [（19.8±2.2）mL vs.（28.5±3.7）mL] andE/A[（1.38±0.22） vs.（1.73 ±0.31）]of the observation group were significantly increased after treatment,the differences were statistically significant （t =5.125,4.035,10.915,7.828,9.864,4.194,all P 〈 0.05）.Conclusion Echocardiography can objectively evaluate the cardiac morphological indexes and functional indexes of children,which has high value in clinicalapplication.