超声心动图在川崎病冠状动脉病变早期诊断中的价值分析

Value analysis of echocardiography in the early diagnosis of Kawasaki disease coronary artery disease

目的探讨超声心动图在川崎病冠状动脉病变早期诊断中的价值。方法选取2018年12月~2020年3月河源市妇幼保健院收治的40例疑似川崎病冠状动脉病变患儿作为研究对象,所有患者进行超声心动图与心电图检测。比较两种检测方法的检出率、灵敏度、特异性及影像学特征。结果超声心动图检查的诊断符合率为85.00%、灵敏度为88.24%、特异性为66.67%;心电图检查的诊断符合率为52.50%、灵敏度为52.38%、特异性为52.63%,超声心动图的诊断符合率、灵敏度、特异性均高于心电图检查,差异有统计学意义(P<0.05)。超声检查表现为冠状动脉管壁增厚,回声增强,内膜回声不均匀,周围组织灰度对比增强。心电图表现为窦性心动过速的患者,恢复正常时间为(4.17±0.21)个月;而诊断为冠状动脉瘤患者,恢复正常时间为(20.12±0.17)个月。在追踪随访过程中未发生管腔<1.5 mm的病例,无复发病例。结论对川崎病冠状动脉病变患者实施超声心动图检查,在早期诊断方面具有十分重要的意义,能提高检出率。

Objective To investigate the value of echocardiography in the early diagnosis of coronary artery disease in Kawasaki disease.Methods A total of 40 patients with suspected Kawasaki disease with coronary artery disease admitted to Heyuan Maternal and Child Health Hospital from December 2018 to March 2020 were selected as the research subjects,echocardiography and electrocardiogram(ECG)were performed in all patients.The detection rate,sensitivity,specificity and imaging characteristics of the two detection methods were compared.Results The diagnostic coincidence rate,sensitivity and specificity of echocardiography were 85.00%,88.24%and 66.67%.The diagnostic coincidence rate,sensitivity and specificity of ECG were 52.50%,52.38%and 52.63%,and the differences were statistically significant(P<0.05).For patients with sinus tachycardia,the time to return to normal was(4.17±0.21)months.In patients diagnosed with coronary aneurysms,the time to return to normal was(20.12±0.17)months.During the follow-up,no lumen<1.5 mm cases occurred,and no recurrence cases occurred.Conclusion Echocardiography is very important for early diagnosis of Kawasaki disease patients with coronary artery disease and can improve the detection rate.