超声心动图诊断儿童川崎病的临床应用价值

Clinical value of echocardiography in the diagnosis of Kawasaki disease in children

目的探讨超声心动图在儿童川崎病诊断中的临床应用价值。方法选取收治川崎病患儿84例作为观察组,另选取同期80例健康儿童作为对照组,均行超声心动图有关检查,比较两组左右冠状动脉主干的内径值,统计观察组冠状动脉病变状况和治疗前后冠状动脉内径值差异,经随访评估冠状动脉病变不同分级患儿的冠状动脉内径值变化情况。结果观察组左右冠状动脉主干的内径值高出对照组(P<0.05)。84例川崎病患儿当中,共有42例观察到冠状动脉出现病变,包含左冠状动脉扩张、右冠状动脉扩张、双侧冠状动脉扩张、巨大动脉瘤各16例、10例、12例、4例。冠状动脉轻度扩张、中小动脉瘤各25例、13例。在病变分级方面,2级、3级、4级分别有32例、7例、3例。结束治疗后,冠状动脉轻度扩张、中小动脉瘤及巨大动脉瘤患儿在冠状动脉内径值上和治疗前相比显著减少(P<0.05)。冠状动脉病变分级为2级的患儿1个月、3个月治疗后的冠状动脉内径值和2周内相比显著降低(P<0.05);冠状动脉病变分级为3级或4级的患儿1个月、3个月治疗后的冠状动脉内径值和2周内相比降低,但无显著差异(P>0.05)。结论将超声心动图用于儿童川崎病诊断能协助临床评定冠状动脉病变的严重度及转归。

Objective To analyze the value of echocardiography in the diagnosis of Kawasaki disease in children.Methods The clinical data of 84 children with Kawasaki disease treated in our hospital from January 2018 to January 2022 were retrospectively analyzed as the observation group.In addition,the physical examination data of 80 healthy children in the same period were retrospectively analyzed as the control group.All of them were examined by echocardiography.The left and right coronary artery diameter values of the two groups were compared,and the coronary artery disease status of the observation group and the difference of coronary artery diameter values before and after treatment were counted,the changes of coronary artery diameter in children with different grades of coronary artery disease were evaluated by follow-up.Results The diameter of left and right main coronary arteries in the observation group was higher than that in the control group(P<0.05).Among 84 children with Kawasaki disease,42 cases were found to have coronary artery lesions,including left coronary artery dilatation,right coronary artery dilatation,bilateral coronary artery dilatation,and giant aneurysms in 16,10,12,and 4 cases respectively.There were 25 cases of mild coronary artery dilatation and 13 cases of small and medium aneurysms.There were 32 cases of grade 2,7 cases of grade 3 and 3 cases of grade 4.After treatment,the diameter of coronary artery in children with mild coronary artery dilatation,small and medium aneurysms and giant aneurysms decreased significantly compared with that before treatment(P<0.05).The coronary artery diameter of children with grade 2 coronary artery disease after 1 month and 3 months of treatment was significantly lower than that within 2 weeks(P<0.05);The diameter of coronary artery in children with grade 3 or 4 of coronary artery disease after 1 month and 3 months of treatment was lower than that within 2 weeks,but there was no significant difference(P>0.05).Conclusion The application of echocardiography in the diagnosis of Kawasaki disease in children can assist in the clinical evaluation of the severity and prognosis of coronary artery disease,and contribute to the early diagnosis and prognosis of the disease.