超声心动图对川崎病冠状动脉损害的评价

Evaluating Coronary Arterial Lesions in Kawasaki Disease by Echocardiography

目的 评价超声心动图在川崎病所引起的冠状动脉的损害造成冠状动脉扩张以及冠状动脉瘤形成中的诊断价值。方法 利用二维超声 ( 2DE)、脉冲多普勒 (PW )、彩色多普勒血流显像 (CDFI)检测受累冠状动脉开口、内径、追踪其走行及扩张处血流特点。结果 本研究共 45例患者 ,男 3 6例 ,女 9例 ,年龄 1个月～ 12岁 ,临床上被明确诊断为川崎病。超声分别测量其冠状动脉内径 ,根据冠状动脉损害的严重程度可分为 0～Ⅲ级。每例患者至少行两次检查 ,并比较其用药前后的冠状动脉扩张程度。 15例属 0级 ,2 6例属Ⅰ级 ,3例属Ⅱ级 ,1例属Ⅲ级 ,治疗后扩张的冠状动脉内径有缩小的趋势。结论 超声心动图诊断川崎病并发心血管损害对判断病情、指导治疗和估计预后发挥越来越重要的作用 ,尤其对冠状动脉扩张和冠状动脉瘤形成的诊断具有特异性 ,能清晰的显示冠状动脉内径、扩张程度 ,但对检出冠状动脉远端的损害有一定的困难。

Objective To evaluate echocardiography in the diagnosis of coronary dilatation and aneurysm formation caused by coronary arterial lesions. Methods Coronary artery opening and interior diameter were measured. The coronary diameters were traced and the blood flow characteristics were observed using 2 D echocardiography, pulsed wave Dopper and color Dopper flow imaging. Results Forty five patients with Kawasaki disease aged from 0.08 to 12 years old (mean age 3.24 years old),thirty six boys and nine girls, were investigated. We measured the diameters of coronary arteries by echocardiography. Every patient was examined twice at least. According to the severity of coronary arterial lesions in angiography, the coronary diameters were divided into four grades so that we could compare the dilatation of coronary before and after clinical treatment. Fifteen cases belonged to Grade 0,twenty six to Grade Ⅰ, three to Grade Ⅱ and one to Grade Ⅲ. After clinical treatment,the diameters of coronary arteries trended towards minification. Conclusion Measurement of coronary artery in Kawasaki disease by echocardiography plays an important role in the diagnosising, treating and predicting prognosis, especially in diagnosising the dilatation of the coronary artery and coronary aneurysm formation. It can definitely show the diameter and the degree of coronary artery dilatation, but it is difficult to find out the distal coronary lesions. [