川崎病急性期冠状动脉病变的多普勒超声检测及其临床意义

Early Diagnosis of Coronary Arterial Lesions in Kawasaki Disease by Doppler Echocardiograph

目的 探讨川崎病急性期的多普勒超声检测及其临床意义。方法 回顾分析 14 2例川崎病急性期的多普勒超声表现 ,并与 3 6例正常小儿的检测结果对比 ;研究川崎病冠状动脉的二维声像图、左冠状动脉前降支舒张期峰值血流速度和左心室壁的节段性运动异常。结果 川崎病急性期冠状动脉管壁及其周围组织回声异常 94%;管腔扩张2 0 %;川崎病组冠状动脉舒张期峰值血流速度增加 ,与正常组差异有显著性意义 ( 4 8.96± 8.3 8Vs 3 1.85± 2 .5 5 ,P <0 .0 1) ;川崎病急性期左心室壁运动积分指数较正常组显著增加 ( 1.16± 0 .0 9Vs 1.0 0± 0 .0 0 ,P <0 .0 1) ,室壁运动异常率达 10 0 %。结论 川崎病急性期冠状动脉病变不仅可导致冠脉结构形态、内径的变化 ,也可导致冠脉血流速度增加和心肌供血不足 ,多普勒超声可以对川崎病冠状动脉炎进行早期诊断并具有重要的临床意义 。

Objective To investigate clinical significance of Doppler echocardiography to detect coronary arterial lesions in the acute phase of Kawasaki disease (KD). Methods The ultrasound image archires were retrospectively reviewed in 142 patients with KD, to findany clouding coronary image, peak diastolic flow velocity (PDV) of left anterior descending(LAD) and wall motion score index (WMSI) of left ventricle. Results 94% and 20% of the patients in KD group had coronary and perivascular brightness and coronary dilation respectively. The PDV were increased in KD group in comparison with the control group (48.96±8.38 vs 31.85±2.55, P <0.01 ). There were increased WMSI in the KD group than the control group (1.16±0.09 vs 1.0±0, P <0.01) and accuracy of abnormality of ventricular wall movement was 100% in KD group.Conclusion The images of Doppler echocardiography might provide earlier period diagnostic goal of coronary arterial lesions in Kawasaki disease and be one of diagnostic criteria of Kawasaki disease.