超声心动图在小儿不完全型川崎病的诊断价值研究

文杨; 文一州; 柳颐龄; 金梅; 杨胜; 黄国英

文章摘要

文杨,文一州,柳颐龄,等.超声心动图在小儿不完全型川崎病的诊断价值研究[J].安徽医药,2023,27(3):491-497.

超声心动图在小儿不完全型川崎病的诊断价值研究

The value of echocardiography in the diagnosis of children with incomplete Kawasaki disease

DOI：10.3969/j.issn.1009-6469.2023.03.015

中文关键词: 黏膜皮肤淋巴结综合征冠状动脉疾病二尖瓣闭锁不全超声心动图病理状态，体征和症状儿童

英文关键词: Mucocutaneous lymph node syndrome Coronary artery disease Mitral valve insufficiency Echocardiography Pathological conditions, signs and symptoms Child

基金项目:上海市卫健委科研项目(EKYY20180202)；成都市卫健委科研项目(2021131)

作者	单位	E-mail
文杨	电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院，超声科，四川成都611731
文一州	电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院，儿童心脏内科，四川成都611731
柳颐龄	电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院，儿童心脏内科，四川成都611731	516518267@qq.com
金梅	电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院，超声科，四川成都611731
杨胜	电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院，超声科，四川成都611731
黄国英	复旦大学附属儿科医院心血管中心，上海201102

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中文摘要:

目的对儿童及婴幼儿不完全型川崎病的超声心动图资料数据分析，为临床医生对该疾病的早诊断、早治疗提供依据，以便减少该疾病的漏诊与误诊。方法回顾性选取电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院2019年1月至2021年4月收治的128例不完全型川崎病(iKD)病儿为观察组，另选取该院同期收治的297例典型川崎病(cKD)病儿为对照组。比较两组病儿超声心动图(UCG)表现，实验室检查血白细胞、红细胞沉降率(ESR)、C反应蛋白(CRP)以及血小板等炎性指标的差异性。结果 425例KD病儿中，iKD 128例(31.1%)，cKD 297例(69.9%)。全部KD病儿发生冠状动脉扩张有121例(28.5%)，其中iKD组有40例(32.3%)，cKD组有78例(27.3%)；性别、左冠状动脉主干(LMCA)、左前降支(LDA)、回旋支、右冠状动脉(RCA)、RCA中段、二尖瓣反流(MR)、三尖瓣反流(TR)、冠脉管壁毛糙、CRP的差异有统计学意义(P<0.05)。iKD组发生冠状动脉扩张，LMCA、LDA、RCA、RCA中段、MR、TR、冠脉管壁毛糙的差异有统计学意义(P<0.05)。cKD组发生冠状动脉扩张，性别、LMCA、LDA、回旋支、RCA、RCA中段、MR、冠脉管壁毛糙的差异有统计学意义(P<0.05)。iKD组与cKD组发生冠状动脉扩张，MR、TR、冠脉管壁毛糙、血小板的差异有统计学意义(P<0.05)。结论 iKD病儿UCG主要表现为冠状动脉扩张、MR、TR、冠状动脉管壁毛糙，且实验室炎性指标血小板明显升高。UCG可以更早、及时地发现冠状动脉管壁的改变及各瓣膜是否存在反流，能更好的为临床诊断提供证据。

英文摘要:

Objective To analyze the echocardiographic data of incomplete Kawasaki disease in children and infants, so as to pro? vide basis for clinicians to diagnose and treat the disease early to reduce the missed diagnosis and misdiagnosis of the disease.Meth? ods One hundred and twenty-eight children with incomplete Kawasaki disease (iKD) treated in Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China from January 2019 to April 2021 were retrospectively selected as the observation group, and 297 children with typical Kawasaki disease (cKD) treated in our hospital in the same period were selected as the control group. The ultrasonic cardiogram (UCG) and the inflammatory indexes such as blood leukocyte(WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and platelet (PLT) were compared between the two groups.Re?sults Among 425 children with KD, 128 cases (31.1%) had iKD and 297 cases (69.9%) had cKD. There were 121 cases (28.5%) of coronary artery dilatation in all children with KD, including 40 cases (32.3%) in iKD group and 78 cases (27.3%) in cKD group. There were significant differences in gender, left main coronary artery (LMCA), left anterior descending artery (LDA), circumflex branch (LCX), right coronary artery (RCA), middle RCA, mitral regurgitation (MR), tricuspid regurgitation (TR), rough coronary wall and CRP(P<0.05). There were significant differences in coronary artery dilation, LMCA, LDA, RCA, middle RCA, Mr, TR and rough coronary artery wall of iKD group (P<0.05). There were significant differences in coronary artery dilatation, gender, LMCA, LDA, LCX, RCA,middle RCA, Mr and rough coronary artery wall of cKD group (P<0.05). There were significant differences in coronary artery dilatation,MR, TR, rough coronary artery wall and PLT between iKD group and cKD group (P<0.05).Conclusions The main manifestations of UCG in children with iKD are coronary artery dilation, MR, TR, rough wall of coronary artery, and significant increase of laboratory in?flammatory index platelets. UCG can detect the changes of coronary artery wall and whether there is reflux in valves earlier and in time,and can provide better evidence for clinical diagnosis.

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