摘要
目的研究制定最适合的健康儿童冠状动脉内径Z值计算公式。方法选择2015年10月至2016年10月,于吉林大学白求恩第一医院门诊就诊,并进行超声心动图检查显示心脏结构正常的1 000例健康儿童为研究对象。测量受试儿的身高、体重,并计算其人体体表面积(BSA)。采用SSH-880CV型彩色多普勒超声诊断仪,测量受试儿左冠状动脉(LCA)、左冠状动脉前降支(LAD)及右冠状动脉(RCA)内径值。统计学比较不同性别受试儿LCA、LAD及RCA内径值。采用直线相关分析,对受试儿年龄、身高、体重、BSA与其LCA、LAD及RCA内径值进行相关性分析。建立受试儿BSA与其冠状动脉内径值的线性、对数、指数、幂函数、一元二次项、平方根回归模型,根据回归模型的决定系数R2值,确定最佳回归模型,并根据此回归模型建立健康儿童的冠状动脉内径Z值计算公式。结果 (1)本研究中,不同性别受试儿LCA、LAD及RCA内径值比较,差异均无统计学意义(t=1.834、1.723、1.711,P=0.067、0.085、0.087)。(2)直线相关分析结果显示,本研究受试儿的年龄、身高、体重、BSA与其LCA、LAD及RCA内径值,均呈正相关关系(LCA:r=0.773、0.768、0.735、0.779,P<0.001;LAD:r=0.779、0.765、0.743、0.783,P<0.001;RCA:r=0.776、0.772、0.764、0.786,P<0.001),其中,受试儿BSA与其LCA、LAD及RCA内径值的相关性最强(r=0.779、0.783、0.786,P<0.001)。(3)本研究受试儿BSA与其LCA、LAD、RCA内径值的平方根回归模型的决定系数R2最大,R2分别为0.684、0.685、0.687,回归效果最好,最佳回归模型分别为yLCA=0.317+2.162×x_(BSA)^(1/2)、yLAD=2.016+0.239×x_(BSA)^(1/2)、yRCA=0.177+2.023×x_(BSA)^(1/2)(均为P<0.001)。其中,yLCA、yLAD、yRCA分别是指儿童LCA、LAD、RCA内径值,xBSA是指儿童BSA。(4)本研究制定健康儿童冠状动脉内径Z值计算公式为:ZLCA=[xLCA-(0.317+2.162×x_(BSA)^(1/2))]/0.243,ZLAD=[xLAD-(2.016+0.239×x_(BSA)^(1/2))]/0.215,ZRCA=[xRCA-(0.177+2.023×x_(BSA)^(1/2))]/0.236。其中,xLCA、xLAD、xRCA分别是指儿童LCA、LAD、RCA内径值实测值,xBSA指儿童BSA。结论适合中国儿童的冠状动脉内径Z值计算公式,是判断我国儿童冠状动脉异常的理想指标,对指导临床预防和治疗儿童冠状动脉异常疾病具有重要意义。
Objective To research and build the best Z scores formula of coronary artery internal diameters in healthy children. Methods A total of 1 000 healthy children who were outpatients in First Hospital of Jilin University and with normal heart structure by echocardiography were subjected to this study from October 2015 to October 2016.The height,weight and body surface area（BSA）of all children were measured,and the internal diameters of left coronary artery（LCA）,left anterior descending（LAD）and right coronary artery（RCA）were measured by SSH-880 CV Doppler ultrasound.The differences between different gender in the aspects of LCA,LAD and RCA internal diameters were analyzed by statistical methods.The relation between age,height,weight,BSA and internal diameters of LCA,LAD,RCA were analyzed by linear correlation analysis.The linearity,logarithmic,exponential,power function,quadratic and square root regression model of BSA and coronary artery internal diameters were established.And the best regression model was chosen according to the coefficient of determination R2 value of the regression model.At last,the formula of Zscores for coronary artery internal diameters in healthy children was established according to the best regression model.Results（1）There were no significant differences between children with different gender in internal diameters of LCA,LAD and RCA（t=1.834,1.723,1.711;P=0.067,0.085,0.087）.（2）Linear correlation analysis showed that age,height,weight as well as BSA all were positively correlated with the internal diameters of LCA,LAD and RCA（LCA：r=0.773,0.768,0.735,0.779,P0.001;LAD：r=0.779,0.765,0.743,0.783,P〈0.001;RCA：r=0.776,0.772,0.764,0.786,P〈0.001）.And BSA had the strongest correlation with the internal diameters of LCA,LAD and RCA（r=0.779,0.783,0.786;P〈0.001）.（3）The values of coefficient of determination R2 in the square root regression models between BSA and the internal diameters of LCA,LAD and RCA were the biggest which were 0.684,0.685 and 0.687,respectively.So the square root regression models between BSA and the internal diameters of LCA,LAD and RCA were the best regression models which were yLCA=0.317＋2.162× x_（BSA）^（1/2）,yLAD=2.016＋0.239× x_（BSA）^（1/2）,and yRCA=0.177＋2.023× x_（BSA）^（1/2）（all P〈0.001）And yLCA,yLAD,yRCA were referred to the internal diameters of LCA,LAD,RCA,respectively;xBSA was referred to the BSA.（4）The formulas of Z scores for coronary artery internal diameters in healthy children were established as follows：ZLCA =[xLCA-（0.317＋2.162× x_（BSA）^（1/2））]/0.243,ZLAD=[xLAD-（2.016＋0.239× x_（BSA）^（1/2））]/0.215,ZRCA=[xRCA-（0.177＋2.023× x_（BSA）^（1/2））]/0.236,and xLCA,xLAD,xRCAwere referred to the measured values of LCA, LAD and RCA internal diameters,respectively;xBSA was referred to the BSA.Conclusions A valid equation of Zscores for coronary artery diameters which suitable for Chinese children is an ideal index to judge coronary artery abnormalities and is of great significance to guide clinical prevention and treatment of coronary artery abnormalities in children.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2017年第5期539-544,共6页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
吉林省产业技术研究与开发项目(2013C031-1)~~
