摘要
目的分析超声心动图(UCG)评估在冠状动脉无扩张(nCAL)川崎病(KD)中的应用,观察其左前降支血流动力学改变。方法选取2019年2月~2022年2月我院收治的202例nCAL-KD患儿,根据病情分期分为急性期组(76例)、亚急性期组(72例)、恢复期组(54例),另以1∶1比例选取同期202例非KD患儿为对照组,评估静息、充血不同状态下左前降支血流储备,对比各组左前降支内径、左前降支血流量、静息状态下UCG血流动力学,包括舒张期平均流速(MDV)、舒张期峰值流速(PDV)、速度时间积分(VTI)及充血状态下血流速度储备(CFVR)。结果急性期组、亚急性期组左前降支内径小于恢复期组、对照组(P<0.05);急性期组、亚急性期组左前降支血流量大于对照组(P<0.05);充血前后各组左前降支DBP、SBP、心率血压乘积比较,差异有统计学意义(P<0.05);充血后各组心率较充血前升高,充血后各组心率比较,差异有统计学意义(P<0.05),急性期组、亚急性期组、恢复期组左前降支MDV、PDV、VTI均高于对照组(P<0.05);亚急性期组、恢复期组、对照组MDV、PDV CFVR均高于急性期组(P<0.05)。结论UCG可检测不同病变程度nCAL-KD患儿的左前降支血流动力学改变,有利于早期诊断、评估nCAL-KD患儿的冠状动脉损害,对临床治疗具有指导意义。
Objective To analyze the application of echocardiography(UCG)in Kawasaki disease(KD)without coronary artery dilation(nCAL)and observe the hemodynamic changes of the left anterior descending branch.Methods From February 2019 to February 2022,two hundred and two children with nCAL KD admitted to the hospital were divided into acute phase group(76 cases),subacute phase group(72 cases)and recovery phase group(54 cases)according to the disease stage.In addition,two hundred and two non KD children in the same period were selected as the control group with a 1∶1 ratio to evaluate the left anterior descending blood flow reserve under different resting and congestive conditions,and compare the inner diameter,blood flow UCG hemodynamics in resting state MDV,peak diastolic velocity(PDV),velocity time integral(VTI))and blood flow velocity reserve in congestive state(CFVR).Results The diameter of left anterior descending branch in acute and subacute group was smaller than that in convalescent group and control group;The blood flow of left anterior descending branch in acute and subacute group was higher than that in control group;There were significant differences in DBP,SBP,heart rate and blood pressure products of left anterior descending artery between groups before and after hyperemia(P<0.05);The heart rate of each group after hyperemia was higher than that before hyperemia;The heart rate of each group after hyperemia was statistically significant(P<0.05).The MDV,PDV and VTI of the left anterior descending branch in the acute phase group,subacute phase group and recovery phase group were higher than those in the control group(P<0.05);The CFVR of MDV and PDV in subacute group,convalescent group and control group were higher than those in acute group(P<0.05).Conclusion UCG can detect the hemodynamic changes of left anterior descending artery in children with nCAL KD of different lesion degrees,which is helpful for early diagnosis and evaluation of coronary artery damage in children with nCAL KD,and has guiding significance for clinical treatment.
作者
郭怡萍
王圣明
屈娟娟
GUO Yiping;WANG Shengming;QU Juanjuan(Department of Ultrasound Medicine,988 Hospital of the Joint Support Force of the Chinese People's Liberation Army,Zhengzhou 450000,China)
出处
《潍坊医学院学报》
2023年第1期52-55,共4页
Acta Academiae Medicinae Weifang
关键词
川崎病
超声心动图
左前降支
血流动力学
Kawasaki disease
Echocardiography
Left anterior descending branch
Hemodynamics
