川崎病患儿脑血流变化特点

目的探讨川崎病(KD)患儿脑血流变化特点。方法收集2007年1月-2010年12月本院确诊为KD的住院患儿52例,根据是否合并冠状动脉损害,将其分为冠状动脉受损组(n=27)和无冠状动脉受损组(n=25)。用经颅多普勒超声方法观察KD患儿脑血流异常率及脑血流参数变化。结果冠状动脉受损组患儿脑血流异常率较无冠状动脉受损组明显升高(55.6%vs12.0%,χ2=10.671,P=0.001)。脑血流参数主要表现:冠状动脉受损组右侧ACA Vm、PCA Vm值较无冠状动脉受损组显著减低[(59.15±13.23)cm.s-1 vs(68.20±18.59)cm.s-1,t=6.499,P=0.014;(59.00±9.62)cm.s-1 vs(67.71±4.48)cm.s-1,t=6.878,P=0.012)];双侧MCA的PI值(0.94±0.16 vs 0.87±0.69,t=6.709,P=0.013;0.97±0.14 vs 0.88±0.09,t=4.669,P=0.036)、左侧PCA的PI值(0.98±0.11 vs 0.96±0.06,t=7.166,P=0.010)均较无冠状动脉受损组显著升高。冠状动脉受损组神经系统症状发生率较无冠状动脉受损组显著升高(40.7%vs 8.0%,χ2=7.279,P=0.007)。结论合并冠状动脉损害的KD患儿易于出现脑血流异常。脑血流异常较敏感,有助于及早发现颅内动脉血管损害。

Characteristics of Cerebral Blood Flow of Children with Kawasaki Disease

Objective To investigate the characteristics of cerebral blood flow of children with Kawasaki disease(KD). Methods Fifty-two KD patients in Beijing Children′s Hospital Affiliated to Capital Medical University from Jan.2007 to Dec.2010 were collected.Based on whether they were complicated with coronary injury or not,KD cases were divided into 2 groups:coronary injury group(n=27) and no coronary injury group(n=25).Rates of abnormal cerebral blood flow and cerebral blood flow parameter were observed by the method of Doppler. Results Compared with the no coronary injury group,the rate of abnormal cerebral blood flow in coronary injury group was raised significantly [(55.6% vs 12.0%,χ2=10.671,P=0.001].Changed main parameters were as followings:right ACA Vm and PCA Vm were decreased significantly[(59.15±13.23)cm·s-1 vs(68.20±18.59) cm·s-1,t=6.499,P=0.014;(59.00±9.62) cm·s-1 vs(67.71±4.48) cm·s-1,t=6.878,P=0.012)];Bilateral MCA PI(0.94±0.16 vs 0.87±0.69,t=6.709,P=0.013;0.97±0.14 vs 0.88±0.09,t=4.669,P=0.036) and left PCA were raised significantly(0.98±0.11 vs 0.96±0.06,t=7.166,P=0.010).Rate of central nervous system symptoms injury in the coronary injury group was raised significantly compared with the no coronary injury group(40.7% vs 8.0%;χ2=7.279,P=0.007). Conclusions KD children with coronary injury are prone to be complicated with abnormal cerebral blood flow.Abnormal cerebral blood flow is more sensitive and helps to discover early cerebral artery injury.