210例正常儿童冠状动脉内径超声心动图测定的初步研究

目的 应用超声心动图探查正常儿童的冠脉,了解正常变异,总结正常值并对各测值与一些生理指标间的关系进行探讨.方法 选择14岁以下正常儿童210例,年龄新生儿～14岁,其中男118例,女92例.分7个年龄组,分别为3～27d、28～1岁、1～3岁、3～6岁、6～9岁、9～12岁、12～14岁,每组30名,均测身高、体重,求得体表面积.采用HP SONOS 5500型多普勒超声诊断仪测定左、右冠状动脉内径和主动脉根部内径.结果 除新生儿组外,各同年龄组中左冠状动脉(LCA)与右冠状动脉(RCA)均值间差异有统计学意义.冠状动脉内径与年龄、身高、体重和体表面积呈正相关.左冠状动脉/主动脉根部内径(LCA/AO)与右冠状动脉/主动脉根部内径(RCA/AO)值处在较小的范围,各年龄组间差异无统计学意义.结论 冠状动脉内径与年龄、身高、体重和体表面积有关,而冠状动脉内径与主动脉根部的比值是判断冠状动脉扩张的理想指标,进一步大样本研究国内儿科冠脉正常值十分必要.

Study of corrnary artery diameters in 210 normal children by echocardiography

Objective To observe the ultrasonic cardiogram of coronary artery diameters in normal children and the relationships between coronary artery size and age,height,weight,and body surface area.Methods Echocardiographic measurement of the internal diameters of LCA,RCA,and the aortic annulus(AO) and age,height,weight,and body surface area were performed on 210 normal children aged 3d to 14 years.The maximal diameters of LCA and RCA in diastole were measured at predetermined sites.Results Except for the newborn infants,there were significant differences in the diameters of LCA and RCA between the same aged children.The LCA and RCA diameters correlated linearly with age,height,weight,as well as body surface area.Regression equations were constructed.The coronary-aorta index(LCA/AO and RCA/AO) fell within a narrow range.This was independent of age,height,weight,and body surface area.Conclusion The LCA and RCA diameters correlated linearly with age,height,weight,as well as body surface area.The reference ranges for proximal coronary artery diameters in normal children are established.The coronary-aorta index can serve as a quick guide to detect coronary dilation.It is necessary to perform further study and establish the normorgrams of internal diameters of the proximal LCA and RCA in a large population of normal children.