川崎病早期心电图改变的临床意义

目的　观察川崎病 (KD)小儿的早期心电图改变及其在提示合并冠状动脉损害中的作用。方法　以 76例川崎病小儿为研究对象 ,在发病早期 (7d内 )做超声心动图和心电图检查 ,在亚急性期 (病程 10～ 2 0d)再做超声心动图检查。把有冠状动脉损害的患儿作为观察组 ,共 33例 ;把未合并冠状动脉损害的患儿作为对照组 ,共 4 3例。将 2组患儿早期心电图改变的情况进行比较。结果　本组 76例KD患儿 ,在发病早期 (7d内 )超声心动图未见有冠状动脉损害 ,而心电图已发生明显异常 ,其异常率为 96 % (73/ 76 ) ,其中以窦性心动过速最为常见 ,而以ST -T段改变最为严重 ,其发生率为 5 1% (39/ 76 ) ,其他类型的心律失常较少见。在亚急性期 ,伴有心电图异常的患儿中有 4 5 % (33/ 73)的病人相继发生冠状动脉损害。另外 ,本组 76例患儿中心电图发生ST -T段改变的有 39例 ,占心电图异常率的 5 3% (39/ 73) ,在这 39例中有 2 9例发生冠状动脉损害 ,占74 % (2 9/ 39)。观察组中 ,心电图异常率为 10 0 % (33/ 33) ,ST -T段改变发生率高达 88% (2 9/ 33)。对照组心电图异常率也达到 70 % (30 / 4 3) ,但是ST -T段改变发生率仅为 2 3% (10 / 4 3)。 2组比较 ,无论是心电图异常率还是ST -T段改变的发生率 ,观察组明显高于对照组 ,有?

Clinical Significance of Change of ECG in Early Stage on Kawasaki Disease of Child

Objective To observe the ECG change in early stage on children Kawasaki Disease (cKD) and the mentioned action of combination on coronary artery injury. Methods 76 cases of cKD patient were divided into group A with coronary artery injury of 33 cases and group B without coronary artery injury of 43 cases as control. The ECG changes in early stage was compared between two groups. Results There was no coronary artery injury in 76 KD children within 7 days after ultrasound detection but with the abnormal ECG change at rate of 96%. Among them, the common seen arrhythmia was sinus tachycardia with severe change of S-T segment at rate of 51%. In sub-acute stage, 45% patients with abnormal ECG change had coronary artery injury one after another. The 29 cases had coronary artery injury in 39 cases of S-T segment change at rate 74%. In test group, the ECG abnormal rate was 100% and rate of S-T segment change was 88%. In control group, ECG abnormal rate was 70% and rate of S-T segment change was 23%. There was significant difference between two group in abnormal rate and S-T segment change rate (P<0.01). Conclusion The early application of ECG might monitor the myocardiac injury and the change of S-T segment could predict the injury of coronary artery.