组织多普勒成像技术测量二尖瓣环运动评价川崎病患儿左心功能变化

目的应用组织多普勒成像技术(DTI)测量二尖瓣环运动,评价急性期川崎病患儿左心功能变化。方法超声心动图诊断仪检查46例急性期川崎病患儿。常规测量左右冠状动脉内径,左室心室缩短率FS、左室射血分数EF、左室舒张早期峰值速度Ve及左室舒张晚期峰值速度Va,并计算Ve/Va。DTI检测二尖瓣环6个点的收缩期峰值速度Vs、舒张早期峰值速度e及舒张晚期峰值速度a,并计算e/a,取六个点的平均值。同样方法检测20例正常对照组儿童作为对照。结果川崎病患儿左心功能指标中FS、EF、Ve、Vs和e较正常对照组有不同程度减低,Va、a较正常对照组有不同程度增高,Ve/Va和e/a比值均较正常对照组减低。冠状动脉瘤形成患儿中左室收缩和舒张功能均较正常组减低;无冠状动脉瘤形成患儿仅舒张功能低于正常对照组。结论川崎病患儿心脏功能均较正常儿童下降,以舒张功能更明显;心脏功能下降程度与冠状动脉损害严重程度相关。

Doppler tissue imaging measurement of mitral annulus velocity in evaluation of left ventricular function in patients with Kavasaki disease

Objective] To evaluate the change of left ventricular (LV) function in patients with Kavasaki disease by Doppler tissue imaging (DTI) to measure the motion of mitrial annulus. Methods] Cardiomyogrphy was used to check 46 KD children, and 20 healthy children as control. The proximal part of left coronary artery (LCA) and right coronary artery (RCA), shortening fraction (FS) of LV, ejection fraction (EF), mitral inflow velocity Ve, Va, and Ve/Va were checked routinely. DTI was taken to test mitral annulus velocity. e/a were checked and calculated ,the average value of 6 points on each annulus. Results] Compared to control group, FS, EF, Ve, Vs and e decreased, Va and a increased, Ve/Va and e/a decreased in KD group. Positive relationship was detected between EF and Vs, same to Ve/Va and e/a. The systolic and diastolic function of LV decreased in patients with coronary aneurysm, while only diastolic function decreased in those did not develop coronary aneurysm yet. Conclusion] Heart function, especially diastolic function, decreases in children with Kavasaki disease, and the decreasing level related to the damage level of coronary artery.