川崎病冠状动脉病变的超声心动图诊断及治疗评价

目的　评价超声心动图诊断川崎病 (Kawasaki disease,KD)冠状动脉病变、治疗及预后。　方法　超声心动图检查 83例川崎病患儿 ,测量冠状的动脉直径 ,观察有无冠状动脉瘤、血栓和动脉狭窄 ,测量房室内径 ,计算心功能 ,测量心包积液和瓣膜返流。　结果　在受检的 83例川崎病患儿中有冠脉损害的共 34例 ,其中单纯左冠脉主干病变 2 0例 ,双支病变 6例 ,7例发生冠状动脉瘤 ,1例动脉瘤回缩后主干轻度狭窄 ,3例冠脉于发病 30天后出现病变及发生冠脉瘤及血栓形成。本组冠脉受累者均合并轻度、中度二尖瓣及三尖瓣返流 ,2 5例合并心包积液 ,2例左心一过性扩大及心功能降低。　结论　使用高频探头能提高冠脉的显示率 ,特别是实时观察冠脉病理改变及动脉瘤形成和它的进展及转归 ,评价管壁的厚度和是否光滑、有无蛋白样物质沉积、钙化及血栓形成。早期联合使用阿斯匹林与大计量静滴丙种球蛋白 ,可减少冠脉瘤的发生及血栓形成

Diagnosis and Therapy of Kawasaki Disease with Coronary Arterial Lesion by Color Doppler

Objective\ To discuss the diagnosis of coronary arterial lesion, earlier period treatment, and the evaluation of prognosis in Kawasaki disease(KD) by the Doppler echocardiography.\ \{Methods\}\ 83 cases of KD were examined by echocardiography.\ To measure the diameter of the coronary arterial and observe whether there was coronary aneurysm, thrombus and stenosis in it.\ To measure the dimensions of the atrial and the ventricle, calculate the function of the heart and observe whether there was pericardial effusion and valve regurgitation.\ Results\ All of the 83 cases of KD there were 34 patients with coronary arterial lesion.\ 20 patients had arterial lesion in the proximal left coronary main stem and 6 patients had arterial lesion in both of coronary arteries, 7 patients had coronary aneurysm and 1 patient had slight stenosis in the proximal left coronary main stem after the coronary aneurysm drawing back.\ All of the 34 cases had slight or middle regurgitation in mitral and tricuspid.\ 25 patients had pericardial effusion and 2 cases had temporary cardiac dysfunction.\ Conclusion\ High frequency transducers of color Doppler can elevate the detection of the pathologic changes in coronary artery.\ It is the most useful noninvasive technique to detect coronary arterial lesion.\ The coronary artery aneurysm and thrombosis formation can be reduced through the therapy of intravenous immunoglobulin combined with oral aspirin.