彩色多普勒超声结合血清CD64水平对小儿川崎病临床诊断的价值研究

目的 探讨彩色多普勒超声结合血清CD64水平诊断小儿川崎病的临床诊断价值,为小儿川崎病的诊断提供指导。方法 选取2012年1月至2015年12月来安徽省儿童医院就诊的50例小儿川崎病为观察组,所有病儿均接受彩色多普勒超声检查并给予阿司匹林联合丙种球蛋白治疗,检测病儿治疗前后血清CD64水平,观察彩色多普勒超声诊断小儿川崎病的准确性,以健康儿正常血清CD64水平为标准,比较观察组治疗前后血清CD64指数。结果 彩色多普勒超声检出观察组病儿冠状动脉扩张20例,冠状动脉瘤6例,左室内径增大15例,心包积液7例,小儿川崎病确诊48例,阳性检出率为96%。治疗前观察组病儿血清CD64指数显著高于正常值(t=6.165,P=0.000)；治疗后观察组病儿血清CD64指数明显低于治疗前(t=11.557,P=0.000),且与健康组相比差异无统计学意义(t=1.994,P=0.057)。结论 采用彩色多普勒超声检测小儿川崎病具有较好的诊断价值,血清CD64指数对小儿川崎病的鉴别具有重要的临床意义,可作为小儿川崎病诊断和预后评估的重要指标。彩色多普勒超声结合血清CD64水平诊断小儿川崎病临床应用价值高,值得临床推广。

Value of CDUs combined with CD64 in the diagnosis of Kawasaki disease

Objective To explore the clinical diagnostic value of Color Doppler ultrasound (CDUs) combined with CD64 level in the diagnosis of Kawasaki disease,and to provide guidance for the diagnosis of Kawasaki disease.Methods Fifty cases of Kawasaki disease treated in Anhui Children''s Hospital from January 2012 to December 2015 were chosen as the observation group,receiving CDUs and Aspirin in combination with gamma globulin treatment.Serum CD64 levels were measured before and after treatment.The accuracy of CDUs in the diagnosis of Kawasaki disease was observed.With the normal serum CD64 level in healthy children as the standard,the serum CD64 index before and after treatment in the observation group was compared.Results CDUs showed that there were 20 cases of coronary artery dilatation,6 cases of coronary aneurysm,15 cases of enlarged left ventricular diameter,7 cases of pericardial effusion,and 48 cases of Kawasaki disease.The positive detection rate was 96%.Before treatment,the serum CD64 index of the observation group was significantly higher than that of the normal index (t=6.165,P=0.000).After treatment,the serum CD64 index of the observation group was significantly lower than that before treatment (t=11.557,P=0.000),and there was no significant difference between the observation group and the normal group (t=1.994,P=0.057).Conclusion CDUs detection of Kawasaki disease has good diagnostic value.Serum CD64 index has important clinical significance in differentiating children with Kawasaki disease,which can be used as an important index to evaluate the diagnosis and prognosis of Kawasaki disease.CDUs combined with the level of CD64 has high application value in the diagnosis of Kawasaki disease,which is worthy of clinical promotion.