川崎病患儿颈动脉内膜-中层厚度、踝肱指数分析及其与冠状动脉病变程度的相关性

目的 观察川崎病患儿颈动脉内膜-中层厚度(IMT)和踝肱指数(ABI),探究其与冠状动脉病变程度的相关性.方法 选取2018年2月至2019年10月于衢州市人民医院确诊为川崎病的患儿52例,根据心脏彩色多普勒超声检查结果将所有患儿分为未发生冠状动脉病变的对照组(29例)和发生冠状动脉病变的观察组(23例).同时选取健康...

Correlation of carotid intima media thickness and ankle brachial index with severity of coronary artery lesions in children with Kawasaki disease

Objective To measure the carotid intima-media thickness(IMT)and ankle brachial index(ABI)of 52 children with Kawasaki disease,and analyze their correlation with the severity of coronary artery lesions.Methods Fifty-two children with Kawasaki disease confirmed at People’s Hospital of Quzhou were selected from February 2018 to October 2019.The children were divided into a control group(n=29)without coronary artery lesions or an observation group(n=23)with coronary artery lesions according to the results of color Doppler echocardiography.At the same time,25 healthy children were selected as a healthy group Carotid IMT,ABI,and coronary artery diameter of all children were measured and analyzed by independent sample t-test and ANOVA.Pearson correlation was used to analyze the correlation of carotid IMT and ABI with the severity of coronary artery lesions.The receiver operating characteristic(ROC)curve was used to evaluate the effectiveness of carotid IMT and ABI in predicting coronary artery lesions.Results Among the 23 children in the observation group,21(91.30%,21/23)had coronary artery dilatation and 2(8.70%,2/23)had coronary artery aneurysm.A total of 57 coronary arteries were involved,with 1,2,3,and 4 coronary arteries involved in 3(13.04%,3/23),8(34.78%,8/23),10(43.48%,10/23),and 2 children(8.70%,2/23),respectively.The IMT of the carotid artery and the diameter of coronary artery in the observation group were significantly higher than those in the control group and the healthy group[IMT:(0.61±0.07)mm vs(0.42±0.02)mm and(0.36±0.04)mm,t=13.948 and 15.348,P<0.001;diameter of coronary artery:(3.17±0.18)mm vs(2.51±0.28)mm and(2.13±0.31)mm,t=9.802 and 14.050,P<0.001],and IMT and coronary artery diameter in the control group were significantly higher than those in the healthy group(t=7.118 and 4.732,P<0.001).The ABI of the observation group was significantly lower than that of the control group and healthy group[(0.78±0.17)vs(0.89±0.12)and(0.92±0.05),t=2.733 and 3.940,P=0.009 and<0.001].The carotid IMT in children with Kawasaki disease was positively correlated with the diameter of the coronary artery(r=0.684,P<0.001),and ABI was negatively correlated with the diameter of the coronary artery(r=-0.692,P<0.001).ROC curve analysis showed that the areas under curves(AUCs)of carotid IMT and ABI for predicting coronary artery lesions in children with Kawasaki disease were 0.628(95%CI:0.475~0.781)and 0.649(95%CI:0.499~0.786),respectively,with sensitivities of 60.9%and 64.3%and specificities of 79.4%and 76.8%,respectively.The AUC of combined carotid IMT and ABI was 0.828(95%CI:0.716~0.940).When the optimal cutoff value was0.706,the sensitivity was 81.2%and the specificity was 89.4%.The AUC of combined carotid IMT and ABI was higher than that of either carotid IMT or ABI alone(Z=6.731,P<0.001;Z=6.492,P<0.001).Conclusion The changes of carotid IMT and ABI in children with Kawasaki disease have a certain correlation with the severity of coronary artery lesions,and the combined detection of carotid IMT and ABI can improve the accuracy of predicting coronary artery lesions,which provides a clinical reference for predicting the degree of coronary artery lesions in children with Kawasaki disease.