作者：娄萍，张雪梅，张丹，赵颖，赵欣，王俊香，金晶，曹玲

单位：

陕西省人民医院超声诊断中心

Units：

UltrasonicDiagnosticCenter,ShaanxiProvincialPeople'sHospital,Xi'an710068,China

关键词：

黏膜皮肤淋巴结综合征; 川崎病; 冠状动脉; 超声心动描记术; 心肌做功;

Keywords：

Mucocutaneouslymphnodesyndrome;Kawasakidisease;Coronaryarteries;Echocardiography;Myocardialwork

CLC：

R725.5

DOI：

10.12114/j.issn.1008-5971.2022.00.317

Funds：

陕西省重点研发计划项目( 2021KW-66)

摘要：

目的 分析不同冠状动脉损伤程度川崎病（KD）患儿发病早期（确诊后1 d）超声心动图、左心室心肌做功参数。方法 选取2021年6—12月在陕西省人民医院确诊的KD患儿50例。根据患儿冠状动脉损伤情况，将其分为研究组1（冠状动脉内径正常、管壁增厚毛糙，20例）、研究组2（冠状动脉扩张，20例）、研究组3（冠状动脉瘤形成，10例）。患儿于确诊后1 d、健康儿童于体检当天进行二维超声心动图检查及二维斑点追踪超声心动图（2D-STE）检查，记录超声心动图参数[包括左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）及左心室短轴缩短率（LVFS）]、左心室心肌做功参数[整体做功指数（GWI）、整体有用功（GCW）、整体无用功（GWW）、整体做功效率（GWE）、整体纵向应变（GLS）]。结果 四组LVEDD、LVESD、LVEF、LVFS比较，差异无统计学意义（P>0.05）。四组GWI、GWW、GWE、GLS比较，差异无统计学意义（P>0.05）；研究组3 GCW低于对照组（P<0.05）。结论 冠状动脉内径正常、管壁增厚毛糙的KD患儿和伴有冠状动脉扩张的KD患儿发病早期超声心动图、左心室心肌做功参数无异常，伴有冠状动脉瘤形成的KD患儿发病早期超声心动图参数无异常，而其左心室心肌做功参数中的GCW降低。

Abstract：

ObjectiveToanalyzetheechocardiographyandleftventricularmyocardialworkparametersinKawasakidisease(KD)childrenwithdifferentdegreesofcoronaryarteryinjuryattheearlystageofthedisease(1dayafterdiagnosis).MethodsAtotalof50childrenwithKDdiagnosedinShaanxiProvincialPeople'sHospitalfromJunetoDecember2021wereselected .Accordingtotheconditionofcoronaryarteryinjury,theyweredividedintostudygroup1(20childrenwith normalcoronaryarterydiameterandroughtubewallthickening),studygroup2(20childrenwithcoronaryarteryexpansion)andstudygroup3(10childrenwithcoronaryaneurysmformation).Onedayafterthediagnosisofthechildrenandonthedayofphysicalexaminationofhealthychildren,two-dimensionalechocardiographyand2Dspeckletrackingechocardiography(2D-STE)wereperformed.Echocardiographicparameters[includingleftventricularenddiastolicdiameter(LVEDD),leftventricularendsystolicdiameter(LVESD),leftventricularejectionfraction(LVEF)andleftventricularfractionshortening(LVFS)]andleftventricularmyocardialworkparameters[globalworkindex(GWI),globalconstructivework(GCW),globalwastedwork(GWW),globalworkefficiency(GWE)andgloballongitudinalstrain(GLS)]wererecorded.ResultsTherewasnosignificantdifferenceinLVEDD,LVESD,LVEFandLVFSamongthefourgroups(P>0.05).TherewasnosignificantdifferenceinGWI,GWW,GWEandGLSamongthefourgroups(P>0.05);GCWinstudygroup3waslowerthanthatincontrolgroup(P<0.05).ConclusionTheechocardiogramandleftventricularmyocardialworkparametersofKDchildrenwithnormalcoronaryarterydiameterandroughtubewallthickeningandKDchildrenwithcoronaryarterydilatationattheearlystageofdiseasearenotabnormal,theechocardiogramparametersofKDchildrenwithcoronaryaneurysmformationattheearlystageofdiseasearenotabnormal,whileGCWofleftventricularmyocardialworkparametersdecreases.

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