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目的应用定量组织速度成像技术和组织追踪法研究急性期川崎病(Kd)患儿左心收缩功能,以寻求川崎病早期心脏损害的诊断指标。方法通过M-型超声获得左室射血分数(EF);应用定量组织速度成像技术和组织追踪分析软件测量31例急性期川崎病患儿与20例正常儿童前间隔、后壁、前壁、下壁、后间隔和侧壁的二尖瓣环处、基底部和中间部的收缩期峰值速度(Vs)、收缩期最大位移(D),并比较两组间各参数。结果患儿组左室射血分数与正常组相比无统计学差异;患儿组各室壁的二尖瓣环处和部分室壁的基底部、中间部的Vs低于正常组(P<0.05)。6个室壁的平均Vs在二尖瓣环水平、基底部和中间部两组间均有统计学差异(P<0.05)。患儿各室壁各节段的收缩期最大位移均低于正常儿童,在所有二尖瓣环水平和部分室壁基底部、中间部两组间有统计学差异(P<0.05)。结论川崎病急性期左室整体和部分室壁局部收缩功能受损;定量组织速度成像技术和组织追踪法能够定量急性期川崎病左室功能改变。
Objective To study the left ventricular systolic function in children with acute Kawasaki disease (Kd) by means of quantitative tissue velocity imaging and tissue tracking in order to seek the diagnostic index of early heart damage in Kawasaki disease. Methods The left ventricular ejection fraction (EF) was obtained by M-mode ultrasonography. Quantitative tissue velocity imaging and tissue tracking software were used to measure the anterior segment, posterior wall and anterior wall of 31 children with acute Kawasaki disease and 20 normal children. The mitral valve annulus at the inferior wall, the posterior septum and the lateral wall, the systolic peak velocity (Vs) and the systolic peak displacement (D) at the basal and medial portions were compared. The parameters of the two groups were compared. Results There was no significant difference in left ventricular ejection fraction in children between the two groups. The Vs in the basal and middle parts of the mitral annulus and the middle part of each wall in the pediatric group were lower than those in the normal group (P < 0.05). The mean Vs of 6 ventricular wall was statistically different between the two groups at the mitral annulus level (P <0.05). The maximum systolic displacement of each segment in children was lower than that in normal children. There was a significant difference (P <0.05) between the mitral annulus and some basal and middle parts of mitral wall. Conclusions Local and regional ventricular wall systolic function of Kawasaki disease is acute in acute stage. Quantitative tissue velocity imaging and tissue tracking can quantify left ventricular function in acute Kawasaki disease.