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目的 :探讨川崎病 (KD)患儿空间T向量环变化。方法 :KD患儿 6 2例 ,年龄 0 5～ 11 0 (3 83± 2 4 5 )岁 ,随机匹配 79例健康儿童为对照。采用广东中山SR 10 0 0A心电综合自动分析仪描记心电向量环。人工干预下自动测量额面、横面、左侧面T环参数 ,采用SPSS11 0软件进行数理统计。结果 :与对照组比较 ,KD①急性期额面、横面及左侧面T环最大向量振幅分别减小 14 34%、17 4 3%及 2 0 12 % (P <0 0 5或 0 0 1) ,T环最大向量方位变化不大 (P >0 0 5 ) ,恢复期T环最大向量振幅恢复正常 (P >0 0 5 )。②急性期额面、横面及左侧面最大T QRS向量振幅比值分别减小 19 11%、2 1 4 7%及 2 2 6 1% (P <0 0 1) ,恢复期正常 (P >0 0 5 )。③急性期QRS -T夹角在额面略偏小 ,横面及左侧面略偏小 (P >0 0 5 )。空间T环振幅减小 16 4 3% (P >0 0 5 ) ,空间QRS T夹角稍缩小 (P <0 0 5 )。④冠脉扩张组与未扩张组三个平面T环最大向量振幅及T QRS最大向量比值、QRS T夹角、空间T环振幅、空间QRS T夹角无差异 (P >0 0 5 )。结论 :KD急性期存在T环振幅、T QRS比值降低 ,提示存在心肌缺血 ,临床上应加强急性期KD患儿的心肌保护
Objective: To investigate the changes of T vector ring in children with Kawasaki disease (KD). Methods: Sixty-two children with KD were enrolled, aged 0 5 ~ 11 0 (3 83 ± 2 45 years), and randomly matched 79 healthy children as controls. ECG Zhongshan Central SR 10 0A ECG automatic tracing ECG loop. Under manual intervention, T-ring parameters of frontal plane, transverse plane and left lateral plane were measured automatically, and SPSS11 0 software was used to make mathematical statistics. Results: Compared with the control group, the maximal vector amplitudes of the T ring on the frontal, transverse and left sides of KD① decreased by 14 34%, 17 4 3% and 20 12% respectively (P <0 05 or 0 0 1 ), The orientation of the largest vector of T ring did not change much (P> 0.05), and the amplitude of the largest vector of T ring recovered to normal (P> 0.05). (2) The maximum amplitude of T QRS vector in frontal plane, transverse plane and left side of acute phase decreased by 19 11%, 21 4 7% and 22 6% respectively (P 0 01), recovery period was normal (P> 0 0 5). ③ acute QRS-T angle in the forehead slightly smaller, horizontal and left side slightly smaller (P> 0 0 5). Space T ring amplitude decreased by 16 4 3% (P> 0 0 5), QRS T space slightly smaller angle (P <0 0 5). There was no significant difference (P> 0.05) between QRS T angle, space T ring amplitude and spatial QRS T angle in the three plane T-ring maximum vector amplitude and T QRS maximum vector ratio of coronary artery dilatation group and non-dilatation group. Conclusion: The amplitude of T-ring and the decrease of T-QRS in the acute phase of KD suggest that myocardial ischemia exists and myocardial protection should be strengthened clinically in children with acute KD