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目的探讨彩色多普勒超声心动图在川崎病预后判断和随访中的价值。方法对46例临床诊断川崎病并住院治疗的患儿的病历资料进行回顾性分析,患儿入院后根据病情均行彩色多普勒超声心动图常规和定期检测。于冠状动脉入口0.5 cm处取其内缘测量内径,至少测量3次取其平均值,同时注意观察其内膜的回声和光滑度。比较治疗前后冠状动脉损伤程度和内径变化。结果川崎病患儿治疗后冠状动脉损伤程度明显好转:其中3例左、右冠状动脉Ⅲ级损伤者中2例恢复到Ⅱ级、1例恢复到Ⅰ级;7例Ⅱ级损伤中6例恢复到Ⅰ级;23例Ⅰ级损伤中10例恢复至正常;与治疗前比较,治疗后左、右冠状动脉平均内径明显减小,差异有统计学意义(Pa<0.05)。结论彩色多普勒超声心动图可及时发现川崎病患儿的冠状动脉病变并估计预后,可作为川崎病冠状动脉病变的无创评价和长期随访心脏损害的重要方法。
Objective To investigate the value of color Doppler echocardiography in prognosis and follow-up of Kawasaki disease. Methods Retrospective analysis was performed on 46 cases of Kawasaki disease and hospitalized children with clinical diagnosis. Children were admitted to hospital for routine and regular color Doppler echocardiography. Measure the inner diameter at 0.5 cm at the entrance to the coronary artery and measure the mean value at least 3 times. At the same time observe the echogenicity and smoothness of the intima. The changes of coronary artery injury and internal diameter before and after treatment were compared. Results The degree of coronary artery injury in children with Kawasaki disease was significantly improved after treatment: two of three cases of grade Ⅲ and Ⅳ left and right coronary arteries recovered to grade Ⅱ and 1 to grade Ⅰ; and six of seven of grade Ⅱ were recovered (P <0.05). The mean diameter of the left and right coronary arteries was significantly reduced after treatment (P <0.05). Conclusion Color Doppler echocardiography can detect coronary artery lesions in children with Kawasaki disease in time and estimate the prognosis. It can be used as a noninvasive method to evaluate coronary artery lesions in Kawasaki disease and an important method for long-term follow-up of heart damage.