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目的 评价超声心动图诊断川崎病 (Kawasaki disease,KD)冠状动脉病变、治疗及预后。 方法 超声心动图检查 83例川崎病患儿 ,测量冠状的动脉直径 ,观察有无冠状动脉瘤、血栓和动脉狭窄 ,测量房室内径 ,计算心功能 ,测量心包积液和瓣膜返流。 结果 在受检的 83例川崎病患儿中有冠脉损害的共 34例 ,其中单纯左冠脉主干病变 2 0例 ,双支病变 6例 ,7例发生冠状动脉瘤 ,1例动脉瘤回缩后主干轻度狭窄 ,3例冠脉于发病 30天后出现病变及发生冠脉瘤及血栓形成。本组冠脉受累者均合并轻度、中度二尖瓣及三尖瓣返流 ,2 5例合并心包积液 ,2例左心一过性扩大及心功能降低。 结论 使用高频探头能提高冠脉的显示率 ,特别是实时观察冠脉病理改变及动脉瘤形成和它的进展及转归 ,评价管壁的厚度和是否光滑、有无蛋白样物质沉积、钙化及血栓形成。早期联合使用阿斯匹林与大计量静滴丙种球蛋白 ,可减少冠脉瘤的发生及血栓形成
Objective To evaluate echocardiography in the diagnosis, treatment and prognosis of coronary artery disease in Kawasaki disease (KD). Methods Totally 83 children with Kawasaki disease were examined by echocardiography. Coronary artery diameter was measured. Coronary artery aneurysm, thrombus and artery stenosis were observed. Atrioventricular diameter was measured. Cardiac function was calculated. Pericardial effusion and valvular regurgitation were measured. Results Of 83 children with Kawasaki disease who were examined, there were 34 cases of coronary artery lesion, including 20 cases of simple left main coronary artery lesion, 6 cases of double vessel lesion, 7 cases of coronary aneurysm and 1 case of aneurysm Slight narrowing of the narrowed trunk, 3 cases of coronary artery disease occurred 30 days after the onset and occurrence of coronary aneurysm and thrombosis. The patients with coronary artery involvement were combined with mild and moderate mitral and tricuspid regurgitation, 25 cases with pericardial effusion, 2 cases of transient enlargement of the left heart and decreased cardiac function. Conclusion The use of high-frequency probe can improve the display rate of coronary artery, especially in real-time observation of coronary pathological changes and aneurysm formation and its progression and prognosis, evaluate the wall thickness and smooth, with or without protein-like material deposition, calcification And thrombosis. Early combination of aspirin and intravenous infusion of gamma globulin can reduce the occurrence of coronary aneurysms and thrombosis