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目的 探讨组织多普勒成像（tissue doppler imaging,TDI）在评价低月龄婴儿川崎病(Kawasaki disease,KD)左室功能变化的特点。方法 连续选取住院KD患者125例，分为≤6个月组（n=28)和>6个月组(n=97)。于静脉注射免疫球蛋白（intravenous immunoglobulin,IVIG）前、IVIG后6周、IVIG后12周用TDI分别获得二尖瓣瓣环室间隔侧及左室侧壁处舒张早期运动速度e’sep、e’lat；室间隔处TDI-Tei指数,并对不同时期二组之间及同组间不同时间点参数做比较。结果 ≤6个月组冠状动脉损伤发生率高于>6个月组（32% vs. 24%），且损伤程度较重。IVIG前≤6个月组e’lat、e’sep均显著低于>6个月组，E/e’lat、E/e’sep均显著高于>6个月组（均P<0.01）。IVIG后6周≤6个月组e’lat、e’sep略有恢复，但仍低于>6个月组，E/e’lat、E/e’sep下降但仍高于>6个月组（均P<0.05），IVIG后12周≤6个月组e’lat、e’sep与>6个月组相比无显著差别，E/e’sep进一步减低但仍高于>6个月组（P<0.05）。IVIG前、IVIG后6周≤6个月组TDI-Tei指数均高于>6个月组（均P<0.05），而在IVIG后12周，该指标两组间无显著差别。≤6个月组与IVIG前相比，IVIG后12周e’lat、e’sep及E/A显著升高，E/e’sep及TDI-Tei指数显著下降（均P<0.05）。与IVIG后6周相比，IVIG后12周e’sep进一步显著升高，TDI-Tei指数进一步显著下降（均P<0.05），但IVIG前与IVIG后6周相比，各参数未见显著差异，>6月组各时间点参数未见显著差异。结论 与大龄KD患者相比,低月龄KD婴儿冠状动脉损伤发生率较高且程度较重，左室舒张功能减低明显，且恢复时间长。
Objective To investigate the characteristics of tissue doppler imaging (TDI) in evaluating left ventricular function in Kawasaki disease (KD) in infants of low age. Methods A total of 125 hospitalized KD patients were selected and divided into groups of ≤6 months (n = 28) and> 6 months (n = 97). The early diastolic velocity e’sep at the ventricular septum and the left ventricular wall of the mitral valve annulus was obtained before intravenous immunoglobulin (IVIG), at 6 weeks after IVIG and at 12 weeks after IVIG, respectively ’; lat; TDI-Tei index at interventricular septum, and at different periods of time between the two groups and the same group at different time points to compare the parameters. Results The incidence of coronary artery injury less than 6 months was higher than that of the> 6 months group (32% vs. 24%) and the degree of injury was severe. The e’lat and e’sep in the group of ≤6 months before IVIG were significantly lower than those in the group of> 6 months, and the E / e’lat and E / e’sep were significantly higher than those in the> 6-month group (all P & lt; 0.01). E’lat, e’sep recovered slightly after 6 weeks of IVIG but were still lower than the 6-month group, with E / e’lat and E / e’sep decreasing but still higher than> 6 (All P & lt; 0.05), e’lat, e’sep at 6 weeks after IVIG ≤ 6 months had no significant difference compared with the 6th month group, E / e’sep further decreased but remained higher than & gt; 6-month group (P & lt; 0.05). Before IVIG, the TDI-Tei index of 6 weeks after IVIG ≤6 months was higher than that of> 6 months (all P & lt; 0.05), but there was no significant difference between the two groups after 12 weeks of IVIG. At 6 months, the e’lat, e’sep and E / A were significantly increased and the E / e’sep and TDI-Tei index decreased significantly (all P & lt; 0.05) at 12 weeks after IVIG compared with that before IVIG. Compared with 6 weeks after IVIG, e’sep was further significantly increased and TDI-Tei index was further significantly decreased at 12 weeks after IVIG (all P & lt; 0.05), but there was no significant difference in each parameter before IVIG compared with 6 weeks after IVIG Differences, & gt; The June group showed no significant differences in parameters at each time point. Conclusions Compared with older KD patients, the incidence of coronary artery injury in low-month-old KD infants is higher and more severe, the left ventricular diastolic function is significantly reduced, and the recovery time is longer.