论文部分内容阅读
目的应用斑点追踪成像(STI)技术评估川崎病(KD)患儿急性期及恢复期左心室(LV)扭转参数的变化,探讨扭转参数在评价KD患儿LV心肌力学改变及预后中的临床价值。方法使用STI分析88例KD患儿急性及恢复期LV扭转参数的变化,分为不伴冠状动脉扩张(CAD)组42例,伴CAD组46例,并与常规超声LV功能参数对比。对照组为60例健康儿童。结果 KD急性期常规超声LV功能参数在正常范围内,不伴CAD组收缩期心尖旋转角度峰值、扭转角度峰值及舒张期解旋速度峰值减小(P<0.05);伴CAD组收缩期心尖旋转角度峰值、扭转角度峰值、扭转速度峰值、扭转角度达峰时间、舒张期解旋速度峰值及等容舒张期解旋百分比均减低(P<0.05)。KD恢复期不伴CAD组各扭转参数均与对照组无明显差异(P>0.05);伴CAD组收缩期扭转参数与对照组无明显差异(P>0.05),而舒张期解旋参数仍与对照组有统计学差异(P<0.05)。结论 STI在LV整体功能尚未出现改变时就能敏感地检测KD患儿LV心肌功能的改变;伴CAD组急性期局部冠状动脉供血区心肌功能受损更为明显,且舒张期解旋功能的下降持续至恢复期;舒张期解旋参数的变化更能体现冠状动脉受损的情况。
Objective To evaluate the changes of left ventricular (LV) torsion parameters in acute and convalescent children with Kawasaki disease (KD) by speckle tracking imaging (STI), and to explore the clinical value of torsion parameters in evaluating LV myocardial mechanics changes and prognosis in children with KD . Methods STI was used to analyze the changes of LV torsion parameters in 88 children with KD. The changes were divided into 42 cases without coronary artery dilation (CAD) group and 46 cases with CAD group, and compared with conventional LV function parameters. The control group was 60 healthy children. Results In the normal range of KD, the peak value of systolic apical rotation angle, the peak of torsion angle and the peak value of diastolic unrolling velocity were decreased in the CAD group (P <0.05). In the CAD group, systolic apical rotation The peak of peak angle, the peak of torsion angle, the peak of torsion velocity, the peak time of torsion angle, the peak of diastolic dextrin velocity and the unwinding percentage of isovolumic relaxation phase were all decreased (P <0.05). There was no significant difference between the CAD group and the control group (P> 0.05), but no significant difference between the CAD group and the control group (P> 0.05) The control group had statistical difference (P <0.05). Conclusions STI can detect the changes of myocardial function in patients with KD when the overall function of LV has not changed. In the CAD group, the myocardial function of local coronary artery is more damaged and the diastolic function is decreased Continued to recovery; changes in diastolic unrolling parameters can better reflect the situation of coronary artery damage.