小儿川崎病合并冠状动脉病变诊断中超声心动图和心肌酶学指标的应用价值

夏蓉

摘要：目的 小兒川崎病合并冠状动脉病变诊断中超声心动图和心肌酶学指标的应用价值。方法 选取2019年5月-2020年5月在我院进行治疗的非小儿川崎病合并冠状动脉病变患儿共45例作为观察组，选取同期在我院进行健康体检的小儿共45例作为对照组。两组均接受超声心动图和心肌酶学指标检查，对两组间的超声心动图影像进行比较，包括左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、舒张早期峰值速度与舒张晚期比值（Em/Am）。同时对两组进行心肌酶学指标检查，包括肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、肌酸激酶（CK）水平。结果 两组超声心动图影像学检查结果对比存在差异，观察组LVEF、Em/Am低于对照组，LVEDD高于对照组，差异明显（P<0.05）。两组的心肌酶学指标检查结果存在差异，观察组高于对照组，差异明显（P<0.05）。冠状病变不同程度患儿的心肌酶学指标水平对比存在差异，中度扩张、冠状动脉瘤患儿心肌酶学指标水平均高于轻度扩张患儿，差异明显（P<0.05）。结论 超声心动图和心肌酶学指标均可在小儿川崎病合并冠状动脉病变的诊断中发挥重要作用，值得推广。

关键词：小儿川崎病;冠状动脉病变;超声心动图;心肌酶学指标;诊断价值

The application value of echocardiography and myocardial enzyme indexes in the diagnosis of children's Kawasaki disease with coronary artery disease

【Abstract】 Objective The application value of echocardiography and myocardial enzymes in the diagnosis of children's Kawasaki disease with coronary artery disease. Methods A total of 45 children with non-pediatric Kawasaki disease and coronary artery disease who were treated in our hospital from May 2019 to May 2020 were selected as the observation group， and a total of 45 children who underwent physical examination in our hospital during the same period were selected as the control group . Both groups received echocardiography and myocardial enzyme index examinations. The echocardiographic images between the two groups were compared， including left ventricular ejection fraction （LVEF）， left ventricular end diastolic diameter （LVEDD）， early diastolic peak velocity and Late diastolic ratio （Em/Am）. At the same time， the two groups were examined for myocardial enzyme indexes， including the levels of creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， and creatine kinase （CK）. Results There were differences in the comparison of echocardiographic imaging examination results between the two groups. The LVEF and Em/Am of the observation group were lower than those of the control group， and the LVEDD was higher than that of the control group. The difference was significant （P<0.05）. There were differences in the results of myocardial enzymes between the two groups， the observation group was higher than the control group， the difference was significant （P<0.05）. There are differences in the levels of myocardial enzymes in children with different degrees of coronary lesions. The levels of myocardial enzymes in children with moderate dilation and coronary aneurysm are higher than those with mild dilation （P<0.05）. Conclusion Both echocardiography and myocardial enzymes can play an important role in the diagnosis of children's Kawasaki disease with coronary artery disease， and they are worthy of promotion.

[Keywords] Kawasaki disease in children; coronary artery disease; echocardiography; myocardial enzyme index; diagnostic value

【中图分类号】R445.1  【文献标识码】A  【文章编号】1673-9026（2021）14--02

小儿川崎病是一种急性血管炎综合征，临床多见于婴幼儿群体。现代医学研究指出，小儿川崎病属于我国儿童后天性心脏病发生的主要病因，临床罹患此病的患儿会出现持续性发热、双侧球结膜充血、颈部淋巴肿大等症状表现。……