川崎病合并冠状动脉瘤的超声心动图研究.pdfVIP

临床超声医学杂 ·837 · ·经验交流· 川崎病合并冠状动脉瘤的超声心动图研究 魏亚娟 赵晓兰 刘保民 牛 华 李 谦 摘 要 目的 探讨川崎病合并冠状动脉瘤（CAA）的并发症及超声心动图在其诊断、随访中的价值。方法 回顾 结果 性分析超声心动图定期随访的38例川崎病合并CAA患者的临床资料及并发症。 38例患者共检出79处CAA。其 中17例24处（30%）瘤腔内并发血栓；5例（13%）发生冠脉狭窄，1例因侧支循环形成无明显症状；5例（13%）发生心肌梗 死，4例死亡；2例（5%）因巨大CAA破裂猝死；7例（18%）CAA瘤壁钙化。本组共7例死亡，占18%，死亡时间均为90年 代初，3例因急性期为不完全川崎病未识别故而未做系统治疗。结论 川崎病合并CAA的并发症主要包括血栓形成、冠 脉狭窄、心肌梗死、巨大CAA破裂及心源性猝死等。超声心动图对其诊治及预后评估有重要价值。 关键词 川崎病；冠状动脉瘤；超声心动描记术；并发症；儿童 ［中图法分类号］ ； ［文献标识码］ R541.4 R445.1 A Echocardiographic study of kawasaki disease with coronary artery aneurysms WEI Yajuan ，ZHAO Xiaolan ，LIU Baomin ，NIU Hua ，LI Qian Department of Ultrasound ，the Second Affiliated Hospital of Xi ’an Jiaotong University ，Xi ’an 710004 ，China ABSTRACT Objective To explore the complications of Kawasaki disease （KD）with coronary artery aneurysms （CAA）and the value of echocardiography in its diagnosis and follow-up.Methods The clinical data and complications of 38 cases of KD with CAA who were followed -up regularly using echocardiography were retrospectively analyzed.Fifteen cases were confirmed by coronary angiography ，2 cases were confirmed by EBCT and 3 cases were confirmed by autopsy.Results Of 38 cases ，a total of 79 CAAs were detected.Seventeen cases （24 CAAs ，30%）were complicated with thrombus.Coronary stenosis developed in 5 cases ， 1 case of them who had developed collateral circulation had no symptoms.Myocardium infarction occurred in 5 c