摘要
目的探讨超声心动图技术对心内膜弹力纤维增生症(EFE)和川崎病的临床诊断及鉴别诊断的作用。方法选取我院诊治的川崎病患儿1756例(川崎病组)、EFE患儿1032例(EFE组),以及体检的健康儿童1340例(对照组),应用超声心动图检查其左房内径(LA)、右室内径(RV)、左室舒张末期内径(LVDd)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)、左室舒张早期快速充盈的充盈峰与舒张晚期心房收缩充盈的充盈峰比值(E/A),比较各组临床症状和上述超声心动图检测参数治疗前后的差异。结果 EFE组和川崎病组患儿症状(呼吸道感染、发热/多汗、气促/紫绀、乏力、哭闹/烦躁、不进食/体重增加缓慢、肝脏增大、心动过速/心音低钝、心力衰竭)构成比较差异均有统计学意义(均P<0.05),其中EFE组和川崎病组患儿主要临床症状为呼吸道感染(发生率84.97%vs.75.58%,P<0.05)。三组LA、RV、LVDd、LVEF、LVFS、E/A比较,差异均有统计学意义(均P<0.05);组间两两比较上述各指标差异均有统计学意义(均P<0.05)。EFE组治疗前、后LA、RV、LVDd、LVEF、LVFS、E/A比较,差异均有统计学意义(均P<0.05)。具体分析各项指标差异的来源,均为组间因素、时间因素和交互作用的影响(均P<0.05)。结论超声心动图对EFE和川崎病的诊断及鉴别诊断、评价转归过程均有明显指导作用,具有重要的临床意义。
Objective To evaluate the value of echocardiography in the diagnosis and differential diagnosis of childrenwith endocardial fibroelastosis （EFE）and Kawasaki diseas （KD） .Methods A total of 1756 cases with KD in our hospital （KDgroup）, 1032 cases of EFE （EFE group）and 1340 healthy children from medical center （control group）were enrolled in thisstudy.Left atrial diameter（LA）, right ventricular diameter （RV）, left ventricular end-diastolic internal diameter（LVDd）, leftventricular ejection fraction （LVEF）, left ventricular shortening fraction （LVFS）, early diastolic blood flow peak velocity of leftventricular （E）, late diastolic blood flow peak velocity of left atrial （A）, ratio of E/A were calculated by echocardiography.Theclinical symptoms and those parameters were compared between before and after treatment in each group.Results There weresignificant differences in the composition of symptoms （respiratory tract infection, fever/sweating, shortness of breath/cyanosis,fatigue, crying/restlessness, no food/slow weight gain, liver enlargement, tachycardia/hypocardia, heart failure）between EFE groupand KD group （all P〈0.05） .The main clinical symptom of EFE group and KD group was respiratory tract infection （84.97% vs.75.58%, P〈0.05） .There were significant differences in LA, RV, LVDd, LVEF, LVFS and E/A among the three groups （all P〈0.05）, therewere significant differences in each index between any two groups （all P〈0.05） .There were significant differences in LA, RV,LVDd, LVEF, LVFS and E/A before and after treatment in EFE group （all P〈0.05） .Specific analysis of the source of the differencesin various indicators, were inter-group factors, time factors and interaction （all P〈0.05） .Conclusion Echocardiography plays an important role in the diagnosis, differential diagnosis and evaluation of prognosis of EFE and KD, which has important clinicalsignificance.
作者
李蔚
高峻
彭晶
LI Wei;GAO Jun;PENG Jing(Department of Ultrasound,Wuhan Children＇s Hospital,Tongji Medical College,Huazhong University of Science ＆ Technology,Wuhan 430016,China)
出处
《临床超声医学杂志》
2018年第11期735-739,共5页
Journal of Clinical Ultrasound in Medicine
基金
湖北省武汉市卫生计生委2015年度科研计划课题项目(WX16C20)
