Zhang Yu-qi, Chen Shu-bao, Huang Guo-ying, Zhang Hong-yan, Huang Mei-rong, Wang Shan-shan, Wu Lan-ping, Hong Wen-jing, Shen Rong, Liu Yi-qing, Zhu Jun-xue, Lu Zhao-hui
Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.
J Clin Ultrasound. 2015 Jan;43(1):39-46. doi: 10.1002/jcu.22176. Epub 2014 Jun 27.
In children with coronary disease, clinical decision should be based on detailed measurements of the coronary arteries by two-dimensional echocardiography. We aimed to establish coronary artery reference indexed diameter and z scores regression equations in a large cohort of Chinese Han children.
We measured the diameter of the proximal right (RCA), left main (LMCA), left anterior descending, and left circumflex coronary artery, and of the aortic annulus, and calculated the coronary-aorta index (coronary artery-to-aortic annulus ratio) in 506 Chinese Han children with normal hearts whose ages ranged from 1 day to 18 years. Regression analyses were performed, relating the coronary artery dimensions to body surface area (BSA). Several models were used, and the best model (yielding the maximum adjusted R(2) ) was chosen to establish a z score calculator.
Based on cubic regression, (M) = β0 + β1 × BSA + β2 × BSA(2) + β3 × BSA(3) , the adjusted R(2) values were 0.515, 0.553, 0.505, and 0.518 for the RCA, LMCA, left anterior descending, and left circumflex coronary artery models, respectively. RCA/aortic annulus was 0.14 ± 0.02 (range, 0.07-0.24) and LMCA/AOA was 0.15 ± 0.03 (range, 0.10-0.28).
Our results provide reference values of coronary artery z scores, regression equation, and coronary-aorta index as a quick guide to determine coronary dilation in Chinese Han children.
对于患有冠状动脉疾病的儿童，临床决策应基于二维超声心动图对冠状动脉的详细测量。我们旨在建立一个大型中国汉族儿童队列的冠状动脉参考指数直径和z值回归方程。
我们测量了506名年龄从1天至18岁、心脏正常的中国汉族儿童的右冠状动脉近端（RCA）、左主干（LMCA）、左前降支和左旋支冠状动脉以及主动脉环的直径，并计算冠状动脉-主动脉指数（冠状动脉与主动脉环比值）。进行回归分析，将冠状动脉尺寸与体表面积（BSA）相关联。使用了几种模型，并选择最佳模型（产生最大调整R²）来建立z值计算器。
基于三次回归（M）=β0 + β1×BSA + β2×BSA² + β3×BSA³，RCA、LMCA、左前降支和左旋支冠状动脉模型的调整R²值分别为0.515、0.553、0.505和0.518。RCA/主动脉环为0.14±0.02（范围，0.07 - 0.24），LMCA/AOA为0.15±0.03（范围，0.10 - 0.28）。
我们的结果提供了冠状动脉z值、回归方程和冠状动脉-主动脉指数的参考值，作为确定中国汉族儿童冠状动脉扩张的快速指南。
