Xue Mei, Wang Jing
Department of Ultrasound Diagnosis, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010050, P.R. China.
Exp Ther Med. 2020 Apr;19(4):2597-2603. doi: 10.3892/etm.2020.8519. Epub 2020 Feb 11.
The utility of color Doppler echocardiography in the diagnosis and follow-up of Kawasaki disease (KD) with coronary artery lesions (CAL) was analyzed, and the clinical parameters associated with the disease were examined. The general data, the color Doppler echocardiography data and the biochemical indexes from 102 children with KD were analyzed. The patients were divided into a CAL group and a non-coronary artery lesion (NCAL) group based on the presence or absence of CAL. The risk factors for CAL in KD were screened by univariate and multivariate analyses. Among the 102 cases, CAL complications were identified in 47 cases (46.08%). Compared with the NCAL group, the CAL group showed significantly higher incidences of fever duration, increased levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), C-reactive protein (CRP), intravenous immunoglobulin resistance, erythrocyte sedimentation rate (ESR), platelets, alanine aminotransferase and aspartate aminotransferase, and significantly lower serum albumin levels (P<0.05). According to the multivariate analysis, fever duration [odds ratio (OR)=2.014], NT-proBNP (OR=3.004), cTnI level (OR=2.638), ESR (OR=1.461) and CRP elevation (OR=1.094) were predictors of CAL in KD. During convalescence, the left and right coronary artery diameters in the CAL group significantly decreased (P<0.05). Color Doppler echocardiography can observe the condition of coronary artery disease in patients with KD in real time and predicts its outcomes, which may be helpful for early diagnosis and long-term follow-up. Fever duration, cTnI, NT-proBNP and ESR levels were correlated with coronary artery diameter, of which the comprehensive use may be more accurate in determining the occurrence of CAL in KD.
分析彩色多普勒超声心动图在诊断和随访患有冠状动脉病变（CAL）的川崎病（KD）中的作用，并检查与该疾病相关的临床参数。分析了102例KD患儿的一般资料、彩色多普勒超声心动图数据和生化指标。根据是否存在CAL将患者分为CAL组和非冠状动脉病变（NCAL）组。通过单因素和多因素分析筛选KD中CAL的危险因素。102例病例中，47例（46.08%）发现有CAL并发症。与NCAL组相比，CAL组发热持续时间、N末端B型脑钠肽前体（NT-proBNP）、心肌肌钙蛋白I（cTnI）、C反应蛋白（CRP）、静脉注射免疫球蛋白抵抗、红细胞沉降率（ESR）、血小板、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平显著升高，血清白蛋白水平显著降低（P<0.05）。多因素分析显示，发热持续时间[比值比（OR）=2.014]、NT-proBNP（OR=3.004）、cTnI水平（OR=2.638）、ESR（OR=1.461）和CRP升高（OR=1.094）是KD中CAL的预测因素。恢复期，CAL组左右冠状动脉直径显著减小（P<0.05）。彩色多普勒超声心动图可实时观察KD患者冠状动脉疾病情况并预测其预后，这可能有助于早期诊断和长期随访。发热持续时间、cTnI、NT-proBNP和ESR水平与冠状动脉直径相关，其中综合应用可能在确定KD中CAL的发生方面更准确。
