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[对有皮肤黏膜淋巴结综合征病史的学龄儿童心脏受累情况及左心室功能的无创评估]

[Noninvasive evaluation of cardiac involvements and left ventricular function in schoolchildren with the history of mucocutaneous lymph node syndrome].

作者信息

Ishimitsu T, Sakamoto T, Owaki T, Amano K, Hada Y, Yamaguchi T, Takenaka K, Kawahara T, Murayama M, Kawakubo K

出版信息

J Cardiogr. 1982 Mar;12(1):125-35.

PMID:7119488
Abstract

Mucocutaneous lymph node syndrome (MCLS) in the young has been known to have coronary aneurysms, and then it has been recently suspected as a cause of premature atherosclerosis and cardiomyopathy. Thirty-three schoolchildren who suffered from MCLS were studied to evaluate cardiac involvements and left ventricular function using two-dimensional (2-D) echocardiograms and submaximal stress test. Fifteen normal schoolchildren were studied as normal control. All these MCLS children were asymptomatic and had no significant findings in routine chest X-ray and electrocardiographic examinations. According to submaximal stress test, 8 cases showed a J type ST depression of only 0.5--1.0 mm, and there were no positive cases. Using 2-D echocardiograms, the left coronary artery was detected in 85% and the right coronary in 27%. One case showed an aneurysm of the left coronary artery. However, none of them showed abnormal left ventricular wall motion or the wall motion abnormality compatible with cardiomyopathy. There were no significant differences between MCLS and normal control in ejection fraction, mean VCF, diastolic descent rate of the anterior mitral valve, D/S ratio of the left ventricular wall, and Weissler's index (PEP/ET). These findings suggested that 1) most of MCLS schoolchildren do not have obvious cardiac involvement and their left ventricular function is within normal limits, 2) because of its low sensitivity, submaximal stress test is not so useful in screening coronary lesions, and 3) the 2-D echocardiogram works not only in detecting coronary aneurysms but also in evaluating left ventricular function.

摘要

小儿皮肤黏膜淋巴结综合征(MCLS)已知可导致冠状动脉瘤,近来还被怀疑是早发性动脉粥样硬化和心肌病的病因。对33名患MCLS的学童进行了研究,采用二维(2-D)超声心动图和次极量运动试验评估心脏受累情况及左心室功能。选取15名正常学童作为正常对照。所有这些患MCLS的儿童均无症状,常规胸部X线和心电图检查均无明显异常。根据次极量运动试验,8例出现仅0.5 - 1.0毫米的J型ST段压低,无阳性病例。使用二维超声心动图,85%检测到左冠状动脉,27%检测到右冠状动脉。1例显示左冠状动脉瘤。然而,他们均未出现左心室壁运动异常或与心肌病相符的壁运动异常。MCLS组与正常对照组在射血分数、平均室壁缩短率、二尖瓣前叶舒张期下降速率、左心室壁D/S比值和魏斯勒指数(PEP/ET)方面无显著差异。这些发现提示:1)大多数患MCLS的学童无明显心脏受累,其左心室功能在正常范围内;2)由于敏感性低,次极量运动试验在筛查冠状动脉病变方面不太有用;3)二维超声心动图不仅可用于检测冠状动脉瘤,还可用于评估左心室功能。

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