超声在完全与不完全川崎病患儿冠状动脉病变评估中的应用价值

摘要 目的：探讨超声在完全与不完全川崎病（Kawasaki Disease，KD）患儿冠状动脉病变（Coronary artery lesions，CAL）评估中的应用价值。方法：2019年6月到2021年5月选择在西安医学院第二附属医院住院诊治的83例川崎病患儿，其中完全川崎病患儿43例（完全组），不完全川崎病患儿40例（不完全组）。所有患儿都给予超声检查，评估两组的临床表现、血液学指标、冠状动脉病变情况以及超声的诊断价值。结果：完全组的球结膜充血、皮疹、口唇破裂、手足硬肿、颈部淋巴结肿大等发生率高于不完全组（P>0.05）。两组的白细胞计数、血红蛋白对比差异有统计学意义（P<0.05），C反应蛋白、血小板、白蛋白对比差异无统计学意义（P>0.05）。完全组的冠状动脉病变发生率为60.5 %，高于不完全组的27.5 %（P<0.05）。在83例患儿中，超声诊断为完全川崎病42例，不完全川崎病41例，超声对完全与不完全川崎病患儿的鉴别诊断敏感性与特异性为97.7 %（42/43）和100.0 %（40/40）。结论：完全与不完全川崎病患儿在临床表现、冠状动脉病变与实验室检测指标上都存在一定的差异，超声能鉴别诊断完全与不完全川崎病患儿的敏感性与特异性都比较好。

The Values of Ultrasound in the Assessment of Coronary Artery Lesions in Children with Complete and Incomplete Kawasaki Disease

ABSTRACT Objective: To investigate the values of ultrasound in the evaluation of coronary artery lesions (CAL) in children with complete and incomplete (Kawasaki Disease, KD). Methods: A total of 83 children with Kawasaki disease were selected from the Second Affiliated Hospital of Xi ''an Medical University from June 2019 to May 2021, including 43 children with complete Kawasaki disease (complete group) and 40 children with incomplete Kawasaki disease (incomplete group). All children received ultrasound examination to evaluate the clinical manifestations, hematological indicators, coronary artery lesions and the diagnostic value of ultrasound in the two groups. Results: The incidence of conjunctival hyperemia, skin rash, lip rupture, hard swelling of hands and feet, cervical lymphadenopathy in the complete group were higher than that in the incomplete group (P>0.05). The white blood cell count and hemoglobin compared between the two groups were significantly different (P<0.05), and the difference in C-reactive protein, platelets, and albumin compared were not statistically significant (P>0.05). The incidence of coronary artery disease in the complete group were 60.5 %, which were higher than 27.5 % in the incomplete group (P<0.05). In the 83 children, there were 42 cases were diagnosed as complete Kawereaki disease by ultrasound and 41 cases were incomplete Kawereaki disease. The sensitivity and specificity of ultrasound for differential diagnosis of children with complete and incomplete Kawereaki disease were 97.7 % (42/43) and 100.0 % (40/40). Conclusion: Children with complete and incomplete Kawereaki disease have certain differences in clinical manifestations, coronary artery lesions, and laboratory test indicators. Ultrasound can differentiate between children with complete and incomplete Kawereaki disease with better sensitivity and specificity.