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頁籤選單縮合
題名 | The Significance of Early Subtle Coronary Arterial Lesions on Echocardiogram in Kawasaki Disease=急性期川崎病超音波心圖之細微冠狀動脈 |
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作者 | 張正成; 蔡長海; 吳美環; 王主科; Chang, Jeng-sheng; Tsai, Chang-hai; Wu, Mei-hwan; Wang, Jou-kou; |
期刊 | 中華民國小兒科醫學會雜誌 |
出版日期 | 19990300、19990400 |
卷期 | 40:2 民88.03-04 |
頁次 | 頁101-106+139 |
分類號 | 417.5222 |
語文 | eng |
關鍵詞 | 川崎病; 冠狀動脈瘤; 心臟超音波; 血管炎; Kawasaki disease; Coronary arterial aneurysm; Echocardiography; Vasculitis; |
中文摘要 | 川崎病的冠狀動脈病變,在急性期就可能發生。由心臟超音波的檢查中我們發現,有些急 性期川崎病的冠狀動脈變化雖然未達到冠狀動脈瘤的診斷標準,仍然呈現明顯的異常。我們因此針 對37名急性期川崎病患以及12名對照病人,作密集的心臟超音波檢查。超音波錄影帶分別由兩所 教學醫院的三位小兒心臟專科醫師作雙盲判讀。其中,冠狀動脈的管徑形狀,其內膜平滑性,以及 動脈周圍組織的均勻性等三項特徵,都分別判讀。37名川崎病患中有7名確定有冠狀動脈瘤的併發 症(19%)。此三位心臟醫師對心臟超音波錄影帶判讀的一致性為72%。在急性期時,川崎病組比對 照組較常發生不規則的血管內膜變化(P<0.001)。川崎病人當中,併發冠狀動脈瘤的比沒有併發症的, 在急性期的三項血管變化特徵上,都有顯著偏高(P<0.001)。此外,各川崎病患在急性期的冠狀動脈 管徑大小與其恢復期的最大管徑,有明顯的正性相關(P=0.0001,γ=0.61)。我們因此推論,急性期 川崎病患如發生此三項冠狀動脈的變化,對往後發生冠狀動脈瘤併發症有很高的預測性。 |
英文摘要 | Intersive echocardiographic studies were undertaken in 37 patients with Kawasaki disease (KD) and 12 febrile controls during the acute stages. Video-tape recordings were read doubly-blinded by 3 pediatric cardiologists at 2 hospitals. Three characteristics of subtle coronary arterial lesions, including contour of lumen, Smoothness of endothelium and sono-homogeneity of the surrounding tissue were particularly described. Seven of the 37 KD patients (19%) were found to have coronary arterial aneurysms (CAA) at the end of the convalescent stage. The 3 cardiologists agreed in the diagnosis of the subtle lesions by 72%. More patients with Kawasaki disease were found to have an irregular endothelium than the controls (P<0.001). KD patients later complicated with CAA were more likely to have had the three characteristics of subtle coronary lesions during the acute stage than the KD patients without aneurysms (P<0.001). Also, the coronary arterial size measured during the acute statge were found to be positively correlated with their largest dilatation at the convalescent stage (P=0.0001. γ=0.61). We conclude that early subtle coronary arterial lesions can herald the development of coronary arterial aneurysms. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。