【摘要】 目的探讨超声心动图在川崎病(KD)性冠状动脉瘤(CAA)合并血栓及其并发症的检测与随访中的价值。方法回顾性分析超声心动图定期随访的18例KD性CAA合并血栓患者的临床、超声资料及并发症。4例冠脉造影证实,1例尸检证实,1例EBCT证实。结果 18例KD性CAA合并血栓患儿共检出46处CAA。22处CAA瘤腔内血栓形成。CAA伴血栓者平均瘤径(10.7±4.6)mm,明显大于不伴血栓者平均瘤径(6.3±1.9)mm。其中巨大CAA 25处,巨大CAA伴血栓18处,占82%(18/22)。KD后血栓检出时间10 d~8年(平均1.9年)。本组2例发生心肌梗死死亡,1例发生缺血性心脏病,1例因巨大CAA破裂死亡。结论 KD性CAA瘤径越大,血栓形成的风险越高;其并发症预后较差。超声心动图可为其病情进展和预后评估提供可靠信息。更多还原

【Abstract】 Objective To evaluate the value of echocardiography in the diagnosis and follow-up of coronary artery aneurysms(CAA) with thrombus and its complications caused by Kawasaki disease(KD).Methods The clinical data and complications of 18 cases of CAA with thrombi caused by KD were followed-up with echocardiography retrospectively.Four of them were confirmed by coronary angiography,one by EBCT,one by autopsy.Results Of the 18 patients,a total of 46 CAAs were detected.Thrombi were found in 22 CAAs.The mean diameters of CAAs with thrombi(10.7 ± 4.6) mm were significantly larger than those without thrombi(6.3 ± 1.9) mm.There were 25 giant CAAs;18 of them were complicated with thrombi,accounting for 82%(18/22).The time when thrombi were detected was 10 days to 8 years after the onset of KD(mean 1.9 years).Myocardial infarction occurred in 2 of them and caused death.Ischemic heart disease occurred in 1 of them.Rupture of giant CAA occurred in 1 of them and caused,sudden death.Conclusions The risk of thrombosis increases with the enlargement of the diameter of CAA.The prognosis of its complications is poor.Echocardiography can provide reliable information for progression of the disease and assessing prognosis of them.更多还原