CAJ | 학술논문

目的：探讨儿童川崎病（ KD）冠状动脉病变预后及心脏冠脉成像（ CTA）对判断不同时期冠脉病变的意义。方法对2009年2月～2013年10月间潍坊市人民医院儿内科收治的30例KD并发冠状动脉（冠脉）病变患儿临床资料进行回顾性分析，分别于发病3个月、6个月、12个月及24个月时行CTA检查。截止至2013年10月，最长随访时间24个月。结果3个月时CTA检查各级病变恢复正常例数为：1级14例（77．7％），2级3例（33．3％），3级0例；6个月时恢复正常例数为：1级2例（11．1％），2级2例（22．2％），3级1例（33．3％）；12个月时各级病变中分别有1例恢复正常；2年时各级病变均无恢复病例，另1例多发巨大冠脉瘤患儿随访2年无变化。不同级组～3个月、～6个月时间段冠脉病变恢复率、冠脉内径恢复差异有显著性（ P＜0．01，0．05）。～12个月、～24个月时间段恢复率、内径恢复差异无显著性（P均＞0．05）。同一级别病变在～3个月、～6个月、～12个月冠脉内径恢复差异有统计学意义（P＜0．05），～24个月（P＞0．05），差异无统计学意义。结论KD并冠脉病变1级多数在3个月内恢复正常，6个月内几乎全部恢复；2级病变多数在1年内恢复；3级病变恢复较慢。病变持续12个月以上者，恢复率极低。 CTA技术可用于小儿川崎病冠脉病变的无创评估及远期随访。
목적：탐토인동천기병（ KD）관상동맥병변예후급심장관맥성상（ CTA）대판단불동시기관맥병변적의의。방법대2009년2월～2013년10월간유방시인민의원인내과수치적30례KD병발관상동맥（관맥）병변환인림상자료진행회고성분석，분별우발병3개월、6개월、12개월급24개월시행CTA검사。절지지2013년10월，최장수방시간24개월。결과3개월시CTA검사각급병변회복정상례수위：1급14례（77．7％），2급3례（33．3％），3급0례；6개월시회복정상례수위：1급2례（11．1％），2급2례（22．2％），3급1례（33．3％）；12개월시각급병변중분별유1례회복정상；2년시각급병변균무회복병례，령1례다발거대관맥류환인수방2년무변화。불동급조～3개월、～6개월시간단관맥병변회복솔、관맥내경회복차이유현저성（ P＜0．01，0．05）。～12개월、～24개월시간단회복솔、내경회복차이무현저성（P균＞0．05）。동일급별병변재～3개월、～6개월、～12개월관맥내경회복차이유통계학의의（P＜0．05），～24개월（P＞0．05），차이무통계학의의。결론KD병관맥병변1급다수재3개월내회복정상，6개월내궤호전부회복；2급병변다수재1년내회복；3급병변회복교만。병변지속12개월이상자，회복솔겁저。 CTA기술가용우소인천기병관맥병변적무창평고급원기수방。
Objective To explore children kawasaki disease prognosis of coronary artery disease and CTA to determine the sig -nificance of coronary artery lesions in different periods .Methods From February 2009 to October 2013,inpatients diagnosed as KD with cor-onary arterial lesi on(CAL) were enrolled into the study,In the third month,the 6th month,the 12th month and the 24th month to check with CTA.By October 2013,the longest follow-up is 2 years.Results At the third month,in level 1,14/18 cases(77.7%) showed normal coro-nary artery by CTA,in level 2,3/9 cases(33.3%),in level 3,0/3 cases(0).At the 6th month follow up time point,2 cases(11.1%) in lev-el 1,2 cases(22.2%) in level 2 and 1 case(33.3%) in level 3 showed normal coronary artery .At the 12th month,1 case returned to normal at eath group.At the 24th month,no case returned to normal.Another one in level 3 did not change in end.Different peer group ~third month,~the 6th month,the recovery rate and the diameter have statistically significant (P<0.05).~the 12th month,~the 24th month,it dose not have statistically significant (P>0.05).Conclusion Most of KD with CAL in level 1 come back to normal easily in 3 months,and almost all of them can come to normal in 6 months,but the level 2 lesion need 1 year,level 3 restore slowly.Lesions continued more than one year,the recovery rate is extremely low .CTA can be used for noninvasive assessment of the pediatric kawasaki disease of coronary lesions and long-term follow-up.