CAJ | 학술논문

目的研究不同年龄正常儿童冠状动脉内径随体表面积的变化规律,得出儿童冠状动脉内径随体表面积变化的动态正常参考值范围.方法 2008年12月至2010年11月在北京儿童医院保健中心进行健康体检的中国儿童,除外心脏及其他各系统疾病,最终选取超声心动图图像质量好且冠状动脉显示清晰的儿童共400名,男230名,女170名,年龄0d～18岁,平均(6.43 ±4.45)岁,采月 HP Sonos 5500彩色多普勒超声诊断仪,按冠状动脉内径标准测量方法,分别测量左冠状动脉主干、左前降支、左回旋支及右冠状动脉主干内径.结果左冠状动脉主干、左前降支、左回旋支及右冠状动脉主干内径测量值在各年龄组闾(0 d～12个月、～3岁、～6岁、～9岁、～12岁、～18岁)差异均有统计学意义(F=61.688、51.343、46.375、50.192,P均＜0.01,组间均数的差异有统计学意义,两两年龄组比较P均＜0.05),在男女之间差异均无统计学意义(P＞0.05).左冠状动脉主干、左前降支、左回旋支及右冠状动脉主干内径与年龄、身高、体重、体表面积均呈显著线性相关(r值范围0.71～0.85,P＜0.01).左冠状动脉主干、左前降支、左回旋支及右冠状动脉主干内径分别随体表面积变化进行七次回归分析并建立回归方程,选取其中最适方程,利用其系数,描记出Z值曲线图,经临床实践的验证,选取Z值在±2之间为冠状动脉内径正常值范围,得出适合中国儿童的冠状动脉内径正常参考值的范围.结论冠状动脉Z值曲线图为超声医生及临床医生准确、快速判断冠状动脉内径是否异常提供了客观依据.
목적 연구불동년령정상인동관상동맥내경수체표면적적변화규률,득출인동관상동맥내경수체표면적변화적동태정상삼고치범위.방법 2008년12월지2010년11월재북경인동의원보건중심진행건강체검적중국인동,제외심장급기타각계통질병,최종선취초성심동도도상질량호차관상동맥현시청석적인동공400명,남230명,녀170명,년령0d～18세,평균(6.43 ±4.45)세,채월 HP Sonos 5500채색다보륵초성진단의,안관상동맥내경표준측량방법,분별측량좌관상동맥주간、좌전강지、좌회선지급우관상동맥주간내경.결과 좌관상동맥주간、좌전강지、좌회선지급우관상동맥주간내경측량치재각년령조려(0 d～12개월、～3세、～6세、～9세、～12세、～18세)차이균유통계학의의(F=61.688、51.343、46.375、50.192,P균＜0.01,조간균수적차이유통계학의의,량량년령조비교P균＜0.05),재남녀지간차이균무통계학의의(P＞0.05).좌관상동맥주간、좌전강지、좌회선지급우관상동맥주간내경여년령、신고、체중、체표면적균정현저선성상관(r치범위0.71～0.85,P＜0.01).좌관상동맥주간、좌전강지、좌회선지급우관상동맥주간내경분별수체표면적변화진행칠차회귀분석병건립회귀방정,선취기중최괄방정,이용기계수,묘기출Z치곡선도,경림상실천적험증,선취Z치재±2지간위관상동맥내경정상치범위,득출괄합중국인동적관상동맥내경정상삼고치적범위.결론 관상동맥Z치곡선도위초성의생급림상의생준학、쾌속판단관상동맥내경시부이상제공료객관의거.
Objective To obtain normal range of coronary artery diameter with body surface area (BSA) dynamic changes in normal children at different age.Method The left main coronary artery (LCA),left anterior descending artery (LAD),left circumflex artery (LCX) and the right coronary artery (RCA) diameter were measured in 400 normal subjects from Chinese population aged 0 d to 18 years [(6.43 ± 4.45) years],using HP Sonos 5500 color Doppler ultrasonic system,according to the standard method of measuring the coronary artery diameter.Result (1) The diameters of LCA,LAD,LCX and RCA in different age groups (0 d-12 months,-3 years,-6 years,-9 years,-12 years,-18 years) had significant differences (F =61.688,51.343,46.375,50.192,P ＜ 0.01,all groups mean differences had significant differences,there was significant difference between every two groups,P ＜ 0.05),there were no significant differences between male and female subjects (P ＞0.05).(2) The correlation analyses showed that the diameter of LCA,LAD,LCX and RCA had significant linear correlations with age,height,weight and BSA (r ranged from 0.71 to 0.85,P ＜ 0.01).(3) The regression analyses were respectively performed on the diameters of LCA,LAD,LCX and RCA with BSA to establish seven regression models.The coefficients were compared for each model,the best model was chosen to create a Z score calculator,tracing out the Z value curve,through clinical practice,we chose Z score within ± 2 as the coronary artery diameter's normal range for Chinese children.Conclusion Coronary artety diameter's Z score curve is effective and reliable,it provide objective basis for clinicians and sonographers to accurately and quickly diagnose the anomalies in diameter of coronary artery.