CAJ | 학술논문

目的探讨99Tcm-MIBI静息MPI与二维超声心动图(2-DE)对川崎病(KD)患儿亚急性期冠状动脉病变的诊断价值.方法回顾性分析1999年8月至2012年3月间该院收治的24例KD患儿.所有患儿[男14例,女10例,年龄(2.50±2.19)岁]均于亚急性期行静息MPI和2-DE检查,每7天复查1次直至疾病恢复期.计算2种方法对患儿冠状动脉病变的阳性检出率及检出时间,应用SPSS 13.0软件对数据行x2检验和Wilcoxon秩和检验.结果该组患儿静息MPI阳性者占66.67％ (16/24),2-DE阳性者占37.50％ (9/24),二者阳性检出率差异有统计学意义(x2=4.00,P＜0.05).静息MPI、2-DE阳性检出时间分别为(13.79±2.86)d和(15.89±5.60)d(Z=-0.746,P＞0.05).2种方法均阳性者占33.33％(8/24),均阴性者占29.17％(7/24)；静息MPI阳性、2-DE阴性者占33.33％ (8/24),前者阴性、后者阳性者占4.17％ (1/24).有4例静息MPI缺血区在2-DE上可见相应区域供血冠状动脉存在病变.结论静息MPI是一种较理想的、判断KD亚急性期冠状动脉循环异常及心肌缺血性损害程度和范围的无创检查手段,结合2-DE检查则有利于更全面地发现病变.
목적 탐토99Tcm-MIBI정식MPI여이유초성심동도(2-DE)대천기병(KD)환인아급성기관상동맥병변적진단개치.방법 회고성분석1999년8월지2012년3월간해원수치적24례KD환인.소유환인[남14례,녀10례,년령(2.50±2.19)세]균우아급성기행정식MPI화2-DE검사,매7천복사1차직지질병회복기.계산2충방법대환인관상동맥병변적양성검출솔급검출시간,응용SPSS 13.0연건대수거행x2검험화Wilcoxon질화검험.결과 해조환인정식MPI양성자점66.67％ (16/24),2-DE양성자점37.50％ (9/24),이자양성검출솔차이유통계학의의(x2=4.00,P＜0.05).정식MPI、2-DE양성검출시간분별위(13.79±2.86)d화(15.89±5.60)d(Z=-0.746,P＞0.05).2충방법균양성자점33.33％(8/24),균음성자점29.17％(7/24)；정식MPI양성、2-DE음성자점33.33％ (8/24),전자음성、후자양성자점4.17％ (1/24).유4례정식MPI결혈구재2-DE상가견상응구역공혈관상동맥존재병변.결론 정식MPI시일충교이상적、판단KD아급성기관상동맥순배이상급심기결혈성손해정도화범위적무창검사수단,결합2-DE검사칙유리우경전면지발현병변.
Objective To compare the diagnostic values of rest 99Tcm-MIBI MPI and two-dimensional echocardiography (2-DE) for the detection of coronary artery damage at sub-acute phase of Kawasaki disease (KD).Methods Twenty-four children (14 males and 10 females,mean age:(2.50±2.19)years) with KD at sub-acute phase were studied between August 1999 and March 2012.All patients underwent rest 99Tcm-MIBI MPI and 2-DE.x2 and Wilcoxon rank sum tests with SPSS 13.0 were used for data analysis.Results The positive rate of MPI was 66.67％ (16/24),significantly higher than that of 2-DE (37.50％,9/24; x2 =4.00,P＜0.05).There was no significant difference between the duration for definite diagnosis by MPI and 2-DE ((13.79±2.86) vs (15.89±5.60) d; Z=-0.746,P＞0.05).Eight of 24 patients (33.33％) had positive results for both MPI and 2-DE,and 7 patients (29.17％) had negative findings for both methods.Eight patients (8/24,33.33％) were positive on MPI but negative on 2-DE,and 1 patient (1/24,4.17％) was positive on 2-DE but negative on MPI.The areas of myocardial ischemia detected by MPI in 4 patients were consistent with the findings by 2-DE.Conclusions Rest 99Tcm-MIBI MPI is a valuable noninvasive method to evaluate the coronary circulation and myocardial ischemia in KD patients at sub-acute phase.In combination with MPI,2-DE might provide more comprehensive information for the evaluation of KD.