陕西医学杂志2025，Vol.54Issue(12)：1641-1649,9.DOI:10.3969/j.issn.1000-7377.2025.12.009
超声心动图冠状动脉Z值在川崎病患儿治疗前后的变化及其预测因素分析
Changes in echocardiographic coronary artery Z-scores before and after treatment in children with Kawasaki disease and its predictors
摘要
Abstract
Objective:To analyze the changes in echocardiographic coronary artery Z-scores before and after treatment in children with Kawasaki disease(KD)and identify associated predictive factors.Methods:A total of 215 KD children who were diagnosed and hospitalized for treatment and then re-examined were collected.Echocardio-graphy was used to measure the internal diameters of left main coronary artery(LMCA),left anterior descending ar-tery(LAD),left circumflex artery(LCX),proximal segment of the right coronary artery(RCA-P),middle segment of the right coronary artery(RCA-M),and distal segment of the right coronary artery(RCA-D),and Z-scores for each segment were calculated,and the maximum Z-score was used as the evaluation index for each children.All chil-dren received intravenous immunoglobulin(IVIG)and oral aspirin.Based on the difference in Z-scores before and af-ter treatment(ΔZ-score),the children were divided into the regression group(Z-score at 6 months after treatment decreased by≥1 compared with that before treatment,107 cases),stable group(fluctuation range of Z-score at 6 months after treatment was<1,75 cases),and progression group(Z-score at 6 months after treatment increased by≥1 compared with that before treatment,33 cases).Gender,age,height,weight,body surface area(BSA),heart rate,fever duration,platelets(PLT),C-reactive protein(CRP),white blood cells(WBC),erythrocyte sedimentation rate(ESR),red blood cells(RBC),neutrophil percentage(NE%),albumin(ALB),hemoglobin(HGB)before treat-ment and at 6 months after treatment were compared.The correlation between the difference of biochemical indica-tors before and after the treatment and ΔZ-score of the KD children was analyzed,and multiple linear regression anal-ysis was conducted to screen out the independent risk factors affecting the ΔZ-score.Results:Compared with those before treatment,the levels of heart rate,PLT,CRP,WBC,ESR,and NE%at 6 months after treatment in the regres-sion group and stable group decreased,while the levels of RBC,ALB,and HGB increased(all P<0.05);the levels of heart rate,PLT,CRP,WBC,ESR,and NE%at 6 months after treatment in the progression group increased,while the levels of RBC,ALB,and HGB decreased(all P<0.05).TheΔZ-score was significantly positively correlated with the levels of heart rate,PLT,CRP,WBC,ESR,and NE%before treatment,and significantly negatively correlated with the level of ALB before treatment(all P<0.05).The results of multiple linear regression analysis indicated that pre-treatment CRP had a significant effect on the ΔZ-score(P<0.05).ΔZ-score was positively correlated with Δheart rate,ΔPLT,ΔCRP,ΔWBC,ΔESR,and ΔNE%,and negatively correlated with ΔRBC,ΔALB,and ΔHGB(all P<0.05).Multiple linear regression indicated thatΔheart rate,ΔWBC,ΔRBC,andΔNE%as independent predictors of ΔZ-score(all P<0.05).Conclusion:Evaluating prognosis based on ΔZ before and after treatment,pre-treatment CRP has predictive value for Kawasaki disease outcomes.Differences in heart rate,WBC,RBC,and NE%before and after treatment are independent predictors of prognosis in KD children.关键词
川崎病/超声心动图/冠状动脉Z值/诊断/预后/预测因素Key words
Kawasaki disease/Echocardiography/Coronary artery Z-score/Diagnosis/Prognosis/Predictive factors分类
医药卫生引用本文复制引用
严晓华,张泰鸣,高娜,穆志龙,贺望,万萱,焦富勇,马娟..超声心动图冠状动脉Z值在川崎病患儿治疗前后的变化及其预测因素分析[J].陕西医学杂志,2025,54(12):1641-1649,9.基金项目
陕西省中医药管理局科研课题(2021-01-ZZ-014) （2021-01-ZZ-014）
陕西省中西医结合心血管病防治重点实验室开放课题(KF2224) （KF2224）
陕西省人民医院科技人才支持计划(拔尖人才)资助项目(2022BJ-08) （拔尖人才）
