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目的探讨三磷酸腺苷负荷单光子发射计算机断层摄影术(SPECT)心肌灌注显像在川崎病患儿心肌缺血诊断及随访中的应用价值。方法川崎病患儿27例根据病程分为急性期(15例)、亚急性期(9例)、恢复期(3例)3组;又根据超声结果分为冠状动脉扩张(18例)、非冠状动脉扩张(9例)2组,正常儿童(8例)为对照组;所有病例均行ATP负荷SPECT心肌灌注显像及超声检查,阳性患儿大部分在6个月或冠状动脉扩张消失后复查,并与临床转归相比对。结果对照组均为阴性,15例患儿心肌显像阳性,急性期9例,亚急性期5例,恢复期1例;扩张组12例阳性(66.7%),非扩张组3例阳性(33.3%)。复查结果:15例患儿中13例获得随访,其中7例恢复正常,5例明显改善,1例无改善。结论 ATP负荷SPECT心肌灌注显像能无创、直观地显示川崎病患儿心肌缺血,对川崎病心肌缺血的诊断和随访有一定的临床价值。
Objective To investigate the value of adenosine triphosphate load single photon emission computed tomography (SPECT) myocardial perfusion imaging in the diagnosis and follow-up of myocardial ischemia in children with Kawasaki disease. Methods 27 children with Kawasaki disease were divided into 3 groups: acute stage (15 cases), subacute stage (9 cases) and recovery stage (3 cases) according to the course of disease. According to the results of ultrasound, they were divided into coronary artery dilation (18 cases) Coronary artery dilation (n = 9) was performed in 2 groups and normal children (n = 8) as control group. ATP-loaded SPECT myocardial perfusion imaging and ultrasonography were performed in all cases. Most of the positive children were at 6 months or disappeared Review, and compared with clinical outcomes. Results The control group were all negative. Myocardial imaging was positive in 15 cases. There were 9 cases in acute phase, 5 cases in subacute stage and 1 case in convalescence stage. 12 cases were positive in expansion group (66.7%), 3 cases in non-expansion group %). Review results: Of the 15 children, 13 were followed up, 7 of them returned to normal, 5 were significantly improved, and 1 was not improved. Conclusions ATP-SPECT myocardial perfusion imaging can noninvasively and directly show myocardial ischemia in children with Kawasaki disease. It has certain clinical value in the diagnosis and follow-up of myocardial ischemia in Kawasaki disease.