| Background: KD is a kind of acute vasculitis syndrome more happened inchildren。Coronary artery lesion is the predominant complication。So thediagnosis of coronary artery lesion in children with KD is particularlyimportant. Now the Ultrasound echocardiography is still the major method. Thepublished criteria by the Japanese Ministry of Health criteria that specificallydefine coronary artery abnormality in KD has been used for a long time. Manystudies found that with the increase of the height and weight, the Coronaryartery diameters are increased. The Coronary artery diameters correlatedlinearly with body surface area. So the method of Z score should be used forthe diagnosis of coronary artery lesion.Objective: The aim of this study was to find the best model to obtain validand normally distributed Z scores for coronary artery (CA) diameters in a large,heterogeneous population of healthy children. After that, we calculate the Zscore of the Coronary artery diameters, and then compare the two criteria toanalysis the feasibility and the superiority of Z score used in KD.Methods:1.This study was conducted from Oct.2011to Oct.2013．Thehealthy children who admitted in the First Bethune Hospital of Jilin Universitywere subjected to this study. The diameters of left coronary artery， right coronary artery were measured by color doppler ultrasonic diagnosticapparatus. The body surface area was got according to the height and weight.The date was processed by regression analysis in order to get the best model.Finally, we get the Equation of CoronaryArtery Z Scores based on the original equation of Z scores.2. The childrenwho were diagnosed with KD in the First Bethune Hospital of Jilin Universityfrom Oct.2010to Oct.2013were subjected to this study. The diameters of leftcoronary artery, right coronary artery were measured by color dopplerultrasonic diagnostic apparatus. The body surface area was got according to theheight and weight. We calculate the Z score of each other and then compare thetwo criteria.Results:1. A total of1036cases of normal children included,501of themare male(48.31%) and536of them are female(51.69%). The age of childrenvaried from0.1years to15years. The average age was6.32±3.76year.Theheight varied from55to183cm. The average height was114.25±25.84cm. Theweight varied from4.35～97kg. The average weight was20.00±12.61Kg. Bycomparison, we found the Coronary artery diameters are closed with BSA.2.CA diameter was best predicted using regression with the square root of bodysurface area. We got the final equation as follow: Z （LCA）=X-（0.317+2.162×BSA）/0.243，Z（RCA）=X-（0.177+2.023×BSA）/0.236。The number of the patients who was diagnosed KD was282. The age ofchildren varied from0.12years to14.30years. The average age was2.75±2.17. 176of them(62.54%) were less than3years,70of them(62.54%) were from3to5years,36of them(24.73%) were more than5years. Male were177(66.90%), female were105(37.1%). The ratio of male and female was1.7to1. Based on the Japanese Ministry of Health measurement criteria,51ofpatients (18.02%)were classified as having coronary artery abnormalities.There were significant differences between each group (P＜0.05)．The methodof Z scores can increase the diagnosis rate of coronary abnormalities in eachgroup．Conclusions:1. Coronary artery lesion with KD more happened in thechildren less than3years. The males are more than females.2. The use of Zscore can raise the rate of positive diagnosis of Coronary artery lesion in orderto avoid misdiagnose. |
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