全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Exploratory Study on the Use of Echocardiography Combined with Blood-Related Test Parameters in the Diagnosis and Treatment of Kawasaki Disease in Children

DOI: 10.4236/ojmi.2024.144017, PP. 158-170

Keywords: Echocardiography, Blood Indicators, Children, Kawasaki Disease, Heart

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objective: This study aims to explore the application of echocardiography combined with blood-related detection indicators in the diagnosis and treatment of Kawasaki disease in children, assessing the potential advantages of this combined diagnostic method for early diagnosis, disease monitoring, and evaluation of treatment efficacy, thereby providing more effective treatment strategies. Methods: The study included 50 children diagnosed with Kawasaki disease as the study group, and 50 children with upper respiratory infections as the control group. Both groups underwent echocardiographic examinations to assess cardiac structure and function, while monitoring changes in blood-related inflammatory markers. The differences in echocardiographic and blood-related indicators before and after treatment between the two groups were compared. Results: Echocardiography effectively assessed the cardiac structure and function of children with Kawasaki disease. It was found that the ejection fraction (EF) in the treatment group significantly decreased from 69.94 ± 5.93% before treatment to 65.70 ± 5.56% after treatment (P = 0.0019), while the control group showed no significant change (from 70.94 ± 6.27% to 69.18 ± 6.14%, P = 0.2073). The aortic diameter (AO) in the treatment group increased from 12.85 ± 2.77 mm to 13.17 ± 2.41 mm (P = 0.0000), while in the control group it decreased from 18.58 ± 6.66 mm to 17.64 ± 6.83 mm (P = 0.0000), indicating potential vascular remodeling. In terms of blood indicators, the C-reactive protein (CRP) in the treatment group significantly decreased from 65.82 ± 81.31 mg/L to 14.03 ± 17.94 mg/L (P = 0.028), while in the control group, CRP decreased from 30.66 ± 47.78 mg/L to 8.17 ± 11.71 mg/L (P = 0.0049). Other inflammatory markers, such as procalcitonin (PCT), also showed corresponding changes. Conclusion: This study demonstrates that echocardiography combined with blood-related detection indicators has significant application prospects in the diagnosis and treatment of Kawasaki disease in children. This combined diagnostic approach not only helps improve the diagnostic accuracy and treatment efficacy of Kawasaki disease but also offers new insights for individualized treatment. Further promotion and in-depth research of this combined diagnostic strategy will contribute to optimizing the clinical management of Kawasaki disease in children, improving patient prognosis and quality of life.

References

[1]  Newburger, J.W. and Takahashi, M. (2016) Kawasaki Disease. Journal of the American College of Cardiology, 67, 1731-1741.
https://doi.org/10.1016/j.jacc.2016.01.021
[2]  McCrindle, B.W., Rowley, A.H., Newburger, J.W., et al. (2017) Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals from the American Heart Association. Circulation, 135, e927-e999.
[3]  Friedman, K.G. and Gewitz, M. (2016) Myocarditis: A Review for the Practitioner. Pediatrics, 139, e20163439.
https://doi.org/10.1542/peds.2016-3439
[4]  Burns, J.C. (2019) Commentary: Early Intravenous γ-Globulin Treatment for Kawasaki Disease. Journal of Paediatrics and Child Health, 55, 405-406.
[5]  Singh, S., Jindal, A.K. and Pilania, R.K. (2017) Diagnosis of Kawasaki disease. International Journal of Rheumatic Diseases, 21, 36-44.
https://doi.org/10.1111/1756-185x.13224
[6]  Skulstad, H., Cosyns, B., Popescu, B.A., Galderisi, M., Salvo, G.D., Donal, E., et al. (2020) COVID-19 Pandemic and Cardiac Imaging: EACVI Recommendations on Precautions, Indications, Prioritization, and Protection for Patients and Healthcare Personnel. European Heart JournalCardiovascular Imaging, 21, 592-598.
https://doi.org/10.1093/ehjci/jeaa072
[7]  Lang, R.M., Badano, L.P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., et al. (2015) Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 28, 1-39.E14.
https://doi.org/10.1016/j.echo.2014.10.003
[8]  Nagueh, S.F., Smiseth, O.A., Appleton, C.P., Byrd, B.F., Dokainish, H., Edvardsen, T., et al. (2016) Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart JournalCardiovascular Imaging, 17, 1321-1360.
https://doi.org/10.1093/ehjci/jew082
[9]  Yancy, C.W., Jessup, M., Bozkurt, B., Butler, J., Casey, D.E., Colvin, M.M., et al. (2017) 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation, 136, e137-e161.
https://doi.org/10.1161/cir.0000000000000509
[10]  Thygesen, K., Alpert, J.S., Jaffe, A.S., Chaitman, B.R., Bax, J.J., Morrow, D.A., et al. (2018) Fourth Universal Definition of Myocardial Infarction (2018). Circulation, 138, e618-e651.
https://doi.org/10.1161/cir.0000000000000617
[11]  Newburger, J.W., Takahashi, M., Gerber, M.A., Gewitz, M.H., Tani, L.Y., Burns, J.C., et al. (2004) Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation, 110, 2747-2771.
https://doi.org/10.1161/01.cir.0000145143.19711.78
[12]  Eleftheriou, D., Levin, M., Shingadia, D., Tulloh, R., Klein, N. and Brogan, P. (2013) Management of Kawasaki disease. Archives of Disease in Childhood, 99, 74-83.
https://doi.org/10.1136/archdischild-2012-302841
[13]  Manlhiot, C., Yeung, R.S.M., Clarizia, N.A., Chahal, N. and McCrindle, B.W. (2009) Kawasaki Disease at the Extremes of the Age Spectrum. Pediatrics, 124, e410-e415.
https://doi.org/10.1542/peds.2009-0099
[14]  Dionne, A. and Dahdah, N. (2017) Myocarditis and Kawasaki Disease. International Journal of Rheumatic Diseases, 21, 45-49.
https://doi.org/10.1111/1756-185x.13219
[15]  Burns, J.C. and Franco, A. (2015) The Immunomodulatory Effects of Intravenous Immunoglobulin Therapy in Kawasaki Disease. Expert Review of Clinical Immunology, 11, 819-825.
https://doi.org/10.1586/1744666x.2015.1044980
[16]  Ha, K.S., Jang, G.Y., Lee, J., et al. (2016) Assessment of the 2004 American Heart Association Guidelines for Diagnosis of Kawasaki Disease in an Academic Medical Center. Korean Circulation Journal, 46, 830-836.
[17]  Kuo, H., Hsieh, K., Ming-Huey Guo, M., Weng, K., Ger, L., Chan, W., et al. (2016) Next-generation Sequencing Identifies Micro-RNA-Based Biomarker Panel for Kawasaki Disease. Journal of Allergy and Clinical Immunology, 138, 1227-1230.
https://doi.org/10.1016/j.jaci.2016.04.050
[18]  Burns, J.C. and Newburger, J.W. (2012) Genetics Insights into the Pathogenesis of Kawasaki Disease. Circulation: Cardiovascular Genetics, 5, 277-278.
https://doi.org/10.1161/circgenetics.112.963710
[19]  Tremoulet, A.H., Jain, S., Jaggi, P., Jimenez-Fernandez, S., Pancheri, J.M., Sun, X., et al. (2014) Infliximab for Intensification of Primary Therapy for Kawasaki Disease: A Phase 3 Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet, 383, 1731-1738.
https://doi.org/10.1016/s0140-6736(13)62298-9
[20]  McCrindle, B.W., Li, J.S., Minich, L.L., Colan, S.D., Atz, A.M., Takahashi, M., et al. (2007) Coronary Artery Involvement in Children with Kawasaki Disease: Risk Factors from Analysis of Serial Normalized Measurements. Circulation, 116, 174-179.
https://doi.org/10.1161/circulationaha.107.690875
[21]  Orenstein, J.M. and Baker, S.C. (2019). Kawasaki Disease: A Historical Perspective. Pediatrics, 143, e20183776.
https://doi.org/10.1542/peds.2018-3776
[22]  de Zorzi, A., Colan, S.D., Gauvreau, K., Baker, A.L., Sundel, R.P. and Newburger, J.W. (1998) Coronary Artery Dimensions May Be Misclassified as Normal in Kawasaki Disease. The Journal of Pediatrics, 133, 254-258.
https://doi.org/10.1016/s0022-3476(98)70229-x
[23]  Mavrogeni, S., Papadopoulos, G., Douskou, M., Kaklis, S., Seimenis, I., Baras, P., et al. (2004) Magnetic Resonance Angiography Isequivalent to X-Ray Coronary Angiography for the Evaluation of Coronary Arteries in Kawasaki Disease. Journal of the American College of Cardiology, 43, 649-652.
https://doi.org/10.1016/j.jacc.2003.08.052

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133