目的:研究超声心动图诊断小儿左冠状动脉起源于肺动脉(ALCAPA)的应用价值。方法:选择2009年3月~2013年12月在温岭市中医院接受治疗的ALCAPA患儿43例作为研究对象(观察组),另选同期诊断为心内膜弹力纤维增生症(EFE)的患儿42例作为对照组,对所有患儿实施超声心动图诊断,对比两组患儿左室射血分数(LVEF)、心内膜厚度及RCA主干和主动脉瓣的环比值(RCA/AO),观察两组二尖瓣反流的程度及心肌侧支情况,分析观察组超声等影像学表现。结果:观察组的LVEF及RCA/AO值水平均显著高于对照组,差异均有统计学意义(P均<0.05)。但两组在心内膜厚度方面对比,差异无统计学意义(P>0.05)。观察组二尖瓣反流的程度与对照组相比,差异无统计学意义(P>0.05),但观察组表现为心肌侧支血流,对照组则无此表现。左冠脉(LAC)开口自肺动脉的根部或者主干,LCA中连续低速且逆向的红色血流逐渐进至肺动脉中,此外均表现为侧支血流。结论:通过超声心动图对ALCAPA实施诊断,操作简单便捷,效果较好,但应明确ALCAPA的各类征象,从而做出正确合理的诊断。 Objective: To study the value of echocardiography in the diagnosis of pediatric left coronary artery originated from pulmonary artery (ALCAPA). Methods: Forty-three children with ALCAPA who were treated in Wenling Hospital of Traditional Chinese Medicine from March 2009 to December 2013 were selected as the observation group (observation group), and the other patients with concurrent diagnosis of endocardial fibroelastosis (EFE) Twenty-two children served as the control group. Echocardiography was performed on all children. Left ventricular ejection fraction (LVEF), endocardial thickness, and RCA / AO ratio of RCA trunk and aortic valve were compared between the two groups. The degree of mitral regurgitation and the status of myocardial collateral vessels were observed in two groups. The imaging findings such as ultrasound in the observation group were analyzed. Results: The levels of LVEF and RCA / AO in the observation group were significantly higher than those in the control group (all P <0.05). However, there was no significant difference in endocardial thickness between the two groups (P> 0.05). The degree of mitral regurgitation in observation group compared with the control group, the difference was not statistically significant (P> 0.05), but the observation group showed myocardial collateral flow, the control group did not show this performance. Left coronary artery (LAC) opening from the root or the main pulmonary artery, LCA continuous low velocity and reverse red blood flow gradually into the pulmonary artery, in addition to the performance of collateral blood flow. Conclusion: The diagnosis of ALCAPA by echocardiography is simple, convenient and effective, but all kinds of signs of ALCAPA should be clarified to make the correct and reasonable diagnosis.