超声心动图诊断先天性心脏病合并感染性心内膜炎的价值

The value of echocardiography in the diagnosis of congenital heart disease associated with infectious endocarditis

目的探讨超声心动图在先天性心脏病(CHD)合并感染性心内膜炎(IE)中的诊断价值。方法分析16例CHD合并IE患者的超声心动图特点并与手术结果对照。结果超声心动图显示赘生物10例,最小0.5cm,最大2.0cm;其附着部位及大小与手术结果相符。超声诊断IE阳性率达62%(10/16)。赘生物超声漏诊6例,其中5例小于0.4cm。血培养阳性8例,阳性率50%(8/16)。结论超声心动图诊断心内原发畸形准确率高,对0.4cm以上的心内赘生物有较高的诊断敏感性及准确性;对瓣膜穿孔、关闭不全等IE并发症可作出准确判断,是CHD合并IE的主要诊断依据。

Objective To evaluate the diagnostic value of echocardiography in congenital heart disease（CHD） associated with infectious endocarditis （IE）. Methods Clinical data of 16 cases CHD associated with IE between January 2003 and December 2006 were retrospectively analyzed and compared with operation. Results Sixteen eases CHD were detected with echocardiography and all were consistent with the surgery. Vegetations which size ranged from 0.5 cm to 2.0 cm were detected in 10 eases. The vegetation attached portion, size, and with or without hemodynamie changes were correspondent to those of operation. Six cases were detected vegetations negatively while were found during the operation. The size of five of them were less than 0.4 cm. The positive examination rate of echocardiography （62%） was higher than that of the blood culture （50%）. Conclusion Echocardiography has high sensitivity and specificity in detecting vegetations sized above 0.4 cm and could provide valuable informations for valve complications.