经食道超声心动图对感染性心内膜炎合并瓣周脓肿诊断价值的临床报道

A clinical report of the value for diagnosis infective endocarditis plus perivalvular abscess by transesophageal echocardiography

目的：评价经食道超声心动图对感染性心内膜炎及其合并症的诊断价值.方法：对临床已确诊为感染性心内膜炎患者运用经食道超声心动图与经胸超声心动图探测,以病理检测作为金标准,比较两者诊断心内膜受累各种病理变化的敏感性和特异性.结果：检测心脏瓣膜上赘生物时,TTE的敏感性为65%,TEE的敏感性为85%~95%.检测置换瓣膜上的赘生物时,TTE的敏感性为15%~35%,TEE的敏感性为82%~95%.经食管超声心动图探查能更清晰地显示出微小赘生物及其他心内膜受累各种病理变化情况,提高了诊断的敏感性.结论：经食道超声能更清晰地显示出赘生物及其他心内膜受累各种病理变化情况,对感染性心内膜炎的诊断有重要的意义.

Objective： To evaluate the value for diagnosis infective endocarditis plus heart valve abscess by transesophageal echocardiography. Methods： Patients with infective endocarditis in clinic were surveyed by transesophageal echocardiography or transthoracic echocardiography. Based on pathological examination as the gold standard, the sensitivity and specificity of various pathological changes in patients by different detection methods were compared. Results： When there was vegetation on heart valves, TTE sensitivity was 65%; TEE sensitivity was 85%~95%. When there was vegetation on the valve replacement,TTE sensitivity was 15%~35%; TEE sensitivity was 82%~95%. Transesophageal echocardiography showed small vegetation and various pathological changes of other endocardials more clearly, and could improve the sensitivity of diagnosis. Conclusion： There is important clinical significance for the diagnosis of infective endocarditis by transesophageal echocardiography.