超声心动图对临床表现不典型的感染性心内膜炎的诊断价值

Diagnostic value of echocardiography in clinical manifestations not typical of infective endocarditis

目的分析超声心动图对临床表现不典型的感染性心内膜炎的诊断价值。方法将2014年2月-2015年2月31例不典型的感染性心内膜炎患者纳入本次研究,回顾性分析其影像学资料,总结分析超声心动图检查结果。结果入组31例患者中20例明确伴有器质性心脏病基础,其中12例为先天性心脏病,8例为风湿性心脏病;其余11例患者无明确的心脏合并症,其中包括7例静脉吸毒患者;经外科手术证实者共计18例,18例手术患者超声心动图赘生物的检查情况与手术结果比较,超声心动图对赘生物大小、赘生物数量、赘生物部位等诊断准确率与手术证实比较差异无统计学意义（P〉0.05）,说明超声心动图对不典型感染性心内膜炎诊断率高。结论超声心动图可明确不典型性感染性心内膜炎患者的基础心脏病因,提供必要的诊断与鉴别诊断依据,对于本病治疗以及预后评估也具有极为重要的参考价值。

Objective To analyze the diagnostic value of echocardiography in clinical manifestations not typical of infective endocarditis. Methods 31 cases of patients with not typical of infective endocarditis from February 2014 to February 2015 were selected for the study, the imaging data were analyzed retrospectively. The results of echocardiography were summarized and analyzed. Results In the 31 cases,20 cases were associated with organic heart disease foundation,in which 12 cases were congenital heart disease, 8 cases were rheumatic heart disease, the remaining 11 cases without the clear heart complications, including 7 cases with intravenous drug use. 18 cases were surgically confirmed. Comparing the echocardiography vegetation inspection and operation result of the 18 cases, the accuracy and surgery of echocardiography in vegetation size, vegetation biomass and vegetation area showed that there was no statistical difference（P 〉0.05）, and this showed that the diagnostic rate of echocardiography in the diagnosis of atypical infective endocarditis was high. Conclusion Echocardiography could provide the necessary basis for diagnosis and differential diagnosis of underlying heart disease of patients with not typical of infective endocarditis, which also had a very important reference value for the treatment and prognosis of the disease.