超声心动图在感染性心内膜炎诊断中的应用价值

The value of echocardiography in the diagnosis of infective endocarditis

目的:分析感染性心内膜炎(infective endocarditis,IE)的超声心动图特点,探讨超声心动图在IE诊断中的应用价值。方法:收集我院收治的45例经外科手术确诊的IE患者资料,分析其临床特点及超声心动图表现。结果:45例患者术前经胸超声心动图均提示IE。其中非风湿性瓣膜病34例(75.6%)、先天性心脏病4例(8.9%)、既往人工瓣膜置换术后4例(8.9%)、风湿性心脏瓣膜病1例(2.2%)、肥厚型心肌病1例(2.2%)、无基础心脏疾病1例(2.2%),仅累及二尖瓣、主动脉瓣分别为18例(40.0%)、15例(33.3%),同时累及二尖瓣、主动脉瓣10例(22.2%),同时累及主动脉瓣、三尖瓣1例(2.2%),同时累及二尖瓣、主动脉瓣及肺动脉瓣1例(2.2%)。并发症中伴瓣膜穿孔15例(33.3%),伴腱索断裂6例(13.3%),脓肿形成4例(8.9%),瓣周瘘1例(2.2%)。结论:超声心动图是早期诊断IE的首选无创检查方法,对临床的治疗和决策有重要意义。

Objective:To analyze the echocardiographic features of infective endocarditis(IE)and explore the di-agnostic value of echocardiography in IE.Methods:Data from 45 patients with surgically confirmed IE were retrospec-tively collected,and their clinical characteristics and echocardiographic findings were analyzed.Results:Preoperative transthoracic echocardiography in all 45 patients indicated IE.Among them,non-rheumatic valvular disease was present in 34 cases(75.6%),congenital heart disease in 4 cases(8.9%),postoperative prosthetic valve replacement in 4 cases(8.9%),rheumatic heart valve disease in 1 case(2.2%),hypertrophic cardiomyopathy in 1 case(2.2%),and no un-derlying heart disease in 1 case(2.2%).Involvement of only the mitral valve and aortic valve occurred in 18 cases(40.0%)and 15 cases(33.3%),respectively.Simultaneous involvement of both the mitral and aortic valves was ob-served in 10 cases(22.2%),while simultaneous involvement of the aortic and tricuspid valves occurred in 1 case(2.2%).Simultaneous involvement of the mitral,aortic,and pulmonary valves was observed in 1 case(2.2%).Compli-cations included valve perforation in 15 cases(33.3%),chordal rupture in 6 cases(13.3%),abscess in 4 cases(8.9%),and peripetalous leakage in 1 case(2.2%).Conclusion:Echocardiography is the preferred non-invasive diag-nostic method for early detection of IE,and it holds significant importance for clinical treatment and decision-making.