感染性心内膜炎的临床特点和超声心动图诊断

目的 :探讨感染性心内膜炎 (IE)的临床特点和超声心动图的诊断价值。方法 :对 78例IE患者作超声心动图检查 ,结合临床资料进行分析。结果 :临床资料 ,发热 6 5例 (83 3 % )、脾肿大 41例 (5 2 6 % )、栓塞 15例 (19 2 % )。6 5例作血培养 ,16例培养阳性 ,占 2 4 6 % (16 /6 5 ) ;超声心动图检查 ,有基础心脏病者 6 6例 ,占 84 6 % (6 6 /78) ;发现赘生物 5 1例 ,占 6 5 4% (5 1/78) ,死亡 7例 ,占 9 0 % (7/78)。结论 :由于IE患者典型的临床表现、血培养阳性减少 ,给诊断带来困难 ,延误治疗。超声心动图对IE不仅可提供病因、病理诊断 ,而且能对其并发症及预后作出判断 ,有较高的应用价值。

THE CLINICAL CHARACTER OF INFECTIVE ENDOCARDITIS AND THE DIAGNOSTIC VALUE OF ECHOCARDIOGRAPHY

Objective:To study the clinical character of infective endocarditis (IE) and the diagnostic value of echocardiography to IE.Methods:The clinical and echocardiographic information of 78 patients was analysed.Results:Basic heart diseases in 66 patients (84.6%) and vegetations in 51 patients (65.4%) were found.A total of 65 blood bacterial culture studies were porformed,and positive only in 16 cases (24.6%).The incidence of fever,enlarged spleen,embolism and death was 83.8%,52.6%,19.2% and 9.0% respectively.Conclusion:The decrease of positive blood culture and lack of typical symptoms make it diffcult to diagnose IE and then delay treatment.Echocardiography can provide etiological and pathological diagnose for IE.As a valuable tool,it can also assess the complications and prognosis.