超声心动图在诊断感染性心内膜炎中的评价

本文对我院住院病人中确诊为感染性心内膜炎(IE)并经超声心动图(UCG)检查的43例进行分析。男33例、女10例,年龄13～58岁。赘生物发生于风湿性心脏病者占60%以上。以主动脉瓣赘生物最多见,占42.9%,其次为二尖瓣,占35.7%。M型UCG阳性检出率仅22％,二维UCG阳性检出率为76％,优于M型。 本组血培养阳性率仅26%,远不及UCG阳性检出率高。本组有5例临床表现不典型由UCG发现赘生物而首先提出IE的诊断,因此UCG对IE的诊断价值除了高于血培养外, 在临床表现较少时尚能提供重要的诊断线索。本组UCG提示有赘生物者预后较严重,栓塞并发症和死亡率均明显高于无赘生物者,与一般文献报道相同。本组资料尚未发现在赘生物的存在与心衰的发生间有统计学的相关性

EVALUATION OF ECHOCARDIOGRAPHY IN PATIENTS WITH INFECTIOUS ENDOCARDITIS

Echocardiograms of 43 hospitalized patients with Infectious Endocarditis (IE) were analyzed. There were 33 males, 10 females, aged 13-58. Vegetations were found in patients with rheumatic heart disease more than 60%. Aortic Valve Vegetations were most common(42.9%), mitral valve was the next(35.7%). The sensitivity of M-Mode UCG is only 22%, while that of 2-Dimensional echocardiography is 76%, which is higher than that of M-Mode.The positive rate of blood culture is only 26% in this group.The diagnostic value of blood culture in patients with IE is lower than that of UCG. In this group 5 cases were noticed as IE because the vegetations were found by UCG, however the clinical symptoms were atypical. Thus the diagnostic value of UCG in patients with IE is not only higher than that of the blood culture, but it also provide the important diagnostic clue in patients with fewer clinical symptoms of IE. The data of this group indicated that the prognosis of the patients with vegetations was more serious. Both the incidence of embolism and mortality in patients with vegetations were higher than that of the patients without vegetations. These results were compatible with the other essays.However, there was no statistically positive correlation found between the presence of vegetations and congestive heart failure in this group