超声心动图诊断感染性心内膜炎的意义

目的　探讨感染性心内膜炎 (IE)患者的超声心动图的特征性改变及诊断意义。方法　 17例IE患者进行了经胸超声心动图检查 ,探测赘生物的位置 ,大小 ,活动度及瓣膜功能。结果　男 11例 ,女 6例。平均年龄 3 4岁 (年龄范围 2～76岁 )。超声心动图检查发现 16例自身瓣膜和 1例人工瓣膜有赘生物形成 ,其中 7个二尖瓣 ,9个主动脉瓣和 1个三尖瓣上有赘生物。平均赘生物大小 0 .8cm (范围 0 .3～ 1.6cm)。血培养葡萄球菌 4例 ,链球菌 4例 ,类酵母菌 1例 ,血培养阳性率 5 3 %。住院期间 4例死亡 (2 3 % ) ,11例充血性心衰 (64 % ) ,6例体循环栓塞 (3 5 % ) ,4例接受了瓣膜置换术 (2 3 % )。结论　超声心动图检测IE声像图观察比较直观 ,尤其在血培养阴性的IE患者尤为有用。超声心动图能探测到瓣膜的赘生物 ,提示严重心衰 ,对于需要早期外科手术的IE患者提供重要依据

Assessment of Patients with Infectious Endocarditis by Echocardiography

Objective To discuss the specific features of echocardiography with infectious endocarditis (IE). Methods Seventeen patients in IE were examined by transthoracic echocardiography,and the vegetation size,extent,mobility and valvular function were evaluated. Results There were 11 male and 6 female patients,mean age 34 years old (range: 2-76 years). Echocardiography found vegetations in 16 native valves and 1 prosthetic alteration. There were 7 mitral,9 aortic,and 1 tricuspid valve vegetations,mean vegetation size was 0.8cm (extremes: 0.3-1.6cm). The etiology was determined as staphylococcus in 4 cases,streptococcus in 4 cases and mycosis in 1 case, sand the positive rate of the blood culture was 53%. In the course of hospitalization,4 of the patients died (23%), 11 developed congestive heart failure (64%),6 had systemic emboli (35%),and 4 accepted cardiac surgery (23%). Conclusion Echocardiography was very useful,particularly in the presence of negative blood cultures. Echocardiography can detect or suggest valvular vegetation in infective endocarditis and predicts severe heart failure or the need for early surgical management.