中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
1期
47-51
,共5页
心内膜炎%细菌性%诊断%超声心动描记术
心內膜炎%細菌性%診斷%超聲心動描記術
심내막염%세균성%진단%초성심동묘기술
Endocarditis,bacterial%Diagnosis%Echocardiography
目的 评析Duke标准和试行标准对中国人感染性心内膜炎(infective endocarditis,IE)诊断的价值.方法 以Duke标准和中国试行标准对2004-2008年我院收治的205例临床诊断为IE及其中经病理证实的97例IE进行诊断评估,并比较两种标准对IE诊断的敏感性和特异性.结果 205例IE患者中,连续2次或2次以上血培养阳性并为相同致病菌13例(6.3%),超声心动图检出赘生物183例(89.3%);97例经病理证实病例中,连续2次或2次以上血培养阳性并为相同致病菌6例(6.2%),89例(91.8%)超声心动图检出赘生物.97例经病理证实病例中按Duke标准44例(45.5%)被确诊为IE.按中国试行标准,86例(88.7%)被确诊为IE,其中42例(43.3%)符合心内膜受累超声心动图征象加2项次要临床指标.97例经病理证实病例对Duke标准和中国试行标准诊断的敏感性分别为45.5%和88.7%(P<0.05),而特异性分别为100%和95.7%(P>0.05).结论 中国试行标准增加心内膜受累超声心动图征象和2项次要标准作为临床确诊条件对IE的诊断敏感性明显优于Duke标准,而特异性无明显差异.
目的 評析Duke標準和試行標準對中國人感染性心內膜炎(infective endocarditis,IE)診斷的價值.方法 以Duke標準和中國試行標準對2004-2008年我院收治的205例臨床診斷為IE及其中經病理證實的97例IE進行診斷評估,併比較兩種標準對IE診斷的敏感性和特異性.結果 205例IE患者中,連續2次或2次以上血培養暘性併為相同緻病菌13例(6.3%),超聲心動圖檢齣贅生物183例(89.3%);97例經病理證實病例中,連續2次或2次以上血培養暘性併為相同緻病菌6例(6.2%),89例(91.8%)超聲心動圖檢齣贅生物.97例經病理證實病例中按Duke標準44例(45.5%)被確診為IE.按中國試行標準,86例(88.7%)被確診為IE,其中42例(43.3%)符閤心內膜受纍超聲心動圖徵象加2項次要臨床指標.97例經病理證實病例對Duke標準和中國試行標準診斷的敏感性分彆為45.5%和88.7%(P<0.05),而特異性分彆為100%和95.7%(P>0.05).結論 中國試行標準增加心內膜受纍超聲心動圖徵象和2項次要標準作為臨床確診條件對IE的診斷敏感性明顯優于Duke標準,而特異性無明顯差異.
목적 평석Duke표준화시행표준대중국인감염성심내막염(infective endocarditis,IE)진단적개치.방법 이Duke표준화중국시행표준대2004-2008년아원수치적205례림상진단위IE급기중경병리증실적97례IE진행진단평고,병비교량충표준대IE진단적민감성화특이성.결과 205례IE환자중,련속2차혹2차이상혈배양양성병위상동치병균13례(6.3%),초성심동도검출췌생물183례(89.3%);97례경병리증실병례중,련속2차혹2차이상혈배양양성병위상동치병균6례(6.2%),89례(91.8%)초성심동도검출췌생물.97례경병리증실병례중안Duke표준44례(45.5%)피학진위IE.안중국시행표준,86례(88.7%)피학진위IE,기중42례(43.3%)부합심내막수루초성심동도정상가2항차요림상지표.97례경병리증실병례대Duke표준화중국시행표준진단적민감성분별위45.5%화88.7%(P<0.05),이특이성분별위100%화95.7%(P>0.05).결론 중국시행표준증가심내막수루초성심동도정상화2항차요표준작위림상학진조건대IE적진단민감성명현우우Duke표준,이특이성무명현차이.
Objective To compare the value of the new national criteria (2 major or one major plus 3 minor criteria) with the Duke criteria for diagnosis of infective endocarditis (IE). Methods A total of 205 patients with clinical diagnosis of IE admitted at West China Hospital of Sichuan University were included in this study. Among them, IE was pathologically confirmed in 97 patients. The sensitivities of both criteria for the diagnosis of IE were compared. Results In 205 cases, the same microorganisms were detected twice in blood cultures in 13 cases (8.3%). Vegetations were detected by echocardiography in 183 patients (89.3%). In 97 cases with pathologically confirmed IE, the same microorganisms were detected twice in blood cultures in 6 cases (6.2%). Vegetations were detected by echocardiography in 89 patients (91.8%). IE diagnose was made in 44 (45.5%) and 86 (88.7%, P < 0.05 vs. Duke criteria) out of 97 pathologically confirmed IE patients by the Duke criteria and new national criteria, respectively. The specificities were 100% and 95.7% by Duke and new national criteria, respectively (P > 0.05). Conclusion With the addition of echocardiographic evidence of endocardial involvement and 2 minor criteria as definite diagnostic criteria, the sensitivity of the new national criteria is superior to that of the Duke criteria for diagnosing IE and the specificity for the diagnosis of IE between the two criteria is similar.
