河北医学
河北醫學
하북의학
HEBEI MEDICINE
2015年
11期
1795-1798
,共4页
超声心动图%感染性心内膜炎%临床诊断
超聲心動圖%感染性心內膜炎%臨床診斷
초성심동도%감염성심내막염%림상진단
Echocardiography%Infective endocarditis%Clinical diagnosis
目的：探讨分析超声心动图对感染性心内膜炎患者临床诊断价值。方法：回顾性分析2009年1月至2015年1月我院收治的疑似为感染性心内膜炎患者64例，比较经胸超声心动图（ TTE）以及经食管超声心动图（ TEE ）对感染性心内膜相关并发症以及赘生物的检出情况，比较TTE与TEE诊断患者心内膜受累各种病理变化的特异性以及敏感性。结果：TTE 检出赘生物31例（48．44％）、TEE检出赘生物49例（76．56％），两种检测方式对赘生物的检出率具有统计学差异（P＜0．05）；TTE检出平均赘生物的大小显著低于TEE检出赘生物的大小（ P＜0．05）；在瓣周脓肿、瓣周漏、瓣膜穿孔、腱索断裂等感染性心内膜炎相关并发症检出方面，两种检测方式检出率无统计学意义（ P＞0．05）；若以TEE检测作为感染性心内膜炎诊断标准，则TTE检出敏感性为63．27％、TTE检出特异性为86．67％。结论：超声心动图对于感染性心内膜炎患者的诊断具有着重要的临床意义，其中TEE对感染性心内膜炎的检出更为敏感，但是TTE对也能够提供较为肯定的证据，目前仍是感染性心内膜炎患者诊断的首选手段。
目的：探討分析超聲心動圖對感染性心內膜炎患者臨床診斷價值。方法：迴顧性分析2009年1月至2015年1月我院收治的疑似為感染性心內膜炎患者64例，比較經胸超聲心動圖（ TTE）以及經食管超聲心動圖（ TEE ）對感染性心內膜相關併髮癥以及贅生物的檢齣情況，比較TTE與TEE診斷患者心內膜受纍各種病理變化的特異性以及敏感性。結果：TTE 檢齣贅生物31例（48．44％）、TEE檢齣贅生物49例（76．56％），兩種檢測方式對贅生物的檢齣率具有統計學差異（P＜0．05）；TTE檢齣平均贅生物的大小顯著低于TEE檢齣贅生物的大小（ P＜0．05）；在瓣週膿腫、瓣週漏、瓣膜穿孔、腱索斷裂等感染性心內膜炎相關併髮癥檢齣方麵，兩種檢測方式檢齣率無統計學意義（ P＞0．05）；若以TEE檢測作為感染性心內膜炎診斷標準，則TTE檢齣敏感性為63．27％、TTE檢齣特異性為86．67％。結論：超聲心動圖對于感染性心內膜炎患者的診斷具有著重要的臨床意義，其中TEE對感染性心內膜炎的檢齣更為敏感，但是TTE對也能夠提供較為肯定的證據，目前仍是感染性心內膜炎患者診斷的首選手段。
목적：탐토분석초성심동도대감염성심내막염환자림상진단개치。방법：회고성분석2009년1월지2015년1월아원수치적의사위감염성심내막염환자64례，비교경흉초성심동도（ TTE）이급경식관초성심동도（ TEE ）대감염성심내막상관병발증이급췌생물적검출정황，비교TTE여TEE진단환자심내막수루각충병리변화적특이성이급민감성。결과：TTE 검출췌생물31례（48．44％）、TEE검출췌생물49례（76．56％），량충검측방식대췌생물적검출솔구유통계학차이（P＜0．05）；TTE검출평균췌생물적대소현저저우TEE검출췌생물적대소（ P＜0．05）；재판주농종、판주루、판막천공、건색단렬등감염성심내막염상관병발증검출방면，량충검측방식검출솔무통계학의의（ P＞0．05）；약이TEE검측작위감염성심내막염진단표준，칙TTE검출민감성위63．27％、TTE검출특이성위86．67％。결론：초성심동도대우감염성심내막염환자적진단구유착중요적림상의의，기중TEE대감염성심내막염적검출경위민감，단시TTE대야능구제공교위긍정적증거，목전잉시감염성심내막염환자진단적수선수단。
Objective:To investigate the clinical diagnosis value of echocardiogram in patients with in-fective endocarditis .Method: The data of 64 patients with suspected infective endocarditis treated in our hospital between January 2009 and January 2015 were retrospectively analyzed , the detection of infective en-docarditis -associated complications and excrescences was compared by transthoracic echocardiography (TTE) and by transesophageal echocardiography (TEE), and the sensitivities and specificities of TTE and TEE in diagnosis of various pathological changes in patients with endocardium involved were compared .Re-sult:Excrescences were detected by TTE in 31 patients (48.44%) and by TEE in 49 patients (76.56%), and the difference in detection rate between the two detection methods was statistically significant ( P<0.05);the average size of excrescences detected by TTE was significantly smaller than that detected by TEE ( P<0. 05);the differences in detection rates of endocarditis -associated complications including perivalvular ab-scess , perivalvular leakage , perforation of cardiac valve and ruptured chordae tendineae by the two detection methods were statistically insignificant ( P>0.05); when taking TEE as the diagnostic criterion of infective endocarditis, the sensitivity and specificity of TTE detection were 63.27%and 86.67%, respectively.Con-clusion:Echocardiography has important clinical significances in diagnosis of infective endocarditis .TEE is more sensitive for the detection of infective endocarditis , but TTE can also provide positive evidence , and TTE is the first choice for diagnosis of infective endocarditis currently .
