经胸超声心动图对人工瓣膜心内膜炎的诊断价值  

Diagnostic Value of Transthoracic Echocardiography For Prosthetic Valve Endocarditis

作　　者：王斯宇 谷孝艳[1] 郭建华 阮燕萍[1] 何怡华[1] Wang Siyu;Gu Xiaoyan;Guo Jianhua;Ruan Yanping;He Yihua(Department of Echocardiography,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院超声心动科二部,北京市100029

出　　处：《中国超声医学杂志》2020年第2期128-131,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京市医院管理局临床医学发展专项基金(No.XMLX201604);首都卫生发展科研专项基金(No.2016-1-2061);北京市科学技术委员会基金(No.Z181100001918008)。

摘　　要：目的评估经胸超声心动图诊断人工瓣膜心内膜炎的价值。方法收集符合Duck标准的人工瓣膜心内膜炎的患者33例,所有患者术前均行经胸超声心动图检查,回顾性分析33例患者的经胸超声心动图特征,并与手术病理结果进行对比。结果经胸超声心动图结果显示,人工瓣膜心内膜炎的主要表现有赘生物21例,瓣周漏14例,瓣叶狭窄9例,瓣周脓肿8例。经胸超声心动图诊断赘生物、瓣周漏、瓣周脓肿的灵敏度、特异度、误诊率、漏诊率分别为76.92%(20/26)、85.71%(6/7)、14.29%(1/7)、23.08%(6/26),100%(13/13),95%(19/20)、5%(1/20)、0(0/13)和54.54%(6/11)、90.91%(20/22)、9.09%(2/22)、45.45%(5/11)。结论经胸超声心动图诊断人工瓣膜心内膜炎赘生物及瓣周漏的灵敏度和特异度均较高,诊断瓣周脓肿的特异度较高而灵敏度低。Objective To evaluate the diagnostic value of transthoracic echocardiography for prosthetic valve endocarditis.Methods Totally 33 patients with prosthetic valve endocarditis was confirmed by Duck criteria.Among 33 patients,all of them underwent transthoracic echocardiography.The echocardiographic characteristics of 33 patients were retrospectively analyzed and compared with those of surgical pathology.Results The main echocardiography characteristics were vegetation in 21,perivalvular leak in 14,perivalvular abscess in 8 and stenosis in 9.Compared with surgical pathology showed that the sensitivity,specificity,false positive rate,false positive rate of transthoracic echocardiography in diagnosis of vegeration,perivalvular abscess,perivalvular leak was 76.92%(20/26),85.71%(6/7),14.29%(1/7),23.08%(6/26);54.54%(6/11),90.91%(20/22),9.09%(2/22);45.45%(5/11),100%(13/13),95%(19/20),5%(1/20),0(0/13),respectively.Conclusions The sensitivity and specificity of transthoracic echocardiography in the diagnosis of vegetations and periprosthetic leakage in patients with prosthetic valvular endocarditis both high,the specificity in the diagnosis of perivalvular abscess is high and the sensitivity in the diagnosis of in patients is low.

关 键 词：人工瓣膜心内膜炎 经胸超声心动图 

分 类 号：R542.41[医药卫生—心血管疾病] R540.45[医药卫生—内科学]