超声心动图在诊断不合并先天性心脏病儿童感染性心内膜炎中的临床应用价值  

The Value of Echocardiography in the Diagnosis of Infective Endocarditis in Children without Congenital Heart Disease

作　　者：徐丽媛 张红菊 孙妍[1] 李静雅[1] 杨娇 刘国文 马宁[1] Xu Liyuan;Zhang Hongju;Sun Yan;Li Jingya;Yang Jiao;Liu Guowen;Ma Ning(Department of Echocardiography,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院心脏超声科,北京市100045

出　　处：《中国超声医学杂志》2024年第4期427-430,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都卫生发展科研专项(No.首发2022-1G-4262);北京市自然科学基金(No.7202046)。

摘　　要：目的探讨超声心动图诊断不合并先天性心脏病(CHD)儿童感染性心内膜炎(IE)的临床应用价值。方法回顾性分析住院确诊的不合并CHD儿童IE的临床及超声心动图特征。结果共42例患儿纳入研究,其中男性24例,女性18例,平均年龄(7.09±4.27)岁。临床表现发热最常见。血培养阳性32例(76.2%),其中金黄色葡萄球菌22例。39例(92.9%)超声心动图提示赘生物,其中位于左心31例,右心7例,累及双心系统1例。赘生物多位于瓣膜,21例累及二尖瓣。37例患儿出现瓣膜反流,1例患儿出现瓣膜轻度狭窄。内科治疗后超声发现赘生物减小或消失16例。结论超声心动图能够为不合并CHD儿童IE的早期诊断、临床治疗的效果监测提供重要的科学依据。Objective To explore the clinical value of echocardiography in the diagnosis of infective endocarditis(IE)in children without congenital heart disease(CHD).Methods The clinical data and echocardiographic characteristics of IE in children without CHD who were diagnosed during hospitalization were retrospectively analyzed.Results A total of 42 children were included in the study,including 24 males and 18 females,with an average age of(7.09±4.27)years.Fever was the most common clinical manifestation.Blood cultures were positive in 32 cases(76.2%),including 22 cases of Staphylococcus aureus.Echocardiography indicated vegetations in 39 cases(92.9%),which was located in the left heart in 31 cases,the right heart in 7 cases,and the bilateral system in 1 case.Most of vegetations were located on the valves,and mitral valve was involved in 21 cases.Valvular regurgitation occurred in 37 children and mild stenosis occurred in 1 child.After medical treatment,ultrasound showed that the vegetations decreased or disappeared in 16 cases.Conclusions Echocardiography can provide an effective basis for the early diagnosis,clinical treatment and prognosis of IE in children without CHD.

关 键 词：感染性心内膜炎 儿童 超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病] R725.4[医药卫生—内科学]