| 毛善永,龚琳捷,张蓓,杨琳,付蕾.感染性心内膜炎伴心功能不全超声表现[J].中国医学影像技术,2022,38(1):64~67 |
| 感染性心内膜炎伴心功能不全超声表现 |
| Ultrasonic manifestations of infective endocarditis complicated with cardiac insufficiency |
| 投稿时间：2021-02-08 修订日期：2021-08-24 |
| DOI：10.13929/j.issn.1003-3289.2022.01.015 |
| 中文关键词: 心内膜炎, 细菌性 心脏功能试验 超声心动描记术 |
| 英文关键词:endocarditis, bacterial heart function tests echocardiography |
| 基金项目:国家自然科学基金(81960315) |
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| 中文摘要: |
| 目的 观察感染性心内膜炎(IE)伴心功能不全超声表现及其诊断价值。方法 回顾性收集98例IE伴心功能不全患者, 根据纽约心脏协会(NYHA)分级将其分为NYHA Ⅱ级组(n=30)、NYHA Ⅲ级组(n=43)及NYHA Ⅳ级组(n=25);对比3组临床及超声资料, 将组间差异有统计学意义的指标纳入logistic回归分析, 观察各指标与IE伴心功能不全的关系。结果 98例中, 45例血培养阳性(45/98, 45.92%), 其中24例(24/45, 53.33%)致病菌为甲型溶血性链球菌; 67例(67/98, 68.37%)合并心脏基础疾病, 其中19例(19/67, 28.36%)合并二叶主动脉瓣。经手术治疗后, 77例症状减轻, NYHA Ⅲ级组8例、NYHA Ⅳ级组13例死亡。3组合并瓣膜反流、赘生物累及多个瓣膜及瓣叶穿孔病例占比差异均有统计学意义(P均＜0.05), 且重度瓣膜反流、赘生物累及多个瓣膜及瓣叶穿孔是评估IE伴心功能不全分级的独立预测因素(P均＜0.05)。结论 IE伴心功能不全超声心动图可表现为重度瓣膜反流、赘生物累及多个瓣膜和瓣叶穿孔; 根据上述表现可预测其分级。 |
| 英文摘要: |
| Objective To observe ultrasonic manifestations of infective endocarditis (IE) complicated with cardiac insufficiency, and to assess the diagnostic value of these findings.Methods Totally 98 patients with IE complicated with cardiac insufficiency were enrolled and divided into New York Heart Association (NYHA) grade Ⅱ group (n=30), NYHA grade Ⅲ group (n=43) and NYHA grade Ⅳ group (n=25). The clinical and ultrasonic data were compared among 3 groups. Indexes being statistically different among 3 groups were enrolled in logistic regression analysis to observe the relationships of above indexes and IE complicated with cardiac insufficiency.Results Among 98 patients, positive blood culture test (45/98, 45.92%) was found in 45, and the pathogenic bacteria of 24 cases (24/45, 53.33%) was α-hemolytic streptococcus. Totally 67 cases (67/98, 68.37%) complicated with basic cardiac diseases, including 19 (19/67, 28.36%) complicated with bicuspid aortic valve. After surgical operation, the symptoms relieved in 77 cases, while 8 patients in NYHA grade Ⅲ group and 13 patients in NYHA grade Ⅳ group died. There were significant differences of the ratio of cases with valve regurgitation, vegetation involving multiple valves and valve leaflet perforation among 3 groups (all P < 0.05). Severe valve regurgitation, vegetation involving multiple valves and valve leaflet perforation were independent predictors of the classification of IE complicated with cardiac insufficiency (all P < 0.05).Conclusion IE might present as severe valve regurgitation, vegetation involving multiple valves and valve leaflet perforation on echocardiogram, which could be used to predict and grade IE complicated with cardiac insufficiency. |
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