摘要
目的探究MRI、血培养联合经胸心脏超声诊断感染性心内膜炎(IE)的临床价值。方法回顾性选取2016年1月至2018年6月本院收治的134例IE患者作为研究对象,所有患者均具有MRI、血培养、经胸心脏超声诊断及预后资料;观察MRI和经胸心脏超声对IE患者不同大小赘生物和不同位置赘生物的检出率,并分析血培养的病原菌分布特点,比较3种方式的诊断正确率。结果在赘生物检出率上,经胸心脏超声检出率为93.28%,显著高于MRI的72.39%,差异有统计学意义(P<0.05);经胸心脏超声对≤5 mm的赘生物检出率为27.61%,显著高于MRI的11.94%,差异有统计学意义(P<0.05);而不同位置的赘生物检出中,经胸心脏超声对主动脉瓣、肺动脉瓣赘生物的检出率分别为14.93%、11.94%,均显著高于MRI检出的5.97%、2.99%,差异均有统计学意义(均P<0.05);在血培养检查中,病原菌检出率为61.19%,病原菌以革兰氏阳性菌为主,占53.66%。3种方式联合诊断的准确率为98.51%,均显著高于经胸心脏超声、MRI和血培养的93.28%、72.39%、61.19%,差异有统计学意义(均P<0.05)。结论MRI、血培养联合经胸心脏电动图应用于IE患者中,提高了赘生物部位及检出率,并提供了更多的心功能和病原微生物信息,而帮助临床医师制定更为有效的干预手段。
Objective To explore the clinical value of MRI,blood culture,and transthoracic cardiac ultrasound in the diagnosis of infective endocarditis(IE).Methods 134 IE patients admitted to our hospital from January,2016 to June,2018 were retrospectively selected as the study objects.All the patients had the data of MRI,blood culture,and transthoracic ultrasound diagnosis as well as of prognosis.The detection rates of vegetations of different sizes and different locations by MRI and the chest cardiac ultrasound were observed.The pathogenic bacteria distribution characteristics of blood culture were analyzed.The diagnostic accuracies of the three methods were compared.Results The detection rate of transthoracic echocardiography was 93.28%,and was significantly higher than that of MRI(72.39%;P<0.05).The detection rate of transthoracic echocardiography for vegetation less than 5 mm was 27.61%,and was significantly higher than that of MRI(11.94%;P<0.05).The detection rates of aortic and pulmonary valve vegetations by transthoracic echocardiography were 14.93%and 11.94%,respectively,which were significantly higher than those of MRI(5.97%and 2.99%;both P<0.05).In blood culture examination,the detection rate of pathogens was 61.19%;Gram-positive bacteria were the main pathogens,accounting for 53.66%.The combined diagnostic accuracy of the three methods was 98.51%,which was significantly higher than those of transthoracic echocardiography,MRI,and blood culture(93.28%,72.39%,and 61.19%;all P<0.05).Conclusion The application of MRI and blood culture combined with transthoracic electrocardiogram for IE patients has improved the detection rate of vegetation sites and provided more information on cardiac function and pathogenic microorganisms,and helped clinicians to develop more effective interventions.
作者
张志洁
王建美
王丹萍
Zhang Zhijie;Wang Jianmei;Wang Danping(Dezhou People's Hospital,Dezhou 253000,China)
出处
《国际医药卫生导报》
2019年第23期3895-3898,共4页
International Medicine and Health Guidance News
关键词
感染性心内膜炎
MRI
血培养
经胸心脏超声
Infective endocarditis
MRI
Blood culture
Transthoracic cardiac ultrasound
作者简介
通信作者:张志洁,Email:yuyandy@sina.com。
