中国医学影像技术2024,Vol.40Issue(7) :968-972.DOI:10.13929/j.issn.1003-3289.2024.07.003

儿童感染性心内膜炎合并瓣膜损害超声心动图表现

Echocardiographic manifestations of infective endocarditis complicated with valve damage in children

徐丽媛 张红菊 李静雅 孙妍 杨娇 薛丽 刘国文 胡翼飞 马宁
中国医学影像技术2024,Vol.40Issue(7) :968-972.DOI:10.13929/j.issn.1003-3289.2024.07.003

儿童感染性心内膜炎合并瓣膜损害超声心动图表现

Echocardiographic manifestations of infective endocarditis complicated with valve damage in children

徐丽媛 1张红菊 1李静雅 1孙妍 1杨娇 1薛丽 1刘国文 1胡翼飞 2马宁1
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作者信息

  • 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中心心脏超声科,北京 100045
  • 2. 首都医科大学公共卫生学院,北京 100069
  • 折叠

摘要

目的 观察儿童感染性心内膜炎(IE)合并瓣膜损害超声心动图表现.方法 回顾性分析104例IE患儿,根据是否合并瓣膜损害及损害程度将其分为无损害组(n=34)、轻度损害组(n=39)及功能障碍组(n=31);比较3组一般资料及超声心动图资料,分析合并瓣膜损害IE患儿超声心动图特点.结果 3组合并其他先天性心脏病(即排除主动脉瓣二叶畸形)占比、住院期间栓塞事件发生率及左心系统心内膜炎发生率差异均有统计学意义(P均<0.05).两两比较,无损害组合并其他先天性心脏病占比高于、而左心系统心内膜炎发生率低于轻度损害组及功能障碍组(P均<0.05);无损害组住院期间栓塞事件发生率低于功能障碍组(P<0.05).70例存在瓣膜损害,其中以二尖瓣(30/70,42.86%)占比最高,多表现为瓣膜反流(63/70,90.00%).轻度损害组与功能障碍组瓣膜受累部位、瓣膜结构病变及瓣膜狭窄发生率差异均无统计学意义(P均>0.05).结论 儿童IE合并瓣膜损害多累及左心系统,栓塞事件风险高于无瓣膜损害者;超声心动图可作为评估瓣膜受累部位及损害程度的重要手段.

Abstract

Objective To observe the echocardiographic manifestations of infective endocarditis(IE)complicated with valve damage in children.Methods Totally 104 children with IE were retrospectively enrolled and divided into non-damage group(n=34),mild damage group(n=39)and dysfunction group(n=31)according to whether complicated with valve damage and damage's degree.The general and echocardiographic data were compared among groups,and the echocardiographic characteristics of IE complicated with valve damage in children were analyzed.Results Significant difference of the proportion of combining with other congenital heart diseases(excluding bicuspid aortic malformations),the incidence of embolization events during hospital stay,also of endocarditis of left cardiac system were found among groups(all P<0.05).Pairwise comparison showed that in non-damage group,the proportion of combining with other congenital heart diseases was higher,while the incidence of endocarditis of left cardiac system was lower than those in both mild damage group and dysfunction group(all P<0.05).The incidence of embolization events during hospital stay in non-damage group was lower than that in dysfunction group(P<0.05).Among 70 cases of IE complicated with valve damage,mitral valve(30/70,42.86%)was the most common involved valve,mostly presented as valve stenosis(63/70,90.00%).No significant difference of valve involvement site,valve structural lesions nor the incidence of valve stenosis was found between mild damage group and dysfunction group(all P>0.05).Conclusion IE complicated with valve damage in children mostly involved left cardiac system,and the risk of embolization events was higher than that of IE children without valve damage.Echocardiography could be used as an important method for evaluating the site of valve involvement and the degree of damage.

关键词

心内膜炎,细菌性/心脏瓣膜/儿童/超声心动描记术

Key words

endocarditis,bacterial/heart valves/child/echocardiography

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基金项目

首都卫生发展科研专项(首发2022-1G-4262)

北京市自然科学基金(7202046)

出版年

2024
中国医学影像技术
中国科学院声学研究所

中国医学影像技术

CSTPCD北大核心
影响因子:0.763
ISSN:1003-3289
参考文献量3
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