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法洛四联症合并亚急性感染性心内膜炎的超声诊断分析
周文霞,钟雪梅,唐红,赁可
0
(四川大学华西医院心内科超声心动图室,四川 成都 610041;四川大学华西医院胸心血管外科,四川 成都 610041)
摘要:
目的 探讨法洛四联症(TOF)合并亚急性感染性心内膜炎(SIE)的临床特点和超声诊断价值。方法 对1例多年前诊断为TOF的青年男性患者,后无明显诱因下出现左侧肢体无力,肘关节无法活动,无明显发烧等症状。超声心动图检查示先天性心脏病TOF,主动脉瓣见异常回声团,反复血培养查见少许金黄色葡萄球菌。结果 术后诊断为先天性心脏病TOF合并SIE,主动脉上赘生物形成。病理报告示主动脉瓣膜纤维组织增生、玻璃样变及粘液样变,符合亚急性感染性心内膜炎改变。结论 TOF合并SIE较为罕见,当SIE临床症状不典型,血培养阳性率较低,超声心动图是诊断此类疾病的主要依据和重要手段,可为临床早期诊断、选择治疗方案和评估预后提供重要信息。
关键词:  法洛四联症(TOF)  亚急性感染性心内膜炎(SIE)  超声心动图  诊断
DOI:
基金项目:四川省科技厅科研基金(TXKY2016001)
Diagnosis of TOF with SIE using echocardiography
ZHOU Wenxia,ZHONG Xuemei,TANG Hong,DIAN Ke
(Department of Cardiology and Echo Lab, West China Hospital, Sichuan University, Chengdu 610041, China;Department of Cardiovascular Surgery, West China Hospital, Sichuan University,Chengdu 610041, China)
Abstract:
Objective To explore the characteristics in clinic and the value of Echo diagnosis of TOF with SIE. Methods A young male patient was diagnosed TOF many years ago. Later, no obvious factors appear on the left side of the body lack of power, and elbow can,t activities. Recently, he was no obvious history of fever. Echocardiography (echo) diagnosis: CHD TOF, the abnormal hyperechogenicity on aortic valve. Results Postoperative Diagnosis: CHD TOF merger SIE, aorgic valve with vegetations. Pathological Report: Fibrous tissue hyperplasia of the aortic valve, hyaline degeneration and myxoid degeneration. Conform to the change of the SIE. Conclusion TOF with SIE is very rare. When sometimes SIE has not typical clinical symptoms, the positive rate of blood culture is also low. Echocardiography examination can give a clear early and an important diagnosis,which can guide clinical early diagnosis, provide important information to select a treatment and evaluate prognosis.
Key words:  TOF  SIE  Echocardiography  Diagnosis

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