Rao Xi, Lü Xiao-ju, Wang Xiao-hui
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Jan;38(1):47-51.
To compare the value of the new national criteria (2 major or one major plus 3 minor criteria) with the Duke criteria for diagnosis of infective endocarditis (IE).
A total of 205 patients with clinical diagnosis of IE admitted at West China Hospital of Sichuan University were included in this study. Among them, IE was pathologically confirmed in 97 patients. The sensitivities of both criteria for the diagnosis of IE were compared.
In 205 cases, the same microorganisms were detected twice in blood cultures in 13 cases (8.3%). Vegetations were detected by echocardiography in 183 patients (89.3%). In 97 cases with pathologically confirmed IE, the same microorganisms were detected twice in blood cultures in 6 cases (6.2%). Vegetations were detected by echocardiography in 89 patients (91.8%). IE diagnose was made in 44 (45.5%) and 86 (88.7%, P < 0.05 vs. Duke criteria) out of 97 pathologically confirmed IE patients by the Duke criteria and new national criteria, respectively. The specificities were 100% and 95.7% by Duke and new national criteria, respectively (P > 0.05).
With the addition of echocardiographic evidence of endocardial involvement and 2 minor criteria as definite diagnostic criteria, the sensitivity of the new national criteria is superior to that of the Duke criteria for diagnosing IE and the specificity for the diagnosis of IE between the two criteria is similar.
比较新的国家标准（2项主要标准或1项主要标准加3项次要标准）与杜克标准对感染性心内膜炎（IE）的诊断价值。
本研究纳入了四川大学华西医院收治的205例临床诊断为IE的患者。其中，97例患者经病理证实为IE。比较两种标准对IE的诊断敏感性。
205例患者中，13例（8.3%）血培养两次检测到相同微生物。183例（89.3%）患者经超声心动图检测到赘生物。97例病理证实为IE的患者中，6例（6.2%）血培养两次检测到相同微生物。89例（91.8%）患者经超声心动图检测到赘生物。97例病理证实为IE的患者中，分别有44例（45.5%）和86例（88.7%，与杜克标准相比P<0.05）依据杜克标准和新国家标准被诊断为IE。杜克标准和新国家标准的特异性分别为100%和95.7%（P>0.05）。
新国家标准增加了心内膜受累的超声心动图证据及2项次要标准作为明确诊断标准，其诊断IE的敏感性优于杜克标准，且两种标准诊断IE的特异性相似。
