Int J Cardiol:感染性心内膜炎的分子影像学诊断!

2017-11-10 xing.T MedSci原创

由此可见,18F-FDG和WBC对IE的诊断具有良好的敏感性,特异性和准确性。这两种方式在IE的筛查中都是有用的,并且在诊断不明确的情况下应该考虑采用这些手段。

感染性心内膜炎(IE)是严重的,可能危及生命的疾病。目前,改良后的Duke标准被用来辅助IE的诊断,但对其诊断仍然很难。越来越多的数据支持分子成像在辅助IE诊断上的潜在用途。近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员的目标是了解18F-氟脱氧葡萄糖(18F-FDG)正电子发射计算机断层扫描(PET-CT)、67Ga柠檬酸盐和放射性标记的白细胞(WBC)闪烁扫描在IE诊断中的潜在用途。

研究人员对IE诊断中使用的三种诊断方式的文献进行了荟萃分析和系统评价。研究人员通过文献检索,确定了2753篇文章。共有14项研究符合纳入标准(关于18F-FDG的研究有10项,关于WBC的研究有3项,关于两种方式的研究有1项)。没有关于使用67Ga柠檬酸盐的研究符合纳入标准。18F-FDG研究中合并的敏感性为81%(95%可信区间为73%-86%)和合并的特异性为85%(95%可信区间为78%-91%)。总体准确度良好,其曲线下面积(AUC)为0.897。 WBC诊断IE的合并灵敏度为86%(95%可信区间为77%-92%),特异性为97%(95%可信区间为92%-99%)。 WBC的总体准确性优良,其AUC为0.957。

由此可见,18F-FDG和WBC对IE的诊断具有良好的敏感性,特异性和准确性。这两种方式在IE的筛查中都是有用的,并且在诊断不明确的情况下应该考虑采用这些手段。

原始出处:

Daniel Juneaua, d,et al. Molecular Imaging for the diagnosis of infective endocarditis: A systematic literature review and meta-analysis.International Journal of Cardiology.2017.https://doi.org/10.1016/j.ijcard.2017.10.116

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  5. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Nov 10 13:03:33 CST 2017, time=2017-11-10, status=1, ipAttribution=)]
    2017-12-04 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

  6. 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channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31603, encryptionId=0dec316038d, topicName=分子影像)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73176737184, createdName=jwf_2003, createdTime=Sun Nov 12 01:39:00 CST 2017, time=2017-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260457, encodeId=31b526045e2a, content=学习学习.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat Nov 11 08:34:42 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260279, encodeId=16662602e9f3, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Nov 10 13:03:33 CST 2017, time=2017-11-10, status=1, ipAttribution=)]
    2017-11-12 1201e5c5m39暂无昵称

    学吸了

    0

  7. 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  8. 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  9. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Nov 10 13:03:33 CST 2017, time=2017-11-10, status=1, ipAttribution=)]
    2017-11-11 1dd8c52fm63(暂无匿称)

    学习学习.继续关注

    0

  10. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Fri Nov 10 13:03:33 CST 2017, time=2017-11-10, status=1, ipAttribution=)]
    2017-11-10 清风拂面

    很好的文章.谢谢分享

    0

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感染性心内膜炎(IE) 是一种致死性疾病, 虽然其治疗获得进展, 但死亡率仍居高不下并可导致各种严重并发症。2015年欧洲心脏病学会更新发布了感染性心内膜炎的管理指南,本文主要解读2015年欧洲心脏病学会关于左心系统感染性心内膜炎并发症治疗的指南。 作者: 首都医科大学大兴医院心内科 梁峰,北京大学人民医院心脏中心 胡大一,中国协和医科大学北京协和医院心内科 方全 沈珠军

Int J Cardiol:儿童感染性心内膜炎以及血栓栓塞并发症的发生率分析!

在研究期间,研究人员报道了在年龄较大的儿童中社区获得性IE的发病率正在上升,同时TEC的发病率也在上升。心力衰竭和赘生物与死亡率增加有关,这些初步数据需要通过前瞻性数据来确认。

Heart:预防性抗生素的使用真的能改善感染性心内膜炎的预后吗?

对于感染性心内膜炎患者的抗生素预防性使用(AP)一直存在争议。近日,在国际心血管权威杂志《Heart》上发表了一篇关于评估预防性抗生素的使用在细菌感染的预防或接受牙科手术的感染性心内膜炎患者中价值的荟萃分析。

EUR HEART J:先天性心脏病患者使用假体材料与感染性心内膜炎的发病率之间的关系!

外科手术的进展改变了先天性心脏病(ACHD)人群,然而,与手术相关的假体材料可能引起附加的感染性心内膜炎(IE)。近日,在心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员旨在全国范围内ACHD人群中,前瞻性地确定感染性心内膜炎(IE)的发病率、风险因素和预测因子,重点关注假体材料。

PLos One:庆大霉素在感染性心内膜炎治疗中的药代动力学模型

庆大霉素在个体之间的半衰期和分布体积(Vd)都有很大变化。因此,需要监测和准确预测其血清水平以优化药物的有效性并尽量减少其毒性。目前,有两种药代动力学模型用于预测成年人的庆大霉素剂量。但是,对于心内膜炎患者,最佳模型尚未可知。近期,一项发表在杂志PLos One上的研究旨在:1)为心内膜炎患者评估最佳模型;和2)评估心内膜炎和现有的模型是否可以准确预测出血清水平。此项研究进行了回顾性观察性两队列研