RESUMO
Objective To compare the diagnostic results and values among Duke criteria,St Thomas criteria,the modified Duke criteria and domestic criteria for the diagnosis of infective endocarditis (IE) in children.Methods Forty-five children were clinically diagnosed IE,the surgical or the pathologic or autopsy findings were served as the golden criteria for the diagnosis of IE.The children were classified by Duke criteria,St Thomas criteria,the modified Duke criteria and domestic criteria respectively,so as to compare the sensitivity and specificity and accuracy of all criteria for the diagnosis of IE.Results During the forty-five children were clinically diagnosed IE,of whom 32 cases with IE were confirmed by the surgical or the pathologic or autopsy findings; 13 cases were ruled out from the diagnosis of IE.The specificity of Duke criteria,the modified Duke criteria and domestic criteria were all 100％,but the specificity were 92.3％ in St Thomas criteria for the 45 cases with clinically diagnosed IE and 26 cases with negative blood culture.For the children with clinically diagnosed IE,the sensitivity and the accuracy were 90.6％ and 93.3％ in domestic criteria,62.5％ and 73.3％ in Duke criteria and the modified Duke criteria,87.5％ and 88.9％ in St Thomas criteria.For the children with negative blood culture,the sensitivity and the accuracy were 76.9％ and 88.5％ in domestic criteria,7.7％ and 53.8％ in Duke criteria and the modified Duke criteria,69.2％ and 80.8％ in St Thomas criteria.The Youden index had no significant difference among domestic standard and Duke standard,Duke modified standard,St Thomas standard for children clinically diagnosed IE (P ＞ 0.05) ; however,the significant difference of the Youden index among domestic standard and Duke standard,Duke modified standard for children with negative blood culture were found(P ＜ 0.01),no significant difference of the Youden index between domestic standard and St Thomas standard was found (P ＞ 0.05).Conclusions With the addition of echocardiographic evidence of endocardial involvement,2 minor criteria as definite diagnostic criteria and some clinical minor criteria,the sensitivity and accuracy of the domestic criteria is superior to those of the Duke criteria,St Thomas criteria and the modified Duke criteria,and the domestic criteria is more suitable for the diagnosis of IE in Chinese children.