摘要
目的分析南方医科大学南方医院近10年收治的112例感染性心内膜炎(IE)的流行病学、临床表现、致病菌及治疗、预后等临床特点,总结IE的变化。方法对近10年本院收治的112例IE患者的诊治过程进行回顾性分析。结果 112例患者平均年龄46±17.1岁,其中70例(62.5%)存在各种基础心脏病,按发病高低依次为风湿性心脏病32例(28.6%),先天性心血管畸形22例(19.6%),老年性瓣膜退行性变16例(14.3%)。临床表现包括发热(93.8%)、贫血(77.7%)、充血性心衰(33.0%)、栓塞现象(32.1%)等。超声心动图提示瓣膜或心内膜赘生物105例(93.8%)。血培养阳性者61例(58.1%),按检出率高低依次为链球菌(23例)、葡萄球菌(22例)等。91例经治疗后痊愈或好转出院,10例放弃治疗出院,11例死亡,死亡原因为充血性心衰(8例)、肺栓塞(2例)及脑出血(1例)。结论 IE的流行病学、易感因素、致病菌等发生了变化,临床表现多样,病死率仍较高,需临床医生提高警惕。
Objective To analyze the clinical manifestations, epidemiological features, pathogens, treatment and outcomes of 112 patients with infectious endocarditis. Methods The clinical data were reviewed for all the patients with the diagnosis of infectious endocarditis in Nanfang Hospital over the period from 2002 to 2012. Results The average age of disease onset was 46 ± 17.1 years among these cases. Seventy patients （62.5%） had underlying cardiac conditions, including, in the order of frequenc）5 rheumatic heart disease, congenital cardiovascular anomalies, and senile valve degeneration. Clinically the patients presented with fever, anemia, congestive heart failure, and embolism events, etc. Echocardiography found endocardial neoplasms in 105 Cases, and the mitral valve was often involved. Blood culture yielded positive results in 61 cases, and the most common causative bacteria were Streptococcus （20.5%）, Staphylococcus （19.6%） and Enterococcus （5.4%）. Surgical intervention was performed in 78 cases. Ninety-one patients were cured or improved after comprehensive treatment, and 10 discontinued treatment for financial reasons; 11 died of cardiac failure （8 cases）, pulmonary embolism （2 cases） and central nervous system events （1 case）. Conclusion Infectious endocarditis shows a significant change in the clinical profiles and its mortality remains high despite improved diagnostic and therapeutic procedures.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2013年第2期279-281,共3页
Journal of Southern Medical University
基金
国家自然科学基金(81172057)~~
