感染性心内膜炎住院患者临床特点分析  

Clinical Feature Analysis of Infective Endocarditis in Hospital

作　　者：杨平[1] 胡健[2] 

机构地区：[1]辽宁中医药大学附属医院,沈阳110032 [2]中国医科大学附属一院,沈阳110032

出　　处：《中国医药导刊》2009年第8期1261-1263,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:通过对中国医科大学附属一院感染性心内膜炎(IE)住院患者的临床资料分析,探讨IE患者的临床特点及变化趋势。方法:对近20年67例IE的住院病例资料进行回顾性分析。将前后十年内的病例分为两组,对两组患者的流行病学特点、基础病因、临床表现及并发症等进行对比分析。结果:发病年龄有所增高。呼吸道感染为主要诱因。IE基础心脏病中,风湿性心脏病的比例(45.5%)有所下降,无基础性心脏病的比例(22.7%)增加。发热(80.6%)为IE最常见的临床表现及首发症状。心力衰竭(68.7%)、脏器血管栓塞(40.3%)是最常见、最严重的并发症,并发心力衰竭较过去十年明显下降(P<0.05)。血红蛋白下降(61.2%)、白细胞增高(50%)是本病常见的实验室所见。超声心动图赘生物检出率为67.2%,赘生物好发部位依次为主动脉瓣,二尖瓣,二尖瓣合并主动脉瓣。血培养阳性率为34.5%,金黄色葡萄球菌及表皮葡萄球菌占首位。结论:IE基础病因和致病菌较以往发生变化,早期诊断及时使用有效抗生素并选择合适的手术时机进行手术治疗是提高长期生存率的关键。Objective： To discuss infection endocarditis （ IE ） clinical characteristics changed trend by analyzing our hospital IE cases clinical data. Methods： We retrospectively analyzed this 20 years our hospital 67cases of IE clinical data. Divided 20 years cases to two sets, Analyzed and compared two sets patients epidemiologieal characteristic ,underlying disease, Clinical manifestation and complications of IE .Results： Data has shown age of onset raised up. The common inducing factor was respiratory infection .Among the underlying disease, The proportion of rheumatic heat disease was descend to 45.5%, The proportion of no underlying disease （22.7 %） were increase. Fever was the most common and initial symptom （80.6 %） .The most common and severe complications of IE were congestive heart failure and visceral embolism or vascular embolism, heart failure eases were obviously descend compared with last ten years （P〈0.05） .The most common laboratory findings of the disease were hemoglobin decreased （61.2%） and leucocytes increased （50%） . Detection rate of endocardial vegetation was 67.2% by echocardiography. Endocardial vegetation most common accreted aortic valve, next was mitralis, and thirdly was aortic valve together with mitralis ~ Positive rate of blood culture was 34.5%; mainly pathogenic bacteria were staphylococcus aureus and staphylococcus epidermidis. Conclusion： There are changes in predisposing diseases and microorganisms. Early diagnosis and promptly using effective antibiotics and selecting suitable opportunity to operate are pivotal to get long-term survival rate.

关 键 词：感染性心内膜 临床分析 

分 类 号：R542.42[医药卫生—心血管疾病]