感染性心内膜炎临床特点及危险因素分析  

Analysis of clinical features and risk factors for infective endocarditis

作　　者：王莉[1] 赵良平[2] 徐卫亭[2] 陈建昌[2] 佟光明[2] 洪小苏[2] 

机构地区：[1]苏州市第七人民医院急诊科,江苏苏州215151 [2]苏州大学附属第二医院心内科,江苏苏州215004

出　　处：《苏州大学学报（医学版）》2012年第2期241-244,共4页Suzhou University Journal of Medical Science

摘　　要：目的分析感染性心内膜炎(IE)的临床特点及影响其预后的危险因素。方法回顾性分析65例IE患者的临床资料,对基础疾病、临床表现、血培养结果、超声心动图结果、预后等进行统计分析。结果 (1)基础疾病以风湿性心脏病、先天性心脏病及无基础心脏病为主。发热、贫血为主要临床表现。(2)血培养仍以链球菌为主,其他菌种呈上升趋势。(3)住院期治疗无效率仍高(20.0%)。(4)治疗无效组血红蛋白与血白蛋白均明显低于治疗有效组(均P<0.05),而白细胞、高敏C反应蛋白(hsCRP)、血沉、中重度贫血比例均明显高于治疗有效组(均P<0.05)。多因素回归分析提示,中重度贫血、低白蛋白血症、hsCRP升高均与治疗无效明显相关(均P<0.05)。结论近年来,IE患者以风湿性心脏病为易患因素的比例下降,病原菌仍以链球菌属为主,但呈多样化;病死率仍高;贫血、低白蛋白血症、hsCRP升高明显影响患者的预后。Objective To analyze the clinical features of infective endocarditis（IE） and explore the risk factors for it＇ s prognosis. Methods Clinical data of 65 patients with IE were acquired retrospective- ly, and its causes, clinical characterstics, pathogenic microorganism, clinical outcomes were analyzed. Results The major occurring heart diseases for IE in all patients were rheumatic heart disease, congeni- tal heart disease, and there was no any previously known heart disease. The major clinical manifestations included fever and anemia. The major pathogenic bacteria is streptococcus, but percentage of other bacte- ria increased gradually. Thirteen patients were refractory in hospital. Haematoglobin and seralbumin were significantly lower, and leucocyte, hsCRP, erythrocyte sedimentation were significantly higher in refracto- ry group. Anaemia, lower seralbumin, higher hsCRP were independent predictors for bad prognosis. Con- clusion The proportion of rheumatic heart disease is decreasing as one of the risk factors for IE in recent years. Streptococcus is major pathogen of IE, and the mortality of IE is still very high. Anaemia, lower seralbumin, higher hsCRP are independent predictors for bad prognosis.

关 键 词：感染性心内膜炎 贫血 高敏C反应蛋白 预后 

分 类 号：R542-4207[医药卫生—心血管疾病]