感染性心内膜炎合并血管栓塞的临床研究  

Clinical study on infectious endocarditis complicated with vascular embolization

作　　者：陈志刚[1] 秦瑞英[1] 席鸿霞[1] 姚红波[1] 桑文凤[1] 

机构地区：[1]新乡医学院第一附属医院心内科,河南卫辉453100

出　　处：《中华医院感染学杂志》2013年第14期3354-3356,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅自然科学研究项目(12A360019)

摘　　要：目的探讨感染性心内膜炎合并血管栓塞的临床特点,并分析其发生的相关危险因素,为其临床防治提供依据。方法回顾性分析心内科120例感染性心内膜炎住院患者,采用统一的调查表详细记录其病史及相关信息,根据其是否并发血管栓塞分为栓塞组与未栓塞组,应用多因素回归分析进行多因素分析。结果 120例感染性心内膜炎患者有20例合并血管栓塞,发生率为16.7%,其中14例患者存在赘生物;感染性心内膜炎合并血管栓塞患者患高血压15例占75.0%、糖尿病14例占70.0%、血培养阳性14例占70.0%、赘生物培养阳性14例占70.0%,赘生物≥10mm 10例占50.0%;未并发血管栓塞组患者高血压50例占50.0%,糖尿病50例占50.0%、血培养阳性45例占45.0%、赘生物培养阳性40例占40.0%,赘生物≥10mm 25例占25.0%;两组间差异有统计学意义(P<0.05);进一步多因素分析显示,赘生物培养阳性及赘生物直径≥10mm为感染性心内膜炎合并血管栓塞发生的独立危险因素。结论感染性心内膜炎亦并发血管栓塞的发生,赘生物培养阳性及赘生物直径≥10mm为感染性心内膜炎合并血管栓塞发生的独立危险因素,因此在感染活动期应积极控制感染,能更好地预防栓塞的发生。OBJECTIVE To explore the clinical characteristics of infectious endocarditis complicated with vascular embolization and analyze the related risk factors so as to guide the clinical treatment.METHODS A total of 120 patients with infectious endocarditis,who hospitalized the cardiology department,were retrospectively analyzed,the medical history and the relevant information were recorded in detail by using the unified questionnaires,the patients were divided into the embolization group and the non-embolization group according to the status of vascular embolization,then the multivariate regression analysis was performed.RESULTS Of 120 cases of patients with infectious endocarditis,there were 20 cases complicated with vascular embolization with the incidence of embolism 16.7%,among which there were 14 patients with neoplasm;there were 15（75.0%）cases of infectious endocarditis patients complicated with vascular embolization who suffered from high blood pressure and 14（70.0%）cases with diabetes.There were 14（70.0%）cases of patients with blood culture positive and 14（70.0%）cases of patients with neoplasm cultured positive.There were 10（50.0%）cases with the neoplasm more than 10mm,which was significant higher than the patients without concurrent vascular embolization（there were 50（50.0%）cases with high blood pressure and 50（50.0%）cases with diabetes;there were 45（45.0%）cases with blood cultured positive and 40（40.0%）cases with neoplasm cultured positive;there were 25（25.0%）cases with the neoplasm more than 10mm）,the difference between the two groups was significant（P0.05）.The multivariate analysis showed that the vegetations cultured positive and the neoplasm with diameter more than 10mm were the independent risk factors of the infectious endocarditis complicated with vascular embolization.CONCLUSIONThe infectious endocarditis is also complicated with the vascular embolization,the vegetations cultured positive and the neoplasm with diameter more than 10mm are the independent

关 键 词：感染性心内膜炎 血管栓塞 危险因素 多因素分析 

分 类 号：R181.32[医药卫生—流行病学]