感染性心内膜炎患者的临床特点分析  

Clinical characteristics of patients with infective endocarditis

作　　者：冯姗 刘靖[2] 罗雪勇 

机构地区：[1]驻马店市第一人民医院心内科,河南驻马店463000 [2]郑州铁路职业技术学院护理学院,河南郑州450052

出　　处：《中华医院感染学杂志》2014年第9期2200-2202,共3页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(2012XB2937)

摘　　要：目的探讨分析感染性心内膜炎(IE)患者的临床特点和预防治疗对策,以提高治疗效果。方法回顾性分析2008年2月-2013年5月收治的182例IE患者临床资料,对患者的临床检验结果及生命体征进行分析;采用SPSS17.0软件进行数据分析,组间率的比较采用χ2检验,计量资料比较采用t检验。结果 IE患者中患有基础心脏病患者172例占94.51%,明显多于无基础心脏病患者,差异有统计学意义(P<0.05),基础心脏病以非风湿性瓣膜心脏病、先天性心脏病和风湿性瓣膜心脏病为主,分别占34.62%、25.27%和21.43%;182例患者中存在易感因素的有32例,占17.58%,其中糖尿病患者最多,17例占9.34%,其次为心脏手术或介入术后的患者,11例占6.04%;182例患者临床表现以发热最多见,73例占40.11%,其次为贫血和脑出血或脑梗死,分别占20.88%和14.29%;临床体征以肝肿大为最多,39例占21.43%,其次为脾肿大,占19.23%;共分离出病原菌75株,其中链球菌属所占比例最高,37株占49.34%,其次为葡萄球菌属和铜绿假单胞菌,分别占28.00%和13.33%。结论 IE患者多伴有基础心脏病且血糖控制不佳,临床表现上以发热、贫血症状为主,以及肝、脾肿大的体征,及时的抗菌药物的使用可以提高患者治疗效果,必要时可行手术治疗。OBJECTIVE To explore the clinical characteristics of the patients with infective endocarditis so as to put forward the treatment countermeasures.METHODS The clinical data of 182infective endocarditis patients,who were treated in the hospital from Feb 2008to May 2013,were retrospectively analyzed,then the results of clinical examinations and the life signs were analyzed,the statistical analysis of the data was performed with the use of SPSS17.0software,the rate was compared between the groups by using the chi-square test,and the measurement data were compared by means of the t-test.RESULTS Among the patients with infective endocarditis,there were 172（94.51%）cases of underlying heart disease,significantly more than the cases without underlying heart disease,the difference was significant（P＆lt;0.05）.Of the patients with underlying heart diseases,the patients with non-rheumatic valvular heart disease accounted for 34.62%,the patients with congenital heart disease 25.27%, the patients with rheumatic valvular heart disease 21.43%.Among the 182patients,32（17.58%）cases had predisposing factors,of which 17（9.34%）cases had diabetes and 11（6.04%）cases underwent the cardiac surgery and interventional surgery.For the clinical manifestations in the 182patients,the patients with fever accounted for 40.11%（43cases）,the patients with anemia 20.88%,the patients with cerebral hemorrhage or infarction 14.29%.For the clinical signs,the patients with hepatomegaly accounted for 21.43%（39cases）,the patients with splenomegaly 19.23%.A total of 75strains of pathogens have been isolated,among which the Streptococcus spp accounted for 49.34%（37strains）,the Staphylococcus spp 28.00%,the Pseudomonas aeruginosa 13.33%.CONCLUSIONThe underlying heart disease and poor control of blood glucose are common in the patients with infective endocarditis.The fever and anemia are the main clinical manifestations;the hepatomegaly and splenomegaly are the predominant signs.The therapeutic effect can be improved through time

关 键 词：感染性心内膜炎 预后 临床特点 

分 类 号：R542.41[医药卫生—心血管疾病]