老年感染性心内膜炎合并血管栓塞的临床分析  

Clinical analysis of elderly infective endocarditis complicated with vascular thrombosis

作　　者：尚喜艳[1] 陈世芳[1] 杨淑娥[1] 

机构地区：[1]河南科技大学第一附属医院心内科,河南洛阳471003

出　　处：《中华医院感染学杂志》2014年第24期6136-6138,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅科技攻关基金资助项目(201003080)

摘　　要：目的分析老年患者感染性心内膜炎合并血管栓塞的临床资料,了解相关的危险因素,并探讨其相应的干预对策。方法对2010年1月-2013年10月感染性心内膜炎的124例老年患者临床资料进行分析,根据患者是否具有血管栓塞将其分为血管栓塞组28例和血管非栓塞组96例,对其进行单因素和分析,再对所有因素综合进行logistic多因素回归分析,数据采用SPSS13.0进行统计分析。结果血管栓塞组有22例赘生物培养为阳性,占78.57%;赘生物>10mm的有14例占50.00%;非血管栓塞组赘生物培养阳性有50例占52.08%,赘生物>10mm的有24例占25.00%;两组患者对比,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和血培养阳性为感染性心内膜炎合并血管栓塞发生的独立危险因素。结论与非栓塞患者相比,合并栓塞的患者在临床表现、赘生物的大小和血培养情况方面均有所不同,而赘生物的直径和阳性率是感染性心内膜炎合并血管栓塞出现的独立的危险因素,所有对于感染期的患者应该积极控制感染的发生,及时对栓塞的防治。OBJECTIVE To analyze the clinical cases of infective endocarditis in elderly patients with vascular thrombosis , understand the relevant risk factors and explore appropriate intervention countermeasures . METHODS Clinical data of 124 cases of elderly infective endocarditis in the medical department during Jan .2010 to Oct .2013 were analyzed .The patients were divided into the vascular embolization group （28 cases） and the non‐vascular embolization group （96 cases） according to the presence of vascular embolization .The univariate analysis was conducted for the two groups and the multivariate logistic regression analysis was conducted for all factors . The software SPSS13 .0 was used for statistical analysis .RESULTS In the vascular embolization group ,there were 22 cases （78 .57% ） showing positive results for vegetation culture and 14 cases （50 .00% ） with vegetations ＆gt;10 mm .In the non‐vascular embolization group ,there were 50 cases showing positive results for vegetation culture and 24 cases with vegetations ＆gt;10 mm .The difference was significant between the two groups （P＆lt;0 .05） .The further multivariate analysis showed positive culture and vegetation diameter ≥10 mm were independent risk fac‐tors for infective endocarditis complicated with vascular thrombosis .CONCLUSION Compared to patients with no embolization ,patients with complicated embolization showed differences in clinical manifestations ,size of vegeta‐tion and blood culture .The diameter and the positive rate of vegetation were the independent risk factors for infec‐tive endocarditis complicated with vascular embolization .Active control should be conducted for patients in the in‐fective stage to prevent the incidence of embolization .

关 键 词：感染性心内膜炎 血管栓塞 临床分析 干预配合 

分 类 号：R542.41[医药卫生—心血管疾病]