感染性心内膜炎诊治进展  

Progress of diagnosis and treatment of infective endocarditis

作　　者：周云芳[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心感染科,200127

出　　处：《中华实用儿科临床杂志》2016年第10期725-728,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：感染性心内膜炎（IE）是因心脏瓣膜受到某种病原体的侵袭而引起的心内膜炎症。静脉导管、植入性人工装置和外科手术是IE发生的最常见的原因，儿童以先天性心脏畸形和心脏手术为主要原因。感染性心内膜炎的发生率居高不下，病死率高达20％。IE的病原体以革兰阳性菌占绝对优势。1994年后经过多次修改后的Duke标准是目前诊断IE的金标准，新增了一些其他影像学证据，使该诊断标准的敏感度提高。除此，一些实验室检测和生物标志物也作为IE诊断的参考指标。最有效预防IE的措施是良好的口腔卫生习惯和定期牙科检查。最新有关IE指南推出“心内膜炎管理团队”的理念，要求多学科专家共同参与IE的诊治，个体化治疗是提高患者生存率的最佳途径。Infective endocarditis （IE） is a kind of endocardial infection which cardiac intima is affected by some pathogens. Intravaseular catheter, implantable artificial device and surgery are the common reasons for IE, congeni- tal heart diseases and cardiac surgery are the main causes for IE in children. The incidence of infective endocarditis is high and case fatality rate is as high as 20%. The dominant pathogen of IE is gram - positive bacteria. Modified Duke standard is the gold standard in the diagnosis of IE, some other imaging evidence and new laboratory tests and biomarkers for diagnosis of IE have improved the sensitivity of the diagnostic criteria. Good oral hygiene and regular dental check are the most effective prevention measures. The idea of ＂ endocarditis management team＂ in the newest guidelines on IE requires muhidiseiplinary experts to participate in diagnosis and treatment of IE. Individualized treat- ment is the best way to improve the patients survival rate.

关 键 词：感染性心内膜炎 诊断 治疗 进展 

分 类 号：R725.4[医药卫生—儿科]