感染性心内膜炎老年患者的临床特征及病原学分析  

Clinical features and etiological analysis of elderly patients with infective endocarditis

作　　者：黄慧君[1] Hui-jun Huang(Shanghai Eighth People's Hospital, Shanghai 200233, China)

机构地区：[1]上海市第八人民医院,上海200233

出　　处：《中国现代医学杂志》2017年第20期105-108,共4页China Journal of Modern Medicine

摘　　要：目的分析感染性心内膜炎(IE)老年患者的病原学和临床特征,为该病的预防和治疗提供科学依据。方法选取2015年3月-2016年2月上海市第八人民医院收治的IE老年患者96例,对其采动脉血,进行细菌培养,使用Phoenix-100全自动细菌鉴定/药敏系统进行病原学鉴定。结果 96例IE患者中,病变位置在左心者76例(79.17%);病变位置在右心者7例(7.29%);病变位置在左右心者7例(7.29%);病变位置不明确者6例(6.25%);在上述96例患者中,检出病原菌45株,以酿脓链球菌为主,有25株占55.56%;伴有心脏基础疾病者46例(47.92%)。在多因素分析中,血红蛋白<90g/L和医院感染是IE老年患者的主要不安全性因素,而对其采取手术治疗是安全性因素。结论酿脓链球菌是IE老年患者的主要病菌,应预防控制其危险因素,手术治疗是保护性因素。Objective To analyze the etiology and clinical characteristics of elderly patients with infectiveendocarditis,and to provide scientific evidence for the prevention and treatment of the disease.MethodsNinety-six elderly patients with infective endocarditis,who were treated in Shanghai Eighth People's Hospitalfrom March2015to February2016,were selected,and arterial blood was collected for bacterial culture.Thepathogens were identified by Phoenix-100automatic bacterial identification/drug sensitive system.Results Inthe96patients,76cases(79.17%)had lesions located in the left heart,7cases(7.29%)had lesions in theright heart,7cases(7.29%)had lesions in both left and right hearts,6cases(6.25%)had uncertain lesionlocation.Among the96cases,45bacterial strains were found,mainly Streptococcus pyogenes(25strains,55.56%).Underlying heart diseases were found in46cases accounting for47.92%.In the multivariateanalysis,hemoglobin<90g/L and hospital infections were the major factors of insecurity for the elderlypatients with infective endocarditis,and surgical treatment was the safety factor.Conclusions Infectiveendocarditis is a serious threat to the life of elderly patients.Streptococcus pyogenes is the major pathogen,so early diagnosis,rational use of antibiotics and surgical treatment have good effect.

关 键 词：感染性心内膜炎 病原学 危险因素 

分 类 号：R542.41[医药卫生—心血管疾病]