43例感染性心内膜炎患者的预后影响因素分析及临床指标特征  

Prognostic Factors and Clinical Indicators of 43 Patients with Infective Endocarditis

作　　者：孟贝贝 刘学花[1] MENG Beibei;LIU Xuehua(Department of General Practice,Tianjin People’s Hospital,Tianjin 300121,China)

机构地区：[1]天津市人民医院全科医学科,天津300121

出　　处：《中国伤残医学》2024年第17期114-116,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析感染性心内膜炎(IE)患者的预后影响因素分析及临床指标特征。方法:回顾性分析2010年1月—2024年1月天津市人民医院收治的43例IE患者资料,分析一般资料、病原微生物检查、实验室血样本检查及心脏超声检查结果,分析IE患者的预后影响因素。结果:43例IE患者中,平均年龄为(61.6±16.6)岁;常见临床表现为发热41例(95.35%),常见基础病为贫血26例(60.47%),常见并发症为血栓18例(41.86%),感染性休克5例(11.63%);心脏超声检查显示明确检出心脏赘生物29例(67.43%);病原微生物检查检出革兰阳性杆菌25例(58.14%),常见为金黄色葡萄球菌13例(30.23%),实验室血样本检查显示所有炎性指标均明显高于正常值,差异均有统计学意义(P<0.05)。Logistic回归分析显示感染性休克、血栓事件、金黄色葡萄球菌培养阳性为IE患者预后的影响因素(P<0.05)。结论:感染性休克、血栓事件、金黄色葡萄球菌培养阳性会影响IE患者的预后情况,在积极抗感染的同时,应尽快联合病原微生物、实验室血样本及心脏超声检查以明确诊断,对IE患者的治疗具有临床指导价值。Objective:To analyze the prognostic factors and clinical indicators of patients with infective endocarditis(IE).Methods:The data of 43 patients with IE admitted to Tianjin People’s Hospital from January 2010 to January 2024 were retrospectively analyzed,and their general data,pathogenic microorganism examination,laboratory blood sample examination and cardiac ultrasound examination results were analyzed.the prognostic factors of IE patients were analyzed.Results:The mean age of 43 IE patients was(61.6±16.6)years;the common clinical manifestations were fever in 41 cases(95.35%),anemia in 26 cases(60.47%),thrombosis in 18 cases(41.86%)and septic shock in 5 cases(11.63%);cardiac echocardiography showed that cardiac neoplasms were detected in 29 cases(67.43%);in the examination of pathogenic microorganisms,25 cases(58.14%)were detected gram-positive bacilli,and 13 cases(30.23%)were common staphylococcus aureus.Laboratory blood samples showed that all inflammatory indexes were significantly higher than normal values,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that septic shock,thrombotic events and positive culture of staphylococcus aureus were prognostic factors of IE patients(P<0.05).Conclusion:Septic shock,thrombotic events and positive culture of staphylococcus aureus can affect the prognosis of IE patients.While actively fighting infection,it is necessary to combine pathogenic microorganisms,laboratory blood samples and cardiac ultrasonography as soon as possible to make a clear diagnosis,which has clinical guiding value for the treatment of IE patients.

关 键 词：感染性心内膜炎 预后 感染性休克 血栓事件 

分 类 号：R542.41[医药卫生—心血管疾病]