亚急性感染性心内膜炎36例临床分析

目的 探讨亚急性感染性心内膜炎的基础病因、临床特征、治疗方法及预后,以提高对该病的诊治水平.方法 对36例亚急性感染性心内膜炎患者的基础心脏疾病、临床特点、致病菌、超声心动图、治疗方法、预后等进行回顾性分析.结果 本资料亚急性感染性心内膜炎的基础病因构成发生改变,风湿性心脏病所占比例下降,先天性心脏病及无基础心脏病所占比例升高;临床特征仍以发热、心力衰竭、中性粒细胞增加、红细胞沉降率增加、贫血常见;血培养阳性率58.33%,致病菌以草绿色链球菌多见.63.89%患者经胸超声心动图发现心脏有赘生物形成;本资料亚急性感染性心内膜炎的近期病死率是19.44%.结论 亚急性感染性心内膜炎的基础病因构成、临床特征、致病菌和以往比较发生改变,虽经积极治疗,病死率仍很高,对有手术适应证的患者应尽早手术治疗.

Clinical analysis on 36 cases of sub-acute infective endocarditis

Objective To study the basic pathogenic cause,clinical characteristics,treatment methods and prognosis of sub-acute infective endocarditis (IE) ,and to improve the diagnosis and treatment against it Methods The basic cardiac disease,clinical characteristics,pathogenic bacteria,ultrasound cardiogram, therapy and prognosis of 36 cases of sub-acute IE was retrospectively analyzed. Results Compared to previous reports, the proportion of rheumatic cardiac disease was a little lower, whereas the proportion of congenital cardiac disease and not-recorded cardiac diseases were a little higher.The main clinical characteristics showed as fever, heart failure, increasing in number of neutrophile granulocyte,blood sedimentation and anemia, The positive rate of blood culture was 58. 33% with the most common pathogenic bacterium of streptococcus viridans. Endocardial vegetation has been diagnosed in 63. 89% of patients through-thoracic echo-cardiography. The short-term fatality rate was 19. 44% . Conclusions There have been significant changes in the basic pathogenic causes,clinical characteristics and pathogenic bacteria of sub-acute IE as compared to the previous reports. The fatality rate remains high even after active treatment. Early surgical operation is recommended to those suitable patients.