静脉药瘾者心内膜炎13例临床分析

Clinical Analysis of Endocarditis in Intravenous Drug Abusers in 13 Cases

目的:探讨静脉药瘾者心内膜炎(EIDA)的临床特点。方法:回顾性分析我院近10年13例EIDA患者的临床资料。结果:所有患者均有2～5年的静脉吸毒史,起病前无基础心脏病;主要临床表现为发热,呼吸道症状,心脏杂音;12例血培养阳性,以金黄色葡萄球菌多见;超声心动图显示所有患者三尖瓣受累,12例三尖瓣赘生物形成;10例患者经抗生素或外科手术治疗后痊愈,1例死亡,2例放弃治疗。结论:静脉药瘾者心内膜炎多为右心感染,表现为发热、肺部及全身多部位感染,致病菌多为金黄色葡萄球菌,经敏感抗生素或手术治疗预后相对良好,超声心动图对本病的诊治具有重要价值。

Objective：To explore the clinical characteristic of endocarditis in intravenous drug abusers （EIDA）. Methods：The clinical data of 13 patients with EIDA diagnosed in our hospital in the last ten years were retrospectively analyzed. Results： All the patients had the experience of intravenous drug abuse for 2 to 5 years. None had basic heart disease before. The main clinical manifestations included fever, respiratory symptoms and cardiac murmur. The blood culture was positive in 12 cases and the most common pathogen was staphylococcus aureus. Echocardiography revealed that tricuspid valve was infected in all patients.There were vegetations on tricuspid valves in 12 cases. 10 cases recovered after being treated with antibiotics or surgery. 1 case died and 2 cases abandoned treatment. Conclusions： Endocarditis in intravenous drug abusers occur more in the right heart. Clinical manifestations include fever, infection of lung and multiple organs. The most common pathogen is staphylococcus aureus. The prognosis is good by treating with sensitive antibiotics or surgery. Echocardiography has important value in diagnosis and therapy of this disease.