摘要
目的:探讨感染性心内膜炎发生心脏传导阻滞的类型、原因及其危险因素。方法:检索我院1996-07至2006-06期间治疗的感染性心内膜炎381例。回顾性分析感染性心内膜炎发生心脏传导阻滞的类型和原因;并根据是否发生心脏传导阻滞将感染性心内膜炎病人分为心脏传导阻滞组(n=25)和无心脏传导阻滞组(n=356),探讨感染性心内膜炎发生心脏传导阻滞的危险因素。结果:感染性心内膜炎心脏传导阻滞发生率6.6%,其中房室传导阻滞52.0%,室内传导阻滞48.0%。未发现窦房传导阻滞和房内传导阻滞。累及主动脉瓣的感染性心内膜炎可发生多种类型的心脏传导阻滞;累及主动脉瓣的感染性心内膜炎、人工瓣膜感染性心内膜炎、肠球菌或表皮葡萄球菌感染性心内膜炎是发生心脏传导阻滞的危险因素(P<0.05);伴瓣周脓肿的主动脉瓣感染性心内膜炎是发生心脏传导阻滞的高危因素(P<0.001)。感染性心内膜炎发生心脏传导阻滞以房室传导阻滞中的Ⅰ度房室传导阻滞和室内传导阻滞中的右束支传导阻滞最常见。结论:感染性心内膜炎发生心脏传导阻滞的类型与感染部位相关,伴瓣周脓肿的主动脉瓣感染性心内膜炎是发生心脏传导阻滞的高危因素。
Objective： To investigate the cause, type and risk factor of heart block of infective endocarditis.
Methods ： All cases who met Modified Duke Criteria of infective endocarditis from West China Hospital of Sichuan University during the last 10-year period were collected. The cause and type of heart block of infective endocarditis were studied retrospectively; according to whether the patients with infective endocarditis complicated with heart block, the patients were divided into two groups for risk analysis of heart block of infective endocarditis.
Results： The incidence of heart block of infective endocarditis was 6. 6%, of which, atrio-ventricular and intraventricular block accounted for 52%, 48% respectively. No Sinoatrial block was found in our cases. Most type heart block can happened in infective endocarditis of aortic valve. Aortic valvular infective endocarditis, PVE, infective endocarditis resulted from staphylococcus epidermidis, and infective endocarditis resulted from enterococci was risk factors resulting in heart block of infective endocarditis（P 〈 0. 05 ） ;the aortic valvular infective endocarditis complicated with periarmular abscess was the most dangerous factor（ P 〈 0. 001 ）.
Conclusion： The I°AVB and RBBB was the most common in heart block of infective endocarditis. The type of heart block of infective endocarditis is correlated with infective position. The AVE complicated with periannular abscess was the most dangerous factor.
出处
《中国循环杂志》
CSCD
北大核心
2008年第2期131-134,共4页
Chinese Circulation Journal
