活动期感染性心内膜炎手术治疗的近远期疗效

Short-and Long-term Outcomes of Surgical Treatment of Active Infective Endocarditis

目的回顾性分析北京协和医院71例活动期感染性心内膜炎（active infective endocarditis,AIE）患者手术治疗的近远期疗效。方法 2001年1月至2010年7月,根据杜克诊断标准（Duke criteria）共确诊感染性心内膜炎（infective endocarditis,IE）209例,78例接受了手术治疗,选择其中71例活动期感染性心内膜炎患者的临床资料,进行回顾性分析;排除病例包括同期人工瓣膜感染性心内膜炎和愈合期心内膜炎。结果 71例活动期感染性心内膜炎患者的平均年龄为（44.6±14.4）岁,其中男性55例（77.5%）。链球菌是最常见的致病菌。术后住院期间死亡2例（2.8%）。平均随访时间（42.4±32.4）个月（1-126个月）,1、5和10年实际生存率分别为（98.5±1.5）%、（92.6±4.5）%和（79.4±12.8）%。结论手术治疗活动期感染性心内膜炎的近远期临床疗效满意。

Objective To analyze the short-and long-term outcomes of surgical treatment of active infective endocarditis（IE）.Methods Surgeries were performed for 71 patients with active IE from January 2001 to July 2010.Patients with prosthetic valve or healed IE were excluded.Results Of these 71 patients,the mean age was 44.6±14.4 years,and 55（77.5%）were men.Streptococcus was the most common causative microorganism.Two patients（2.8%）died during post-surgical hospital stay.Survivors were followed up for 42.4±32.4 months.The actuarial 1-,5-,and 10-year survival rates were（98.5±1.5）%,（92.6±4.5）%,and（79.4±12.8）%,respectively.Conclusion Surgery can achieve satisfactory short-and long-term effectiveness for active IE.