135例成年人感染性心内膜炎的分析

INFECTIVE ENDOCARDITIS IN ADULTS: Clinical analysis of 135 cases (1980～1987)

感染性心内膜炎(IE)越来越多见,与过去几十年相比,患病年龄、病原体、临床表现、治疗方式等均有变迁。本文通过135列IE复习,分析我院80年代IE的特点。

On.the basis of strict clinical criteria 135cases of adult infective endocarditis (IE) de-fined during the period of 1980--1987 in outinstitute. The clinical features of these casesare as follows: 1. Ages ranging 14--60 years (mean 29.5years), 57.8% of hem were 14--29 years. 2. Predisponsing cardial condition: AmongIE cases, the major underline heart diseasewas RHD (49.6%). 11.9% of IE developedfrom prothetic valves (PV) ane 8.9% fromapparently normal valves. 3. The typical manifestations of IE werenot found frequently in these series. Osler'snodes, petechiae, cubbing and splenomegalywere presented in 4.4%, 5.1%, 23. 7%, and20% of IE respectively. 4. Blood cultures were positive in 41cases (31.1%) of native valve 26.1%(31/119)and 62.5% (10/16) of prosthetic valve.77.4% of positive cultures in native valvewere streptococci. Baterias of earlier cases ofPVE with positive culture were Gram-negativebacilli, among later cases, four of which werestreptococci and fungi. 5. Major complications: 34.8% of IE hadcongestive heart failure. Complicated embolismand nephritis were found in 18.5% 11.9% ofcases respectively. 6. Fatality rate of inpatients with nativeralve was 22.7%, PVE 56.3%; 7. 10 cases of this series underwent aroticvalve replacements.