肝硬化合并感染性心内膜炎2例

Cirrhosis with infective endocarditis: Report of two cases

流行病学研究显示近年来感染性心内膜炎(infective endocarditis,IE)发病率已有所下降,但临床上仍不罕见.IE需及时治疗,否则死亡率极高.可以通过早期预防、及时诊断、合理应用抗菌药物及选择手术时机降低病死率.肝硬化患者免疫力低下且易发生肠道细菌移位,临床上如出现不明原因的长期发热或败血症、新近出现的心脏杂音或原有心脏杂音强度或性质发生改变,需要高度警惕IE可能,应尽早行血培养及心脏超声检查以明确诊断.

Epidemiological studies have shown that the incidence of infective endocarditis（IE） has dropped, but it is not clinically rare. If not treated timely, the patients will suffer from a high risk of mortality. Early prevention, timely diagnosis, rational use of antimicrobial drugs and proper operation timing are important for decreasing the fatality rate. Cirrhotic patients are prone to low immunity and intestinal bacterial translocation. When unexplained fever, septicemia, new heart murmurs or the changes of primary heart murmurs are noted clinically, the physicians should pay attention to IE, and blood culture and cardiac ultrasound are needed to establish a diagnosis.