感染性心内膜炎患者血管栓塞的相关因素分析

Analysis of related factors on infectious endocarditis complicated with vascular embolization

目的对感染性心内膜炎合并血管栓塞的相关因素进行分析，为临床防治提供参考。方法选取2009年6月-2014年6月于我院治疗的感染性心内膜炎患者126例，按是否合并血管栓塞分为栓塞组24例与未栓塞组102例。分析影响感染性心内膜炎患者发生血管栓塞的相关危险因素。结果单因素分析结果显示，吸烟、高血压、高血脂、糖尿病等与感染性心内膜炎发生血管栓塞有关，多因素分析结果显示高血压病史、吸烟及赘生物直径较大可作为预测感染性心内膜炎发生血管栓塞的危险因素；C反应蛋白高，致病菌以葡萄球菌为主，以及赘生物大、数目多对早期诊断感染性心内膜炎并发血管栓塞具有较高的价值；感染性心内膜炎合并血管栓塞患者手术治疗效果可能更好。结论导致感染性心内膜炎合并血管栓塞的因素是多方面的，对相关因素应早期预防；高血压病史、吸烟及赘生物直径较大可作为预测感染性心内膜炎发生血管栓塞的危险因素；手术治疗可能更有助于改善预后。

Objective To explore the related factors on infectious endocarditis（IE） complicated with vascular embolization, so as to provide a reference level to improve the clinical treatment of the disease. Methods Totally 126 cases of patients with IE were selected. The patients were divided into the embolization group and the non-embolization group according to the status of vascular embolization. The data obtained were processed by statistical software. Results Single factor analysis results showed that history of smoking, hypertension, high cholesterol, diabetes were associated with infectious endocarditis complicated with vascular embolization, and multi-factor analysis results showed that the history of high blood pressure, smoking and larger vegetations diameter could be used as predictive factors for infective endocarditis complicated with vascular embolization. High levels of creaction protein（ CRP）, staphylococ- cus aureus, and the large size and number of neoplasm were of high value in early diagnosis of IE compli- cated with vascular embolization, and operation might be much better for this disease. Conclusion The factors for IE complicated with vascular embolization are multiple, history of high blood pressure, smoking and larger vegetations diameter can be used as predictive factors for infective endocarditis complicated with vascular embolization. Operation might be much better for this disease.