感染性心内膜炎合并中枢神经系统并发症的回顾性研究

Retrospective analysis of central nervous system complications related to infective endocarditis

目的探讨感染性心内膜炎(infective endocarditis,IE)患者出现中枢神经系统并发症的临床特征及危险因素。方法选取广东省人民医院1980年3月至2014年2月期间201例有完整超声心动图结果及临床资料的IE患者,采用回顾性分析研究其是否合并中枢神经系统并发症及其临床特征,采用SPSS 16软件进行统计学分析。结果出现神经系统并发症的IE患者占19.90%(40/201),脑梗死是最常见的神经系统并发症。最常累及的瓣膜是主动脉瓣,且赘生物长度与是否出现神经系统并发症具有相关性,长度>14.58 mm(平均值)的赘生物出现神经系统并发症的几率下降(OR=0.412,P=0.026)。结论神经系统并发症在IE患者中并不少见,最常表现为脑梗死,以主动脉瓣的赘生物脱落引起为主,且赘生物长度与神经系统的并发症出现呈负相关。

Objectives To investigate the clinical features and risk factors of infective endocarditis（IE）patients withcentral nervous system complications.Methods We retrospectively studied the echocardiographic data and clinical da-ta of 201 patients with IE from March 1980 to February 2014 in Guangdong General Hospital.The SPSS 16 softwarewas used to analyze the data.Results Occurrence rate of central nervous system complication was 19.90%（40/201）.The most common valve that involved was the aortic valve.Additionally,there was a significant relationship betweenthe length of the vegetation and the occurrence of central nervous system complications（OR=0.412,P=0.026）.Cerebral infarction was the most common presentation of central nervous system complications.Conclusions Centralnervous system complication in IE patients is not rares,mainly induced by aortic valve dropping.The length ofvegetation is related to the occurrence of complications.