目前感染性心内膜炎存在的争议

Controversy over Infective Endocarditis

感染性心内膜炎（Infective Endoearditis，IE）作为一种感染性疾病严重威胁到患者的生命，他是由病原菌的直接感染引发的邻近大动脉内膜炎症或心瓣膜、心室壁炎症，该病的常见致病菌是细菌，病毒、真菌、衣原体以及立克次体等微生物也可能引发该病。对于临床医师和科研医师，感染性心内膜炎已成为一个不断发展的微生物学和更改病人人口统计的动态目标。在缺乏大量试验数据来指导临床实践的情况下，争议比比皆是。在这里，我们归纳了三方面的不确定性：①感染性心内膜炎的预防，包括抗生素预防的作用和策略来减少卫生保健相关菌血症；②感染性心内膜炎的诊断，多重成像的使用；③手术治疗最佳时机的选择和心脏器械感染率增加构成的挑战。

Infective endocarditis is a life - threatening disease caused by a focus of infection within the heart. For clinicians and scientists it is the index that has been evolving microbiology and changing patient demographic. There were 3 kinds of the contro- versies because of the absence of an extensive base to guide clinical practice. （1）In the prevention of infective endocarditis, including the role of antibiotic prophylaxis and strategies to reduce health care - associated bacteraemia ; （2）In the diagnosis, specifically the use of multimodality imaging; （3）The optimal timing of surgical intervention and the challenges posed by increasing rates of cardiac device infection.