心律植入装置相关感染性心内膜炎的病因分析

Risk factors of infective endocarditis related to cardiovascular implantable electronic devices

目的探讨心律植入装置相关的感染性心内膜炎的相关病因。方法回顾性分析2011年1月至2018年2月就诊于北京大学人民医院的心律植入装置相关的感染性心内膜炎患者的临床资料。结果 56例发生心律植入装置相关感染性心内膜炎,其中男性44例(78.6%),女性12例(21.4%),年龄(66±13)岁。有囊袋感染清创史的35例(62.5%),有起搏器更换史23例(41.1%),深静脉置管2例(3.6%),糖尿病史11例(19.6%),乙肝病史5例(8.9%),肿瘤史2例(3.6%)。56例中1例患者因重症感染死亡,余55例患者均行电极导线拔除治疗,其中12例为外科拔除。术中发生心脏压塞3例(5.5%),肺栓塞1例(1.8%),再植入患者27例(49.1%),无一例手术相关的死亡病例。结论囊袋感染后保守清创治疗与心律植入装置相关感染性心内膜炎直接相关,一旦明确诊断应行电极导线拔除。

Objective To explore the risk factors of infective endocarditis related to cardiovascular implantable electronic devices(CDRIE). Methods We performed a retrospective study of consecutive patients in a single center from January 2011 to February 2018.Basic clinical data of patients,the reason of infection and outcoms were analyzed. Results There were 56 patients(age 66±13 years;44 male) had happended CDRIE,of which, 35 paients had a history of conservative treatment,23 cases had replacement history, 11 cases had diabetes,5 cases had hepatitis B virus,2 painets had cancer.One of 56 patients died of severe infection,others undergoing lead extraction.There were no major complications,including death and surgery. Conclusions The incidence of CDRIE is related to conservative treatment of pocket infection. Lead extraction should be performed once CDRIE is confirmed.[Chinese Journal of Cardiac Pacing and Electrophysiology,2019,33(2):112-114]