感染性心内膜炎168例临床特点分析

Clinical Analysis of 168 Cases of Infective Endocarditis

目的分析笔者医院近8年来确诊并收治的168例感染性心内膜炎患者的临床特点,为感染性心内膜炎的诊断和治疗提供参考.方法对同济医院2011~2018年168例符合Duke大学诊断感染性心内膜炎标准的病例进行分析统计.结果 168例确诊感染性心内膜炎患者平均年龄43.66±13.76岁,既往有基础心脏病患者112例(66.67%),其中先天性心脏病所占比例最高,为50例(29.76%),风湿性心脏病22例(13.10%).临床表现中发热所占的比例最大(135例,80.36%).血培养阳性患者中,最常见为草绿色链球菌(33例,28.95%),其次为血链球菌(19例,16.67%)和金黄色葡萄球菌(17例,14.91%).82例(48.81%)患者进行了手术治疗,86例(51.19%)患者进行非手术治疗.168例患者中,63例(37.50%)痊愈出院,86例(51.19%)有效,11例(6.55%)未愈,8例(4.76%)死亡,经统计,手术组疗效优于非手术组.结论感染性心内膜炎最常见的病因为先天性心脏病,其次为风湿性心脏病,发热仍是最常见的临床表现,最常见的致病菌为草绿色链球菌,手术疗法优于非手术疗法.

Objective To analyze the clinical characteristics of 168 cases of infective endocarditis (IE) in the author's hospital and to provide clinical reference for the diagnosis and treatment of infective endocarditis. Methods Clinical data of 168 patients with IE between 2011 and 2018 in Tongji Hospital were analyzed. Results The average age of 168 patients with IE were 43. 66 years. 112 patients (66. 67%) had underlying cardiac diseases and the most common disease was congenital cardiovascular disease. The main clinical manifestation was fever ( 135 cases, 80. 36%). Blood culture results showed that the most common bacteria were streptococcus (33 cases, 28. 95%), streptococcus sanguis( 19 cases, 16.67%) and staphylococcus( 17 cases, 14.91%). 82 patients were given surgical treatment and 86 patiensts were given non - surgical treatment. 63 patitents were cured, 86 patietns were improved, 11 patitents were null and 8 patitents were dead. The treatment effect of surgical group was better than non - surgical group. Conclusion The most common disease of IE was congential cardiovascular disease and fever is the main clinical manifestation. The most common bacteria were Streptococcus and the treatment effect of surgical group was better than non - surgical group.