CAJ | 학술논문

目的探讨静脉药瘾者右心感染性心内膜炎(right-sided infective endocarditis,RIE)并人类免疫缺陷病毒(human immunodeficiency virus,HIV)抗体阳性的临床特点.方法回顾性分析21例HIV抗体阳性的RIE患者临床资料,着重分析患者的检查结果和治疗情况.结果 ①无业男青年居多,无基础心脏病,静脉吸毒时间0.5年～5年不等;②均有发热、浅表静脉炎性反应及肺损害等;③心脏损害以三尖瓣受损为主,部分有肺动脉瓣受损,少数并发二尖瓣受累;④实验室检查多有贫血,白细胞升高及低蛋白血症,血培养阳性率达61.9%,以金黄色葡萄球菌居多;⑤超声心动图检出三尖瓣赘生物达100%,符合右心感染性心内膜的特点;⑥预后较差.结论静脉药瘾是RIE与HIV感染的致病原因,RIE与HIV感染共患,相互影响,增加RIE的严重性及治难性,临床症状重,预后较差.
목적 탐토정맥약은자우심감염성심내막염(right-sided infective endocarditis,RIE)병인류면역결함병독(human immunodeficiency virus,HIV)항체양성적림상특점.방법 회고성분석21례HIV항체양성적RIE환자림상자료,착중분석환자적검사결과 화치료정황.결과 ①무업남청년거다,무기출심장병,정맥흡독시간0.5년～5년불등;②균유발열、천표정맥염성반응급폐손해등;③심장손해이삼첨판수손위주,부분유폐동맥판수손,소수병발이첨판수루;④실험실검사다유빈혈,백세포승고급저단백혈증,혈배양양성솔체61.9%,이금황색포도구균거다;⑤초성심동도검출삼첨판췌생물체100%,부합우심감염성심내막적특점;⑥예후교차.결론 정맥약은시RIE여HIV감염적치병원인,RIE여HIV감염공환,상호영향,증가RIE적엄중성급치난성,림상증상중,예후교차.
Objectives To investigate the clinical features of the intravenous drugs users who have infected the right-sided infective endocarditis (RIE) with human immunodeficiency virus (HIV)-positive. Methods We retrospectively analyzed the clinical data of 21 patients infected the RIE with HIV-positive. Results Most part of them were unemployed young men who had no heart-disease, they had something in common such as they have shared and repeated to use the unsterilized syringes; the time of intravenous drug abuse was about 0.5-5 years; and HIV-positive. Clinical manifestations: all of them got fever and lung damage and so on. Heart damage was mainly in the tricuspid valve. Laboratory examination showed that most of them had anaemia, high white blood cell count, hypoproteinemia and so on; the positive rate of blood culture was 61.9% , it was staphylococcus aureus in the majority. Eehocardiography detected tricuspid valve vegetation in 100% patients. Conclusions Intravenous drug abuse is the cause of the RIE and HIV infected, and the RIE and HIV can be infected in the same time, they influenced each other and the HIV infection can increase the seriousness and refractoriness of RIE, the clinical symptoms will be heavy. Relatively, it has poor prognosis.