CAJ | 학술논문

目的了解感染性心内膜炎(IE)的临床特征、诊断、治疗及临床结局.方法对2009年1月1日至2011年6月30日浙江大学医学院附属邵逸夫医院符合改良Duke标准的28例IE患者的临床表现、病原学、超声心动图、治疗及临床结局等进行回顾性分析.结果患者平均年龄为(50.9±17.4)岁,以男性为主(57.1％).28例患者均为自身瓣膜性IE,二尖瓣脱垂是最常见的基础心脏疾病.临床表现以发热最常见.血培养阳性11例,占36.4％,最常见的病原菌为草绿色链球菌.超声心动图检查阳性率为96.4％.46.4％的患者接受手术治疗.18例患者至少伴有1项并发症.住院期间病死率为3.6％.结论 IE的典型临床表现少,病原学分布与以往报道无明显改变.抗菌药物的选择尚需进一步规范.
목적 료해감염성심내막염(IE)적림상특정、진단、치료급림상결국.방법 대2009년1월1일지2011년6월30일절강대학의학원부속소일부의원부합개량Duke표준적28례IE환자적림상표현、병원학、초성심동도、치료급림상결국등진행회고성분석.결과 환자평균년령위(50.9±17.4)세,이남성위주(57.1％).28례환자균위자신판막성IE,이첨판탈수시최상견적기출심장질병.림상표현이발열최상견.혈배양양성11례,점36.4％,최상견적병원균위초록색련구균.초성심동도검사양성솔위96.4％.46.4％적환자접수수술치료.18례환자지소반유1항병발증.주원기간병사솔위3.6％.결론 IE적전형림상표현소,병원학분포여이왕보도무명현개변.항균약물적선택상수진일보규범.
Objective To investigate the clinical features,diagnostic examinations,treatment and clinical outcomes of patients with definite infective endocarditis (IE).Methods This retrospective study included 28 adults with IE who were admitted to Sir Run Run Shaw Hospital from January 1,2009 to June 30,2011.All the IE cases met the modified Duke criteria and the data were reviewed on clinical presentations,microbiological profiles,echocardiographic findings,in-hospital course and clinical outcomes.Results The mean age was (50.9± 17.4) years with a male preponderance.All patients had native valve IE.Mitral valve prolapse was the most common underlying heart disease.Fever was presented as the primary manifestation.Blood culture results were positive only in 36.4％ of the 11 cases.Streptococcus viridans represented the leading causative agent.Echocardiography was positive in 96.4％ of the cases.46.4％ of the cases underwent surgery for IE.Eighteen cases had at least one major complication.The in hospital mortality was 3.6％.Conclusions Typical clinical presentations of IE are rare.Comparing with previous studies,there are no changing trends in the microbiology.Advanced antibiotics are overused during the treatment,which is awaiting improvements.