感染性心内膜炎合并血管栓塞的临床研究
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摘要
目的探讨感染性心内膜炎(IE)合并血管栓塞的临床特点及相关危险因素。方法 116例感染性心内膜炎住院患者,按照患者是否有血管栓塞分成栓塞组(19例)与非栓塞组(97例),分析其相关因素。结果 116例感染性心内膜炎患者中,19例发生血管栓塞,其发生率为16.38%。栓塞部位为脑动脉8例,脾动脉3例,肺动脉4例,冠状动脉2例,其他2例。应用超声心动图发现96例有赘生物,发生率为82.76%,其中三尖瓣者18例(15.52%),二尖瓣49例(42.24%),主动脉瓣者29例(25.00%)。高血压病、糖尿病、血培养阳性、赘生物培养阳性及赘生物≥10 mm均与其具有相关性(P<0.05);赘生物培养阳性及赘生物直径≥10 mm为其独立危险因素(P<0.05)。结论感染性心内膜炎会导致血管栓塞病症的产生,经赘生物培养显示阳性、赘生物直径≥10 mm时对IE合并血管栓塞是一种具有独立性的危险因子,当感染处于活动期时需对其进行有效控制,避免栓塞的形成。
Objective To investigate clinical characteristics and related risk factors of infective endocarditis(IE) complicated with vascular embolism. Methods A total of 116 hospitalized patients with infective endocarditis were divided by whether with complicated vascular embolism or not into embolism group(19 cases) and non-embolism group(97 cases). Their related factors were analyzed. Results Among 116 patients with infective endocarditis, there were 19 cases with vascular embolism, with incidence of vascular embolism as 16.38%. There were 8 cases with cerebral artery embolism, 3 cases with splenic artery embolism, 4 cases with pulmonary artery embolism, 2 cases with coronary artery embolism and 2 cases with embolism in other location. Ultrasonic cardiogram showed 96 cases with neoplasm, with incidence as 82.76%. Among them, there were 18 cases with tricuspid valve(15.52%), 49 cases with bicuspid valve(42.24%) and 29 cases with aortic valve(25.00%). There were correlation with hypertension, diabetes, positive blood culture, positive neoplasm culture and neoplasm ≥10 mm(P<0.05), along with positive neoplasm culture and neoplasm ≥10 mm as independent risk factors(P<0.05). Conclusion Infective endocarditis will induce vascular embolism. As independent risk factors for IE complicated with vascular embolism, positive neoplasm culture and neoplasm ≥10 mm require effective inhibition to avoid occurrence of embolism.
Objective To investigate clinical characteristics and related risk factors of infective endocarditis(IE) complicated with vascular embolism. Methods A total of 116 hospitalized patients with infective endocarditis were divided by whether with complicated vascular embolism or not into embolism group(19 cases) and non-embolism group(97 cases). Their related factors were analyzed. Results Among 116 patients with infective endocarditis, there were 19 cases with vascular embolism, with incidence of vascular embolism as 16.38%. There were 8 cases with cerebral artery embolism, 3 cases with splenic artery embolism, 4 cases with pulmonary artery embolism, 2 cases with coronary artery embolism and 2 cases with embolism in other location. Ultrasonic cardiogram showed 96 cases with neoplasm, with incidence as 82.76%. Among them, there were 18 cases with tricuspid valve(15.52%), 49 cases with bicuspid valve(42.24%) and 29 cases with aortic valve(25.00%). There were correlation with hypertension, diabetes, positive blood culture, positive neoplasm culture and neoplasm ≥10 mm(P<0.05), along with positive neoplasm culture and neoplasm ≥10 mm as independent risk factors(P<0.05). Conclusion Infective endocarditis will induce vascular embolism. As independent risk factors for IE complicated with vascular embolism, positive neoplasm culture and neoplasm ≥10 mm require effective inhibition to avoid occurrence of embolism.
引文
[1]杨威,张抒扬.急性感染性心内膜炎致多发栓塞一例.中华临床医师杂志(电子版),2011,5(1):200-201.
[2]方波,奚奇,蔡哲,等.感染性心内膜炎导致冠状动脉栓塞手术麻醉一例.中国医师杂志,2012,14(5):719-720.
[3]陈志刚,秦瑞英,席鸿霞,等.感染性心内膜炎合并血管栓塞的临床研究.中华医院感染学杂志,2013,23(14):3354-3356.
[4]郭振峰,杨士伟,周玉杰,等.肺动脉瓣感染性心内膜炎致肺栓塞一例.中华心血管病杂志,2012,40(6):530-531.
[5]黄楠,徐永通,李建华,等.感染性心内膜炎赘生物超声心动图诊断的临床研究.中华医院感染学杂志,2014,24(8):1935-1936.
[6]李越凡,彭静.感染性心内膜炎合并血管栓塞的临床研究.泰山医学院学报,2015,23(4):426-427.
[7]安静.感染性心内膜炎合并血管栓塞的临床研究.中国现代药物应用,2016,10(18):61-62.
[8]吴延刚.感染性心内膜炎合并血管栓塞的临床研究.中西医结合心血管病电子杂志,2015,23(10):53-54.
[9]肖志荣.39例感染性心内膜炎合并血管栓塞的临床研究.医学信息,2010,23(6):60.
[10]尚喜艳,陈世芳,杨淑娥.老年感染性心内膜炎合并血管栓塞的临床分析.中华医院感染学杂志,2014,24(24):6136-6138.
[11]贾明理,毕静,唐明,等.感染性心内膜炎患者血管栓塞的相关因素分析.临床内科杂志,2015,32(6):386-388.
[12]甄福喜,张伟,倪步青,等.感染性心内膜炎合并栓塞30例临床分析.江苏医药,2013,39(21):2557-2559.
[13]李丽萍,方健,罗崇彬,等.感染性心内膜炎合并脑栓塞患者的药学监护.海南医学,2013,24(9):1379-1381.
[14]张桂华.感染性心内膜炎导致栓塞的临床研究.医学信息,2014,27(4):283.
[2]方波,奚奇,蔡哲,等.感染性心内膜炎导致冠状动脉栓塞手术麻醉一例.中国医师杂志,2012,14(5):719-720.
[3]陈志刚,秦瑞英,席鸿霞,等.感染性心内膜炎合并血管栓塞的临床研究.中华医院感染学杂志,2013,23(14):3354-3356.
[4]郭振峰,杨士伟,周玉杰,等.肺动脉瓣感染性心内膜炎致肺栓塞一例.中华心血管病杂志,2012,40(6):530-531.
[5]黄楠,徐永通,李建华,等.感染性心内膜炎赘生物超声心动图诊断的临床研究.中华医院感染学杂志,2014,24(8):1935-1936.
[6]李越凡,彭静.感染性心内膜炎合并血管栓塞的临床研究.泰山医学院学报,2015,23(4):426-427.
[7]安静.感染性心内膜炎合并血管栓塞的临床研究.中国现代药物应用,2016,10(18):61-62.
[8]吴延刚.感染性心内膜炎合并血管栓塞的临床研究.中西医结合心血管病电子杂志,2015,23(10):53-54.
[9]肖志荣.39例感染性心内膜炎合并血管栓塞的临床研究.医学信息,2010,23(6):60.
[10]尚喜艳,陈世芳,杨淑娥.老年感染性心内膜炎合并血管栓塞的临床分析.中华医院感染学杂志,2014,24(24):6136-6138.
[11]贾明理,毕静,唐明,等.感染性心内膜炎患者血管栓塞的相关因素分析.临床内科杂志,2015,32(6):386-388.
[12]甄福喜,张伟,倪步青,等.感染性心内膜炎合并栓塞30例临床分析.江苏医药,2013,39(21):2557-2559.
[13]李丽萍,方健,罗崇彬,等.感染性心内膜炎合并脑栓塞患者的药学监护.海南医学,2013,24(9):1379-1381.
[14]张桂华.感染性心内膜炎导致栓塞的临床研究.医学信息,2014,27(4):283.