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.
引文
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