【摘要】 目的了解感染性心内膜炎(IE)患者临床特征、术后短期预后影响因素。方法回顾性分析中南大学湘雅医院2013年8月至2015年7月手术治疗的感染性心内膜炎患者110例,通过电子病历信息系统及纸质病历收集数据并整理分析。结果共纳入110例患者,年龄(40.8±14.5)岁,男性占63.6%,病程持续时间为(85.6±77.8)d,最常见症状为发热(72.7%)、气促(56.4%)、胸痛或胸闷(38.2%)。共有20例(18.2%)患者出现各类血管栓塞事件。50例(45.5%)患者有明确易感因素,最常见易感因素依次为主动脉瓣二叶瓣畸形、其他先天性心脏病、风湿性心脏病。术前心功能Ⅲ级或Ⅳ级占75.5%。术后死亡4例,其中3例双瓣膜置换术,1例三尖瓣置换术,其他瓣膜置换或成形术无死亡事件。术前C反应蛋白(CRP)浓度与术后死亡事件相关,术前C反应蛋白浓度及术后肌酐浓度与术后并发症相关。结论感染性心内膜炎患者术后短期预后可能与术前C反应蛋白浓度及术后肌酐浓度相关。更多还原

【Abstract】 Objectives To study the clinical characteristics of patients who suffered from infective endocarditis(IE)and to investigate the short-term prognostic factors after surgery. Methods The IE patients who underwent surgery in Xiangya Hospital from August 2013 to July 2015 were studied and the data were collected through the hospital information system and paper records. Results A total of 110 patients were collected and men accounted for 63.6%.Age was(40.8±14.5) years and illness duration was(85.6±77.8) days. The most common symptoms were fever(72.7%), shortness of breath(56.4%), chest pain or tightness(38.2%). A total of 20(18.2%) cases suffered from various types of vascular thrombotic events. There were 50(45.5%) patients with definite risk factors and the most common risk factors were bicuspid aortic valve malformation, other congenital heart disease and rheumatic heart disease.Cardiac function of 75.5% patients was class Ⅲ or Ⅳ before surgery. Four cases died post-operation, including 3 cases of bicuspid valve replacement surgery and 1 case of tricuspid valve replacement. Preoperative concentration of C-reactive protein(CRP) was related to postoperative mortality. Preoperative concentration of CRP and postoperative concentration of creatinine were related to postoperative complications. Conclusions Short-term prognosis in IE patients after surgery may be related with preoperative concentration of CRP and postoperative concentration of creatinine.更多还原