【摘要】 目的:本研究布鲁菌心内膜炎患者临床特征并探讨内外科治疗的特点及预后分析。方法:回顾性分析2008年10月至2018年12月,在首都医科大学附属北京地坛医院住院诊断布鲁菌感染性心内膜炎患者,并对患者随访。分析患者的流行病学资料、临床特点、内外科治疗方法及预后。结果:811例确诊布鲁菌病患者中,布鲁菌感染性心内膜炎患者共6例,发生率为0. 7%。此6例患者中4例为男性,年龄25~65岁,其中5例接触过牛羊,1例无接触牛羊史,所有患者均发热,4例合并心功能不全表现。6例患者血培养布鲁菌均为阳性。所有患者均累及主动脉瓣。所有患者均接受抗菌药物长程治疗。其中5例接受瓣膜置换术,随访中2例出现瓣周漏,1例重新主动脉瓣膜置换。结论:布鲁菌感染性心内膜炎易引起心功能不全表现,主要累及主动脉瓣,长疗程抗菌治疗联合瓣膜置换手术是有效的治疗措施。更多还原

【Abstract】 Objective: To analyze the the epidemiology and clinical features of patients with Brucella endocarditis in order to improve the treatment. Methods: A retrospective analysis of patients with Brucella endocarditis was performed in Beijing Ditan Hospital affiliated to Capital Medical University from October 2008 to December 2018. demographic,characteristics,clinical features,laboratory data,echocardiography,treatment and clinical outcome of 6 patients with Brucella endocardiris were collected and analyzed and followed up. Results:A total of 6 patients with Brucella endocarditis were diagnosed in 811 patients with brucellosis,the incidence rate was 0. 7%. Of the 6 patients,4 were male,aged 25-65 years,5 of whom had been exposed to cattle and sheep,and 1 had no history of exposure to cattle and sheep. All patients had fever and 4 patients had heart failure at admission. Six patients were positive for blood culture Brucella. All patients involved the aortic valve. All patients received long-term treatment with antibiotics. Five of them underwent valve replacement. In the followup,2 patients had paravalvular leakage and 1 patient underwent re-aortic valve replacement. Conclusions:Brucella endocarditis is easy to cause left ventricular failure,mainly involving aortic valve. Long-term antibiotic treatment combined with valve replacement surgery is an effective treatment to improve the prognosis.更多还原