牛链球菌性心内膜炎及其与慢性肝病的关联：一个被低估的危险因素。
Streptococcus bovis endocarditis and its association with chronic liver disease: an underestimated risk factor.
作者信息
Tripodi M F, Adinolfi L E, Ragone E, Durante Mangoni E, Fortunato R, Iarussi D, Ruggiero G, Utili R
机构信息
Department of Internal Medicine, Second University of Naples, I-80135 Naples, Italy.
出版信息
Clin Infect Dis. 2004 May 15;38(10):1394-400. doi: 10.1086/392503. Epub 2004 Apr 28.
Clinical and epidemiological characteristics of Streptococcus bovis endocarditis were prospectively studied among 199 patients with definite endocarditis. Thirty patients (15.1%) had S. bovis endocarditis. Compared with patients with non-S. bovis endocarditis, these 30 patients were older (mean age, 58.6+/-12.4 years vs. 46.0+/-17.0 years; P<.001) and had higher rates of bivalvular involvement (43.3% vs. 7.7%; P<.001), embolism (73.3% vs. 40.2%; P=.002), and diskitis (23.3% vs. 0.6% P<.001). In patients with S. bovis biotype I (S. bovis I) endocarditis, advanced liver disease was present in 56.7%, compared with 15.3% of patients with non-S. bovis endocarditis (P<.001), and colonic adenoma was present in 46.7%. The in-hospital mortality rate (16.7%) was correlated with delayed diagnosis and advanced liver diseases. In our city, S. bovis I endocarditis is frequently correlated with liver diseases; diskitis may be the first sign of the disease.
我们对199例确诊为心内膜炎的患者进行了前瞻性研究，以了解牛链球菌心内膜炎的临床和流行病学特征。30例患者（15.1%）患有牛链球菌心内膜炎。与非牛链球菌心内膜炎患者相比，这30例患者年龄更大（平均年龄58.6±12.4岁 vs. 46.0±17.0岁；P<0.001），双瓣膜受累率更高（43.3% vs. 7.7%；P<0.001）、栓塞发生率更高（73.3% vs. 40.2%；P=0.002）以及椎间盘炎发生率更高（23.3% vs. 0.6%，P<0.001）。在患有I型牛链球菌（S. bovis I）心内膜炎的患者中，56.7%存在晚期肝病，而非牛链球菌心内膜炎患者的这一比例为15.3%（P<0.001），46.7%的患者存在结肠腺瘤。住院死亡率（16.7%）与诊断延迟和晚期肝病相关。在我们城市，I型牛链球菌心内膜炎常与肝病相关；椎间盘炎可能是该病的首发症状。
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