Walpot Jeroen, Blok Willem, van Zwienen Jan, Klazen Cees, Amsel Bram
Department of Cardiology, Ziekenhuis Walcheren, Koudekerkseweg 88, Postbus 3200, 4380 DD Vlissingen, The Netherlands.
Acta Cardiol. 2006 Apr;61(2):175-81. doi: 10.2143/AC.61.2.2014331.
To measure the incidence of infective endocarditis (IE) in the region of Walcheren and to estimate the complication and comorbidity rate of IE, we conducted a 3-year retrospective study of IE in the only hospital (Ziekenhuis Walcheren) of the region between January, 2002 and December, 2004.
The total number of cases was 32. The calculated yearly incidence of IE was 9.61 cases per 100.000 inhabitants per year. The median age was 64 years (range 36-81 years). When applying the Duke criteria 28 patients (87.5%) were classified as definite IE and 4 patients (12.5%) as possible IE. Blood cultures were positive in 27 patients (84.4%). The most commonly isolated organisms were streptococci (37.5%). Staphylococcus aureus was isolated in 31.3% of positive blood cultures. Enteroccocus faecalis was identified in 3 cases (9.4%). In only 15.6% of the cases was the course of IE uncomplicated. The most frequent complications were heart failure (59.4%) and embolic events (34.4%). Cardiac surgery was performed in 37.5% of the cases. Concomitant morbidity was found in 75% of the patients. Especially, the high incidences of diabetes mellitus (28.1%), chronic renal failure (28.1%) and chronic obstructive pulmonary disease (21.9%) were remarkable.
The calculated incidence of IE of 9.61 cases per 100,000 inhabitants per year was more than five times higher than the one reported in a nation-wide Dutch study of 1992. The present study demonstrates that IE remains a disease with a considerable mortality and complication rate. The majority of the patients with IE had non-cardiac comorbidity. Especially, the prevalence of diabetes mellitus and chronic renal failure in our population of patients with IE is remarkable.
为了测定瓦尔赫伦地区感染性心内膜炎（IE）的发病率，并评估IE的并发症和合并症发生率，我们对该地区唯一的医院（瓦尔赫伦医院）在2002年1月至2004年12月期间的IE病例进行了一项为期3年的回顾性研究。
病例总数为32例。计算得出的IE年发病率为每10万居民每年9.61例。中位年龄为64岁（范围36 - 81岁）。根据杜克标准，28例患者（87.5%）被分类为确诊IE，4例患者（12.5%）为可能IE。27例患者（84.4%）血培养呈阳性。最常分离出的病原体是链球菌（37.5%）。在31.3%的阳性血培养中分离出金黄色葡萄球菌。3例（9.4%）鉴定为粪肠球菌。仅15.6%的IE病程无并发症。最常见的并发症是心力衰竭（59.4%）和栓塞事件（34.4%）。37.5%的病例接受了心脏手术。75%的患者有合并症。尤其是糖尿病（28.1%）、慢性肾衰竭（28.1%）和慢性阻塞性肺疾病（21.9%）的高发病率显著。
计算得出的IE发病率为每10万居民每年9.61例，比1992年荷兰全国性研究报告的发病率高出五倍多。本研究表明，IE仍然是一种死亡率和并发症发生率相当高的疾病。大多数IE患者有非心脏合并症。尤其是，我们的IE患者群体中糖尿病和慢性肾衰竭的患病率显著。
