Abramczuk Elzbieta, Hryniewiecki Tomasz, Stepińska Janina
Klinika Wad Nabytych Serca Instytutu Kardiologii, ul. Alpejska 42, 04-628 Warszawa.
Kardiol Pol. 2007 Feb;65(2):115-22; discussion 123-4.
Despite progress in medicine, the prevalence of infective endocarditis (IE) in patients with prosthetic valves (PVE) has not decreased. Positive blood and valve cultures are one of the most important diagnostic criteria of IE. There are no unambiguous data regarding the influence of pathogenic factors on prognosis.
To analyse blood and valve cultures in patients with PVE and assess their impact on the risk of early and late deaths as well as IE relapse.
The study group consisted of 71 PVE patients. Infective endocarditis was diagnosed based on the Polish Cardiac Society guidelines. Early and late mortality as well as IE relapse were analysed in patients hospitalised between 1988 and 1998.
Positive blood cultures were found in 55 (77.5%) patients. Early mortality was 15.5% (11 deaths). Coagulase-negative Staphylococcus infection was an independent risk factor of early death (p=0.02). During long-term follow-up 8 (13.3%) patients died. The risk of late death increased with positive valve culture (p=0.04). Recurrence of IE was diagnosed in 6 (10%) patients. Staphylococcus epidermidis was a risk factor of disease relapse (p=0.03). Six-year survival was 73%.
尽管医学取得了进步，但人工瓣膜患者感染性心内膜炎（IE）的患病率并未降低。血培养和瓣膜培养阳性是IE最重要的诊断标准之一。关于致病因素对预后的影响，尚无明确数据。
分析人工瓣膜患者的血培养和瓣膜培养情况，并评估其对早期和晚期死亡风险以及IE复发的影响。
研究组由71例人工瓣膜患者组成。根据波兰心脏病学会指南诊断感染性心内膜炎。对1988年至1998年住院的患者分析早期和晚期死亡率以及IE复发情况。
55例（77.5%）患者血培养阳性。早期死亡率为15.5%（11例死亡）。凝固酶阴性葡萄球菌感染是早期死亡的独立危险因素（p=0.02）。在长期随访中，8例（13.3%）患者死亡。瓣膜培养阳性会增加晚期死亡风险（p=0.04）。6例（10%）患者被诊断为IE复发。表皮葡萄球菌是疾病复发的危险因素（p=0.03）。6年生存率为73%。
