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18例孤立性右侧感染性心内膜炎患者的临床特征

[Clinical features of 18 patients with isolated right sided infective endocarditis].

作者信息

Wang Peng, Tan Hui-qiong, Xiong Chang-ming, Zhao Hong

机构信息

Department of Cardiology, Cardiovascular Institute and Fu Wai Hospital, Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Apr;38(4):342-5.

Abstract

OBJECTIVE

To analyze the clinical characteristics of 18 patients with isolated right sided infective endocarditis (RSIE) who hospitalized in our department between August 2005 and February 2009.

METHODS

The epidemiological and clinical data of 18 non-drug addicts with RSIE were retrospectively analyzed.

RESULTS

The incidence of RSIE accounted for 7.23% of all IE patients hospitalized in our department during the same period. Predisposing conditions were as follows: congenital heart disease (76.5%, 14/18), post operative procedures (3/18) and high dose glucocorticoids use (1/18). Fever (100%) was the most common clinical manifestation. Septic pulmonary embolism was the most prevalent complication (5/18). Staphylococci aureus (4/7) were the most common causative patho organisms, while the most common etiological organisms of left-sided and both-sided IE were Streptococci Viridans. Transthoracic echocardiography evidenced 17 cases of vegetations including 59.1% (13/22) tricuspid vegetations. There was no in-hospital death and the mean hospitalization duration was (22.0 +/- 18.9) days.

CONCLUSIONS

Congenital heart diseases, but not intravenous drug abuse, were the most prevalent predisposing factors for RSIE in this cohort. Staphylococci aureus were the most common causative organisms.

摘要

目的

分析2005年8月至2009年2月间在我科住院的18例孤立性右侧感染性心内膜炎(RSIE)患者的临床特征。

方法

回顾性分析18例非吸毒成瘾的RSIE患者的流行病学和临床资料。

结果

RSIE的发病率占同期在我科住院的所有IE患者的7.23%。易感因素如下:先天性心脏病(76.5%,14/18)、术后操作(3/18)和高剂量糖皮质激素使用(1/18)。发热(100%)是最常见的临床表现。脓毒性肺栓塞是最常见的并发症(5/18)。金黄色葡萄球菌(4/7)是最常见的致病病原体,而左侧和双侧IE最常见的病原体是草绿色链球菌。经胸超声心动图证实17例有赘生物,其中三尖瓣赘生物占59.1%(13/22)。无院内死亡,平均住院时间为(22.0±18.9)天。

结论

在该队列中,先天性心脏病而非静脉药物滥用是RSIE最常见的易感因素。金黄色葡萄球菌是最常见的致病病原体。

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