右侧感染性心内膜炎：近期的流行病学变化
Right-sided infective endocarditis: recent epidemiologic changes.
作者信息
Yuan Shi-Min
机构信息
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University Putian, Fujian Province, China.
出版信息
Int J Clin Exp Med. 2014 Jan 15;7(1):199-218. eCollection 2014.
BACKGROUND
Infective endocarditis (IE) has been increasingly reported, however, little is available regarding recent development of right-sided IE.
METHODS
Right-sided IE was comprehensively analyzed based on recent 5⅓-year literature.
RESULTS
Portal of entry, implanted foreign material, and repaired congenital heart defects were the main predisposing risk factors. Vegetation size on the right-sided valves was much smaller than those beyond the valves. Multiple logistic regression analysis revealed that predisposing risk factors, and vegetation size and locations were independent predictive risks of patients' survival.
CONCLUSIONS
Changes of right-sided IE in the past 5⅓ years included younger patient age, and increased vegetation size, but still prominent Staphylococcus aureus infections. Complication spectrum has changed into more valve insufficiency, more embolic events, reduced abscess formation, and considerably decreased valve perforations. With effective antibiotic regimens, prognoses of the patients seemed to be better than before.
背景
感染性心内膜炎（IE）的报道日益增多，然而，关于右侧IE的最新进展却知之甚少。
方法
基于最近5⅓年的文献对右侧IE进行全面分析。
结果
入口、植入的异物和先天性心脏病修复缺损是主要的易感危险因素。右侧瓣膜上的赘生物大小远小于瓣膜外的赘生物。多因素逻辑回归分析显示，易感危险因素、赘生物大小和位置是患者生存的独立预测风险因素。
结论
过去5⅓年中右侧IE的变化包括患者年龄更年轻、赘生物大小增加，但金黄色葡萄球菌感染仍然突出。并发症谱已转变为更多的瓣膜功能不全、更多的栓塞事件、脓肿形成减少以及瓣膜穿孔显著减少。采用有效的抗生素治疗方案后，患者的预后似乎比以前更好。
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