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感染性心内膜炎与非感染性心内膜炎的概述与比较:814 例尸检病例回顾。

Overview and Comparison of Infectious Endocarditis and Non-infectious Endocarditis: A Review of 814 Autoptic Cases.

机构信息

Institute of Pathological Anatomy, Riuniti Hospital and University of Trieste, Trieste, Italy.

Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy

出版信息

In Vivo. 2019 Sep-Oct;33(5):1565-1572. doi: 10.21873/invivo.11638.

Abstract

AIM

We examined evidence on infective and non-infective endocarditis obtained from a database of 50,403 clinical autopsies performed at an Italian general hospital between January 1983 and December 2006.

MATERIALS AND METHODS

Out of 814 endocarditis cases, 409 were of infective endocarditis (IE) and 405 non-infective (NIE). The median age at the time of death was 78 years for those with IE and 83 for those with NIE. Data were collected on gender, clinical history, comorbidities, kind of affected valve (non-prosthetic/mechanical/biological), pathological features of endocarditis, endocarditis complications and microbiological agents.

RESULTS

The diagnosis of IE was frequently missed and these conditions were often complicated by cardiovascular events. IE was more common among patients with prior valve infection or cardiovascular surgery, while malignancies were frequent comorbidities of NIE.

CONCLUSION

In general, we found several data that differ from those generally present in the scientific literature, and this could be explained by the fact that data on IE and NIE are generally obtained from surgical and clinical databases, while we analysed only autoptic cases.

摘要

目的

我们从意大利一家综合医院 1983 年 1 月至 2006 年 12 月间进行的 50403 例临床尸检数据库中,研究了关于感染性和非感染性心内膜炎的证据。

材料与方法

在 814 例心内膜炎病例中,409 例为感染性心内膜炎(IE),405 例为非感染性心内膜炎(NIE)。IE 患者的死亡时中位年龄为 78 岁,NIE 患者为 83 岁。收集的数据包括性别、临床病史、合并症、受累瓣膜类型(非假体/机械/生物)、心内膜炎的病理特征、心内膜炎并发症和微生物制剂。

结果

IE 的诊断经常被漏诊,这些情况常伴有心血管事件。IE 更常见于有先前瓣膜感染或心血管手术的患者,而恶性肿瘤是 NIE 的常见合并症。

结论

总的来说,我们发现了一些与科学文献中通常存在的数据不同的数据,这可能是由于 IE 和 NIE 的数据通常来自手术和临床数据库,而我们仅分析了尸检病例。

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