Manolis A S, Melita H
Department of Medicine, Cabrini Medical Center, New York Medical College, New York.
Arch Intern Med. 1988 Nov;148(11):2461-5.
Thirty-four drug addicts with endocarditis were studied to evaluate the prognostic significance of vegetation size and its short-term changes, as determined by two-dimensional echocardiography. Among 43 episodes of endocarditis, vegetations were detected in 27 (63%), confined to the tricuspid valve in 20 patients, mitral valve in one, aortic valve in two, and both tricuspid and mitral valves in four. All vegetations were large (greater than or equal to 1 cm) (mean maximal dimension, 1.7 +/- 0.5 cm). Medical cure was achieved in all 16 patients without vegetations and in 18 (90%) of 20 patients with tricuspid valve vegetations. One patient with tricuspid vegetation and polymicrobial infection died of respiratory failure. Surgery was required for one patient with tricuspid vegetation, all three patients with isolated left-sided endocarditis, and two of four patients with multivalve involvement. Short-term changes of tricuspid valve vegetations during therapy (one to eight weeks) did not correlate with clinical outcome. Although large tricuspid vegetations may occasionally identify a subset at risk for complications, most patients with isolated tricuspid valve endocarditis have a benign prognosis.
对34例患有心内膜炎的药物成瘾者进行了研究，以评估二维超声心动图所确定的赘生物大小及其短期变化的预后意义。在43例心内膜炎发作中，27例（63%）检测到赘生物，其中20例局限于三尖瓣，1例局限于二尖瓣，2例局限于主动脉瓣，4例同时累及三尖瓣和二尖瓣。所有赘生物均较大（大于或等于1 cm）（平均最大直径为1.7±0.5 cm）。16例无赘生物的患者均实现了药物治愈，20例有三尖瓣赘生物的患者中有18例（90%）实现了药物治愈。1例患有三尖瓣赘生物和多种微生物感染的患者死于呼吸衰竭。1例有三尖瓣赘生物的患者、所有3例孤立性左侧心内膜炎患者以及4例多瓣膜受累患者中的2例需要进行手术。治疗期间（1至8周）三尖瓣赘生物的短期变化与临床结局无关。尽管较大的三尖瓣赘生物偶尔可能会识别出有并发症风险的亚组，但大多数孤立性三尖瓣心内膜炎患者预后良好。
