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[先天性心脏病中的细菌性心内膜炎]

[Bacterial endocarditis in congenital heart diseases].

作者信息

Dahan M, Vernant P, Casasoprana A, Legendre T, Larosa E

出版信息

Arch Mal Coeur Vaiss. 1982 Sep;75(9):1049-54.

PMID:6816169
Abstract

The following observations were made on a series of 15 cases of bacterial endocarditis on congenital cardiac lesions admitted between 1971 and 1980, in 13 patients aged 6 to 48 years old (average 21 yrs old): --The low but constant incidence of endocarditis--The majority of causal lesions were ventricular septal defects of Fallot's tetralogy--The portal of entry diagnosed in 2/3 of cases was usually dental--The causal organism was a streptococcus in 80% of cases--The long period of pyrexia before, the diagnosis of endocarditis was made--M mode, and above all, 2D echo detected vegetations in half the cases where it was performed--The gravity of the immediate prognosis due to a 25% mortality and a high incidence of complications--Early complications present in 2/3 of cases were dominated by true "oslerian" lesions, cardiac failure, cerebral complications, pulmonary embolism and early relapse. --The relatively good secondary prognosis.

摘要

对1971年至1980年间收治的15例先天性心脏病变合并细菌性心内膜炎患者进行了如下观察,其中13例患者年龄在6至48岁之间(平均21岁):——心内膜炎发病率低但持续存在——多数致病病变为法洛四联症的室间隔缺损——三分之二病例中确诊的感染途径通常为牙科感染——80%病例的致病微生物为链球菌——在心内膜炎诊断之前有长时间发热——M型,尤其是二维超声心动图检查时,半数病例检测到赘生物——由于25%的死亡率和高并发症发生率,近期预后严重——三分之二病例出现的早期并发症主要为典型的“奥斯勒氏”病变、心力衰竭、脑部并发症、肺栓塞和早期复发。——相对较好的继发预后。

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