耶路撒冷的感染性心内膜炎。天然瓣膜与人工瓣膜心内膜炎的对比分析。

Infective endocarditis in Jerusalem. A comparative analysis of native and prosthetic valve endocarditis.

作者信息

Leitersdorf E, Friedman G, Gozal D, Appelbaum A, Sacks T

出版信息

Isr J Med Sci. 1983 Jun;19(6):491-4.

Abstract

Thirty patients with prosthetic valve endocarditis (PVE) and 62 patients with native valve endocarditis (NVE) observed during a concurrent period of time (1970-80) were analyzed. Patients with PVE were also compared with 697 patients who underwent cardiac valve replacement in the same period, in an attempt to uncover risk factors for PVE. In the operated patients the overall incidence of endocarditis was 4.3%. There were several significant differences between the NVE and PVE groups. Atrial fibrillation was more prevalent in the PVE group (33.4 vs. 11.5%, P less than 0.05), while infection with gram-positive organisms was more prevalent in the NVE patients (79 vs. 47%, P less than 0.01). The outcome of combined medical and surgical treatment showed a much higher mortality rate (50 vs. 6.4%, P less than 0.01) in the PVE group. Staphylococcal endocarditis resulted in 16% mortality in NVE vs. 100% in the PVE group (P less than 0.01). Careful surveillance may hopefully lead to early detection, treatment and better outcome of PVE.

摘要

对在同一时期（1970 - 1980年）观察到的30例人工瓣膜心内膜炎（PVE）患者和62例天然瓣膜心内膜炎（NVE）患者进行了分析。还将PVE患者与同期接受心脏瓣膜置换的697例患者进行了比较，以试图找出PVE的危险因素。在接受手术的患者中，心内膜炎的总体发病率为4.3%。NVE组和PVE组之间存在几个显著差异。房颤在PVE组中更为普遍（33.4%对11.5%，P<0.05），而革兰氏阳性菌感染在NVE患者中更为普遍（79%对47%，P<0.01）。药物和手术联合治疗的结果显示，PVE组的死亡率要高得多（50%对6.4%，P<0.01）。葡萄球菌性心内膜炎导致NVE的死亡率为16%，而PVE组为100%（P<0.01）。仔细监测有望实现PVE的早期发现、治疗并带来更好的结果。