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[脓毒性(感染性)心内膜炎的临床形态学分析]

[Clinico-morphologic analysis of septic (infectious) endocarditis].

作者信息

Serov V V, Butkevich O M, Chumakov A M, Vinogradova T L, Bogomolova E D

出版信息

Arkh Patol. 1982;44(3):27-33.

PMID:7082189
Abstract

Pathomorphosis of the disease has been studied on the basis of clinical and autopsy observations in the last three decades. The importance of staphylococcus, enterococcus, and gram-negative bacteria has been shown to increase among the causative agents of septic endocarditis; frequently the infectious agents have been observed to alternate in the course of the disease. Many manifestations of endocarditis were established to be associated with the circulating immune complexes containing bacterial antigens. In the last decade, primary septic endocarditis comprised about half of the observations. The proportion of isolated endocarditis and destructive changes of aortal valves increased. Myocarditis has become more frequent and in more than half of the cases it is associated with glomerulonephritis. In contrast, peripheral manifestations of endocarditis have considerably lost their diagnostic value. Among thromboembolic complications, venous thromboembolus of the pulmonary artery, and pulmonary infarction became more prevalent.

摘要

在过去三十年中,已基于临床和尸检观察对该疾病的病理形态进行了研究。已表明,在感染性心内膜炎的病原体中,葡萄球菌、肠球菌和革兰氏阴性菌的重要性有所增加;在疾病过程中经常观察到感染因子交替出现。已确定心内膜炎的许多表现与含有细菌抗原的循环免疫复合物有关。在过去十年中,原发性感染性心内膜炎约占观察病例的一半。孤立性心内膜炎和主动脉瓣破坏性改变的比例增加。心肌炎变得更加常见,并且在一半以上的病例中与肾小球肾炎有关。相比之下,心内膜炎的外周表现已大大丧失其诊断价值。在血栓栓塞并发症中,肺动脉静脉血栓栓塞和肺梗死变得更为普遍。

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