Morguet A J, Bökemeier M, Kreuzer H
Abteilung Kardiologie und Pulmonologie, Zentrum Innere Medizin, Universität Göttingen.
Dtsch Med Wochenschr. 1995 Sep 8;120(36):1191-6. doi: 10.1055/s-2008-1055464.
In a retrospective study, we compared the characteristics of native valve and prosthetic valve endocarditis.
All 155 cases of left-sided infective endocarditis in 142 patients admitted at our institution between 1986 and 1992 were analyzed based on their medical records. Native valve endocarditis was found in 119 cases (74 men, 45 women; median age 55, range 29 to 80 years), prosthetic valve endocarditis in 36 cases (11 men, 25 women; median age 63, range 38 to 80 years; 29 cases of late infection).
There were more older (P < 0.0005) and more female (P = 0.001) patients with prosthetic valve endocarditis. Most frequently, native aortic valves (53.8%) or mitral prostheses (55.6%) were solely involved. In both groups, Staphylococcus epidermidis was the most frequent isolate followed by Staphylococcus aureus and Enterococci. Symptoms and clinical findings were similar in both groups. In all cases since July 1989, transthoracic echocardiography was suggestive of endocarditis in native valves in 63.9% and in prostheses in 29.2% (P = 0.004), combined with the transesophageal approach in 91.7 and 91.8%, respectively (not significant). Embolism and surgical intervention were about equally frequent in both groups. The in-hospital mortality was 19.3% in native valves and 22.2% in prostheses (not significant).
Native valve and late prosthetic valve endocarditis are now similar in the spectrum of causative microorganisms, echocardiographic diagnostics, clinical course and prognosis.
在一项回顾性研究中，我们比较了自体瓣膜心内膜炎和人工瓣膜心内膜炎的特征。
对1986年至1992年间我院收治的142例患者中的155例左侧感染性心内膜炎病例进行了病历分析。自体瓣膜心内膜炎119例（男性74例，女性45例；年龄中位数55岁，范围29至80岁），人工瓣膜心内膜炎36例（男性11例，女性25例；年龄中位数63岁，范围38至80岁；29例为晚期感染）。
人工瓣膜心内膜炎患者年龄更大（P < 0.0005）且女性更多（P = 0.001）。最常受累的是单纯的自体主动脉瓣（53.8%）或人工二尖瓣（55.6%）。两组中，表皮葡萄球菌是最常见的分离菌株，其次是金黄色葡萄球菌和肠球菌。两组的症状和临床发现相似。自1989年7月起，在所有病例中，经胸超声心动图提示自体瓣膜心内膜炎的占63.9%，人工瓣膜心内膜炎的占29.2%（P = 0.004），分别联合经食管超声心动图检查的比例为91.7%和91.8%（无显著差异）。两组的栓塞和手术干预发生率大致相同。自体瓣膜心内膜炎的院内死亡率为19.3%，人工瓣膜心内膜炎为22.2%（无显著差异）。
目前自体瓣膜心内膜炎和人工瓣膜晚期心内膜炎在致病微生物谱、超声心动图诊断、临床病程和预后方面相似。
