Abe T, Tsukamoto M, Komatsu S
Department of Surgery (Section 2), Sapporo Medical University and Hospital, Japan.
Jpn Circ J. 1993 Nov;57(11):1080-8. doi: 10.1253/jcj.57.1080.
The purpose of this study was to determine the clinical predictors of active infective endocarditis in 45 cases we treated between January 1971 and August 1991 (30 native valve endocarditis (NVE) and 15 prosthetic valve endocarditis (PVE). The indication of surgery in 45 patients was progressive congestive heart failure (CHF), septicemia and systemic embolization. The aortic valve was involved in 24 (53%) of 45 patients (13 of 30 NVE and 11 of 15 PVE) and there was significantly higher early mortality in aortic PVE (36%) than in aortic NVE (8%). The 9 patients with severe cardiac failure (NYHA Class V) before surgery were associated with a significantly higher incidence of early mortality (5/9 = 56%) than those in Class III (2/14 = 14%) and Class IV (3/18 = 17%). We concluded that aortic valve infection is more prevalent than mitral valve infection and is more often associated with staphylococcus infection, including abscess formation. Early surgical intervention should be performed despite the risk of cardiac failure and extensive infection.
本研究的目的是确定1971年1月至1991年8月期间我们治疗的45例患者中活动性感染性心内膜炎的临床预测因素（30例自体瓣膜心内膜炎（NVE）和15例人工瓣膜心内膜炎（PVE））。45例患者的手术指征为进行性充血性心力衰竭（CHF）、败血症和全身性栓塞。45例患者中有24例（53%）累及主动脉瓣（30例NVE中的13例和15例PVE中的11例），主动脉PVE的早期死亡率（36%）显著高于主动脉NVE（8%）。术前有严重心力衰竭（纽约心脏协会V级）的9例患者的早期死亡率发生率（5/9 = 56%）显著高于III级（2/14 = 14%）和IV级（3/18 = 17%）的患者。我们得出结论，主动脉瓣感染比二尖瓣感染更普遍，并且更常与葡萄球菌感染相关，包括脓肿形成。尽管存在心力衰竭和广泛感染的风险，仍应尽早进行手术干预。
