Hayashi J, Yamamoto K, Moro H, Eguchi A
Second Department of Surgery, Niigata University School of Medicine, Japan.
Kyobu Geka. 1996 Jul;49(8 Suppl):665-8.
We reviewed clinical course and surgical outcome of 31 patients with native valve endocarditis who underwent an operation between 1980 and 1994. In the present study, 15 patients who manifested a neurologic complication associated with endocarditis and/or those who had a periannular abscess were assigned as 'clinical active'. Comparing with non-active group (n = 16), clinical active group included more patients with increased C-reactive protein level and those with histological acute inflammatory reaction on excised valvular tissue. Optimal timing of the operation and surgical procedures for aortic root reconstruction were significant problems in the active group. Actuarial probability of survival at 5 postoperative year was 50.8 and 87.5% in the active and non-active group, respectively. The results suggest our 'clinical activity' is a useful predictor in patients with native valve endocarditis.
我们回顾了1980年至1994年间接受手术的31例自体瓣膜心内膜炎患者的临床病程和手术结果。在本研究中，15例表现出与心内膜炎相关的神经系统并发症和/或患有瓣周脓肿的患者被归为“临床活动组”。与非活动组（n = 16）相比，临床活动组中C反应蛋白水平升高的患者以及切除的瓣膜组织有组织学急性炎症反应的患者更多。手术的最佳时机和主动脉根部重建的手术方法是活动组中的重要问题。术后5年的实际生存率在活动组和非活动组中分别为50.8%和87.5%。结果表明，我们的“临床活动度”是自体瓣膜心内膜炎患者的一个有用预测指标。
