Smith R H, Radford D J, Clark R A, Julian D G
Thorax. 1976 Aug;31(4):373-9. doi: 10.1136/thx.31.4.373.
The incidence and characteristics of infective endocarditis were studied in a defined community over a four-year period. Seventy-eight cases were found, giving an incidence of 16 cases permillion per year. The commonest presenting features were those of infection; 53% had cardiac failure and 37% evidence of emboli when first seen. Twenty-three cases occurred on rheumatic heart valves, 13 on valvular prostheses, and 19 in previously normal hearts. Streptococcus viridans was the commonest organism, but there was a relatively high incidence of staphylococcal infection. Only four cases were preceded by dental manipulation, and no source for the infection was found in 46 patients. The mortality rate was 46%, cardiac failure and embolic phenomena accounting for 65% of deaths. It is unlikely that earlier diagnosis or cardiac surgery would have reduced the mortality appreciably.
在一个特定社区内，对感染性心内膜炎的发病率及特征进行了为期四年的研究。共发现78例病例，每年发病率为每百万人口中有16例。最常见的临床表现为感染相关症状；初诊时53%的患者有心力衰竭，37%有栓塞迹象。23例发生于风湿性心脏瓣膜，13例发生于人工瓣膜，19例发生于既往正常的心脏。草绿色链球菌是最常见的病原体，但葡萄球菌感染的发病率相对较高。仅有4例发病前有牙科操作史，46例患者未发现感染源。死亡率为46%，心力衰竭和栓塞现象占死亡原因的65%。早期诊断或心脏手术不太可能显著降低死亡率。
