三右侧感染性内心炎:一种未被识别的右侧内心炎类型
Gonzalo Cabezón1, Javier López1, Isidre Vilacosta2
1Hospital Clínico Universitario, CIBERCV, Valladolid, Spain.
Medicine
|July 21, 2023
概括
"3无右侧传染性内心炎" (3no-RSIE) 影响的是没有左侧疾病,药物使用或心脏器件的患者. 手术可能会改善结果,因为死亡率高于其他RSIE类型.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 右侧传染性内心炎 (RSIE) 涉及多种不同患者群体.
- 具体的亚型"3无右侧传染性内心炎" (3无RSIE) 不包括左侧感染,静脉注射药物使用和心脏器械.
- 描述3no-RSIE对于理解其独特的临床和预后特征至关重要.
研究的目的:
- 描述迄今为止最大的系列,描述3no-RSIE的临床,微生物学,心声学和预后概况.
- 确定与3no-RSIE患者的住院死亡率相关的因素.
主要方法:
- 来自八个高等医疗中心的100名确定的3no-RSIE患者的回顾性分析.
- 数据收集包括每位患者53个变量.
- 对住院死亡率进行了单变量分析,以确定预后因素.
主要成果:
- 没有RSIE的病例占所有RSIE病例的16.7%.
- 大多数病例是社区获得的 (72%),先天性心脏病是常见的倾向因素 (32%).
- 葡萄球菌 spp. 葡萄球菌 spp. 是主要原因 (52%),在94%的患者中检测到植被.
- 全球住院死亡率为19%,与医疗治疗患者 (26%) 相比,手术治疗患者 (5.7%) 的死亡率明显较低.
- 与死亡率相关的因素包括非社区获得的感染,糖尿病,右心力衰竭,性休克和急性功能衰竭.
结论:
- 3no-RSIE的临床表现类似于其他类型的RSIE,但死亡率更高.
- 外科手术似乎是改善无RSIE患者治疗结果的重要因素.
- 对优化治疗策略的进一步研究对于这种特定的RSIE亚型是有必要的.
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