侵入性肺炎球菌病后的心血管事件:一个回顾性队列研究
Elisabeth A Dulfer1, Milou J V Serbée2, Kirsten K T Dirkx3
1Department of Clinical Microbiology, Radboud Centre for Infectious Diseases, Radboud University Medical Centre, 6525 GA Nijmegen, the Netherlands; Department of Internal Medicine, Maasziekenhuis Pantein, 5835 DV Beugen, the Netherlands.
概括
诸如中风和急性冠状动脉综合征 (ACS) 等心血管事件 (CVEs) 影响4.2%的侵袭性肺炎球菌病 (IPD) 患者. 风险因素包括滥用酒精,高烧和特定的肺炎球菌血清型,需要针对性的患者护理.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 侵入性肺炎球菌病 (IPD) 可以导致严重的心血管事件 (CVEs).
- 了解CVE后IPD的风险因素和时间对于患者管理至关重要.
- 之前的研究还没有完全阐明IPD后CVE的具体机制和预测因素.
研究的目的:
- 在IPD诊断后一年内确定CVE的发病率和潜在机制.
- 确定与CVE发展相关的特定风险因素,包括临床和微生物预测因素.
- 为IPD患者提供临床实践和患者护理策略的信息.
主要方法:
- 一项多中心队列研究,涉及来自荷兰四家医院 (2012-2020) 的IPD成年患者.
- 从电子病历系统地收集疾病特征和微生物学数据.
- 主要结局措施包括在入院后一年内发生中风和急性冠状动脉综合征 (ACS).
主要成果:
- 在914名符合条件的IPD患者中,4.2%的人在一年内经历了CVE.
- 主要发生在前两周内,而中风发生在整个随访期间.
- ACS的独立预测因素包括酒精滥用 (OR 3.840). 高热 (>39.5°C) 预测中风 (或3.117). 在70岁以下的患者中,7F和22F血清型分别预测了ACS和中风.
结论:
- 心血管事件是IPD诊断后的一个重大问题.
- 高风险群体,包括那些滥用酒精,高烧和特定肺炎球菌血清型的人,需要专注关注.
- 需要进一步的研究来证实特定肺炎球菌血清型在CVE发展中的作用.
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