长期预后和文化阴性传染性内心炎的手术结果
Lanlin Zhang1, Sheng Yang1, Yuanhang Zhai1
1Department of Cardiac Surgery Peking Union Medical College Hospital Beijing China.
Journal of the American Heart Association
|October 28, 2025
概括
培养负性传染性内心炎 (CNIE) 带来了挑战,但整体存活率与培养阳性病例相似. 然而,女性CNIE患者的预后明显较差,功能在结果中起作用.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 外科手术的结果
背景情况:
- 培养负性传染性内心炎 (CNIE) 带来了诊断和治疗方面的挑战.
- 在CNIE中缺乏可识别的病原体,往往导致经验性抗生素治疗.
- 与培养阳性病例相比,CNIE可能与潜在的更糟糕的临床结果有关.
研究的目的:
- 为了比较CNIE和培养阳性传染性内心炎患者的临床特征,手术结果和长期预后.
- 调查影响CNIE结果的因素.
- 找出可能的机制,将文化状态和死亡率联系起来.
主要方法:
- 对698名接受感染性内心炎手术的患者 (2013-2024) 的分析.
- 154名患者 (22.1%) 被归类为CNIE.
- 多变量考克斯回归和结构方程建模用于分析.
主要成果:
- CNIE患者在手术前表现出更差的心脏和功能.
- 在CNIE患者中,术后脏替代疗法的发病率较高.
- 女性CNIE患者的预后明显较差 (HR,2.13;P=0.04),功能下降部分介导死亡风险.
结论:
- 在CNIE和培养阳性传染性内心炎之间,总体长期存活率相似.
- 患有CNIE的女性患者的预后明显差.
- 降低功能是传染性内心炎培养状态和死亡率之间的关系的潜在调解者.
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