查詢結果分析
相關文獻
- Analysis of 109 Cases of Infective Endocarditis in a Tertiary Care Hospital
- 成人感染性心內膜炎的診斷準則--將心臟超音波納入考慮的Duke新診斷準則
- 心臟超音波對評估感染性心內膜炎伴演之角色
- Preoperative Demonstration of Aortocardiac Fistula Caused by Aortic Valve Endocarditis Using Real-Time Three-Dimensional Echocardiography--A Case Report
- 感染性心內膜炎之診斷與治療
- 心臟超音波在感染性心內膜炎的角色--一病例報告及文獻回顧
- Evaluation of Topographic Gastric Histology in H. Pylori Infection--A Comparative Study with CLO Test and Bacterial Culture
- The Significance of Early Subtle Coronary Arterial Lesions on Echocardiogram in Kawasaki Disease
- Fatal Pulmonary Embolism in a Child Undergoing Extra-Ventricular Drainage Surgery--A Case Report
- Midterm Outcome of Mitral Valve Regurgitation after Repair of Atrioventricular Septal Defect
頁籤選單縮合
題名 | Analysis of 109 Cases of Infective Endocarditis in a Tertiary Care Hospital=感染性心內膜炎:109例之分析 |
---|---|
作者 | 翁明章; 張峰義; 楊祖光; 丁予安; | 書刊名 | 中華醫學雜誌 |
卷期 | 58:1 1996.07[民85.07] |
頁次 | 頁18-23 |
分類號 | 415.31 |
關鍵詞 | 細菌培養; Duke定義; 心臟超音波; 感染性心內膜炎; Blood culture; Duke criteria; Echocardiogram; Infective endocarditis; |
語文 | 英文(English) |
中文摘要 | 背景 感染性心內膜炎早期診斷和治療可獲得較佳的預後,以前早期 診斷方法多靠組織病理和血液培養,但其診斷的敏感度較低,因而有許多病例 被認為非感染性心內膜炎。心臟超音波的應用,提高病例診斷的敏感度,且發 現瓣膜贅物的有無對死亡率及併發症的發生有不同結果。 方法 從1984到1994年,11年的時間,本院共有120例感染性心內膜炎的病 例。所有病例均以von Reyn及Duke二定義再重新診斷。記錄男女比例,年齡 分佈,比較二種定義的差別,病人可能的促病原因,及死亡率和併發症與血液 培養結果和心臟超音波的關係。 結果 其中有109例被Duke定義為臨床上確實或可能為感染性心內膜炎而納 入本研究。男女比率為2.8:1,平均年齡為38歲。造成感染性心內膜炎的可能促 病因依次為風濕性心臟病、先天性心臟病、僧帽瓣脫垂、曾接受牙齒治療及靜 脈藥物濫用。本研究病人的存活率為74%,中樞神經併發症是最為常見的併發 症。只有51%的病例在血液中可培養出細菌,而死亡率在血液培養陰性或陽性 二組中分別為26%及25%,並無統計上的差別。依心臟超音波發現有無瓣膜贅 物將病人分為二組,其死亡率及周圍血管或器官血栓的併發症在有贅物的一組 有統計上明顯的增高。 結論 Duke較von Reyn的定義納入較多感染性心內膜炎的病例,23例被von Reyn判定為非感染性心內膜炎病例中有12例被Duke定義為確實(7例)或可能(5 例)是感染性心內膜炎,所以Duke定義診斷感染性心內膜炎,可以有較高的敏 感度。死亡率在血液培養陰性或陽性二組間並無差別。心臟超音波上有瓣膜贅 物發現的病人其死亡率及周圍血管或器官發生血栓的機會較無贅物的病人要來 的高,而中樞神經併發症與充血性心臟衰竭在二組之間並無差別。 |
英文摘要 | Background. Early diagnosis and treatment can benefit the outcome of patients with infective endocarditis. The older diagnostic criteria (von Reyn criteria) relied upon tissue pathology and blood culture results, but the sensitivity was low. A newly proposed criteria, Duke criteria which apply echocardiographic findings as a major factor in diagnosis, have shown a better sensitivity in the diagnosis of infective endocarditis. Methods. From 1984 to 1994, 120 episodes of endocarditis in 119 patients were reviewed retrospectively. One hundred and nine episodes fulfilling the Duke criteria were enrolled. The demographic data, antecedent disease, predisposing factors for infective endocarditis including systemic disease, prosthetic valve, intravenous drug abuse, dental or surgical manipulation, culture results, echocardiographic findings, complications and outcome were recorded and analyzed. Results. Sixty-six percent (72/109) was definite endocarditis, and 34% (37/109) was possible endocarditis, as categorized by Duke criteria. Eleven percent (12/109) of the patients were rejected by von Reyn criteria. The common possible predisposing factors were rheumatic heart disease, congenital heart disease, mitral valve prolapse, dental manipulation and intravenous drug abuse. Both patients with positive blood culture and negative blood culture results had one-fourth mortality rate. A notably higher mortality rate was found in patients with S. aureus endocarditis as compared with those of endocarditis caused by viridans streptococci (44% vs. 8%, p < 0.05). Patients with echocardiographic vegetations had a higher mortality rate (32% vs. 11%, p < 0.05) and more peripheral or organ embolic events (26% vs. 6%, p < 0.05) than those without vegetation. Conclusions. The Duke criteria are more sensitive than the von Reyn criteria for diagnosis of infective endocarditis. S. aureus endocarditis carried a higher mortality rate than viridans streptococci endocarditis. The present study also indicated that patients with discernible valvular vegetation on echocardiogram had a high mortality rate and occurrence of peripheral or organ embolic events. However, there was no statistical significance in the development of congestive heart failure and CNS complications between the patients with and without vegetation. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。