| Objective: This study through to the second hospital,Hebei Medical University from 2015 to 2018 of the 200 cases of patients with infective endocarditis of the demographic characteristics,clinical manifestations,pathogenic bacteria and drug sensitive test,the prognosis and influence factors were analyzed,and for early diagnosis and targeted treatment as soon as possible,to prevent complications,reduce the sick rate,which provides the basis for improving the prognosis of patients.Methods: This study through the retrospective analysis of 2015 to 2018,the second hospital of Hebei Medical University,and a clear diagnosis of infective endocarditis patients in hospital information,read the information from the electronic medical record system,to the patient's clinical characteristic,pathogenic bacteria and drug resistance situation,prognosis,and description and analysis on the influencing factors,count data description with absolute count and percentage,continuous variables with a mean ± standard deviation.The statistical package SPSS21.0 was used for statistical processing.Results:(1)There were 200 patients with infective endocarditis,with an average age of 47.6±16.5 years old.The middle-aged and elderly patients were the main body of the disease,and the male patients were more than 1.7 times of the female patients.(2)fever and heart failure were the most common clinical symptoms and complications,with 174 cases(87%)and 61 cases(30.5%),respectively.More than half of the patients had heart murmur(108 cases,54%),and 54 cases(27%)had combined embolism.(3)in this study,it was found that cardiology,cardiac surgery,department of infectious diseases and general practice were the top four departments for patients with infective endocarditis,accounting for 35%,15%,14% and 5% respectively.(4)a total of 158 vegetations were detected in this study,with a positive rate of 79%.The distribution was dominated by the left cardiac system,with 50 cases(25%)of aortic valve,26 cases(23%)of mitral valve,24 cases(12%)of mitral valve and aortic valve,24 cases(12%)of tricuspid valve,4 cases(2%)of mitral valve and tricuspid valve,and 12 cases(6%)of mitral valve,tricuspid valve and aortic valve.(5)of the 200 patients in this study,150(75%)had susceptibility factors,including dialysis,surgery,oral operations(tooth extraction,etc.),cancer,diabetes,autoimmune diseases and skin diseases.(6)there were 120 cases(60%)with valvular lesions,including 58 cases of congenital heart disease(29%),28 cases of artificial valve disease(14%),20 cases of rheumatic heart disease(10%),14 cases of degenerative valvular disease(7%),and 80 cases of non-heart disease(40%).(7)in this study,there were 93 cases of positive blood culture,with a positive rate of 46.5%,which were staphylococcus aureus(25 cases,26.9%),streptococcus aureus(20 cases,21.5%)and gram-negative bacteria(15 cases,16.1%).Single factor analysis showed that age over 65 years old,heart failure,embolism,staphylococcus aureus infection,and consciousness disorder were the risk factors affecting the prognosis(P<0.05).Conclusions:(1)The clinical manifestations of patients with infective endocarditis are mainly fever,cardiac complications and vascular embolism,with complicated and diversified symptoms and signs.(2)the patients are widely distributed in the departments of internal medicine,cardiac surgery and general medicine.(3)echocardiography is still the main method of IE imaging diagnosis.The detection rate of vegetations is high,and the location of vegetations is related to the basic diseases of the heart.(4)the pathogenic bacteria of infective endocarditis are mainly staphylococcus aureus and streptococcus,which are gradually resistant to penicillin.(5)surgical treatment should be performed as soon as possible in patients with infective endocarditis(infective endocarditis) when the infection worsens uncontrollably,embolism,or heart failure. |
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