Retrospective Analysis Of 115 Cases Of Infective Endocarditis

Objective:To explore the risk factors,clinical manifestations,laboratory examinations,etiology,color Doppler echocardiography,treatment and clinical outcomes of patients with infective endocarditis(IE),in order to improve the level of diagnosis and treatment of infective endocarditis.Methods:The clinical data of 115 patients with infective endocarditis who met the modified Duke diagnostic criteria and were older than 14 years old in our hospital during the past 10 years(2009.01-2018.08)were collected,including general characteristics,risk factors such as cardiac basic diseases and other systemic diseases,clinical manifestations,laboratory examinations,echocardiography,etiological examination,application of antibiotics,surgical operations,prognosis,and so on,these date were retrospective analyzed.Results:The average age of the patients was 49.49 ±17.118 years,and the ratio of male to female was 2.97:1.Male patients were predominant.Among the high risk factors,78.3% of the patients had at least one underlying heart disease.Non-rheumatic heart disease accounted for the highest proportion(39.1%),followed by congenital heart disease(18.3%).The proportion of rheumatic heart disease decreased(12.2%);and the proportion of non-basic heart disease increased(21.7%).The proportion of implantation of artificial materials in the heart also increased(10.4%),which became one of the high risk factors of IE.Fever was the most common clinical manifestation(99.1%).The detection rate of vegetation by echocardiography was 100%,the most of them were left ventricular vegetation(85.2%).Mitral valve was the most frequently involved valve(46.1%).The positive rate of blood culture was 65.2%(73/112),the most common pathogen was Streptococcus(50.7%,37/73),followed by Staphylococcus(19.2%,14/73).Streptococcus is still highly sensitive to Penicillin(90.5%).Vancomycin was the most widely used antibiotic(43.5%).65.2% of patients had at least one complication.40.0% of the patients received surgical treatment.The hospital mortality rate was 3.5%.Conclusion:The age at onset of IE showed an increasing trend,and the distribution of basic heart disease changed significantly.The clinical manifestations of IE are diversified,but lack of specific manifestations.Its vegetation mainly occurs in the left ventricular system.Mitral valve is the most vulnerable type of vegetation,which is highly correlated with the blood pressure it suffers.The change of pathogenic bacteria spectrum was not obvious,the main pathogen still was Streptococcus infection.Antibiotic therapy and surgical treatment are the main treatment methods for IE.The incidence of IE complications is high,but the overall prognosis is acceptable.Improving the understanding of IE is the key to early diagnosis,early effective treatment and improving prognosis.