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目的探讨感染性心内膜炎(IE)合并血管栓塞的临床特点及相关危险因素。方法 116例感染性心内膜炎住院患者,按照患者是否有血管栓塞分成栓塞组(19例)与非栓塞组(97例),分析其相关因素。结果 116例感染性心内膜炎患者中,19例发生血管栓塞,其发生率为16.38%。栓塞部位为脑动脉8例,脾动脉3例,肺动脉4例,冠状动脉2例,其他2例。应用超声心动图发现96例有赘生物,发生率为82.76%,其中三尖瓣者18例(15.52%),二尖瓣49例(42.24%),主动脉瓣者29例(25.00%)。高血压病、糖尿病、血培养阳性、赘生物培养阳性及赘生物≥10 mm均与其具有相关性(P<0.05);赘生物培养阳性及赘生物直径≥10 mm为其独立危险因素(P<0.05)。结论感染性心内膜炎会导致血管栓塞病症的产生,经赘生物培养显示阳性、赘生物直径≥10 mm时对IE合并血管栓塞是一种具有独立性的危险因子,当感染处于活动期时需对其进行有效控制,避免栓塞的形成。
Objective To investigate the clinical features and related risk factors of infective endocarditis (IE) complicated with vascular embolism. Methods One hundred and sixty - six patients with infective endocarditis were divided into embolization group (n = 19) and non - embolization group (n = 97) according to whether the patients had vascular embolism. The related factors were analyzed. Results Of the 116 patients with infective endocarditis, 19 had vascular embolism with a rate of 16.38%. The embolization site was 8 cases of cerebral artery, 3 cases of splenic artery, 4 cases of pulmonary artery, 2 cases of coronary artery, the other 2 cases. Echocardiography revealed 96 cases of neoplasms, the incidence was 82.76%, including 18 cases of tricuspid valve (15.52%), 49 cases of mitral valve (42.24%), aortic valve in 29 cases (25.00%). Hypertension, diabetes mellitus, blood culture positive, neoplasm culture positive and neoplasm≥10 mm were all related to it (P <0.05); neoplasm culture positive and neoplasm diameter≥10 mm were independent risk factors (P < 0.05). Conclusions Infective endocarditis can lead to the development of vascular embolism. It has been shown to be positive by neoplasm culture. When the diameter of neoplasm is greater than or equal to 10 mm, it is an independent risk factor for IE with vascular embolism. When the infection is active It needs to be effectively controlled to prevent the formation of embolism.