Clinical Research Of Infective Endocarditis

ObjectiveInfective endocarditis(IE)is a disease caused by direct infection of bacteria,fungi and other pathogenic microorganisms leading to inflammation of heart valves or inner wall of the ventricle,which can endanger the life of patients in severe cases.This study retrospectively studied the epidemiology,clinical manifestations and diagnosis of infective endocarditis,as well as the therapeutic effect of single drug therapy and surgical treatment,and discussed the situation of simple right heart infective endocarditis.MethodsA total of 260 IE patients admitted to Shandong Provincial Hospital from March 2010 to July 2020 were collected,including 189 male patients and 71 female patients.Among them,106 patients were treated with drugs alone and 154 patients were treated with surgery.There were 52 patients with congenital heart disease,including:24 cases of bicuspid aortic valve,15 cases of ventricular septal defect(VSD),6 cases of patent foramen ovale(PFO),2 cases of complicated congenital heart disease,1 case of atrial septal defect(ASD),1 case of ventricular defect with patent foramen ovale,1 case of unroofed coronary sinus,1 case of congenital aortic stenosis,1 case of tetralogy of Fallot.15 cases of simple right heart infective endocarditisSPSS 20.0 software was used for statistical processing and analysis of relevant data.Measurement data were expressed as x±SD.Independent sample t-test was used to compare the differences between the two groups.ResultsAfter drug therapy alone,86 patients were discharged smoothly,5 patients were discharged automatically,8 patients died during hospitalization,and 7 patients had complications.Of the 145 patients who were cured successfully after surgical treatment,3 died and 6 suffered complications during hospitalization.After surgical treatment,the patient’ s left ventricular end-diastolic diameter and pulmonary systolic pressure decreased,and cardiac function improved.In this study,100 cases of blood bacterial culture were positive,the positive rate was 38.4%.The details were as follows:40 cases of Streptococcus grass green,26 cases of Staphylococcus aureus,6 cases of Brucella,4 cases of Klebsiella pneumoniae,4 cases of Streptococcus hemolyticus,4 cases of Candida candida,4 cases of Enterococcus faecalis,4 cases of Streptococcus gendon,3 case of oral Streptococcus,2 case of Lactobacillus casei,2 case of Mycoplasma,and 1 case of MRSA.A total of 233 cases of valvular disease were suggested in this study,including 103 cases involving the mitral valve,95 cases involving the aortic valve,20 cases involving the mitral valve and aortic valve,6 cases involving the tricuspid valve,and 6 cases involving the pulmonary valve.The pulmonary valve and aortic valve were involved in 2 cases,and the aortic valve and tricuspid valve were involved in 1 case.A total of 50 cases of invasion occurred in the drug treatment group,and a total of 46 cases of invasion occurred in the surgical treatment group.In patients with valve invasion,the cardiac functions of the drug treatment group upon admission were:2 cardiac function Ⅱ,14 cardiac function Ⅲ,34 cardiac function Ⅳ;cardiac function at discharge:cardiac function Ⅱ There were 23 patients with grade Ⅲ,4 patients with grade Ⅲ cardiac function,10 patients with grade Ⅳ cardiac function,and 13 patients died or gave up treatment.Among the patients with valve invasion,the cardiac function of the surgical treatment group upon admission was:20 patients with cardiac function Ⅲ,26 with cardiac function Ⅳ;cardiac function at discharge:30 patients with cardiac function Ⅱ,There were 9 patients with grade Ⅲ cardiac function,4 patients with grade Ⅳ cardiac function,and 3 patients died or gave up treatment.Conclusions1.Surgical treatment has lower in-hospital mortality than medical treatment alone.For patients with valve invasion,surgical treatment is more effective than drug treatment alone,and the long-term prognosis needs further observation and follow-up.2.Early surgical treatment can reduce the risk of death,but the specific time of surgery should be customized according to the patient’ s condition.IE can be secondary to congenital heart disease.For patients with congenital heart disease,deformity should be corrected by surgery as soon as possible to prevent the occurrence of IE.3.The right heart system is rarely invaded,which may be related to the pressure of the heart cavity,the type of pathogenic bacteria,and the blood supply around the valve annulus.4.IE is more common in men,most often involving the aortic valve and mitral valve.5.At the present stage,the main pathogenic bacteria of IE are still Streptococcus virifolia and Staphylococcus aureus.