摘要
目的 探讨感染性心内膜炎(IE)患者病原菌特征、心肌酶谱水平及疾病转归因素。方法 回顾性选取2021年3月至2023年12月山东大学齐鲁医院收治的102例IE患者作为研究对象,根据血培养结果分为阴性组31例、阳性组71例,根据住院期间是否死亡分为死亡组9例、存活组93例。分析IE患者病原菌分布特征,比较2组血清炎症指标、心肌酶谱指标水平变化情况;采用Pearson相关分析探讨IE患者患者心肌酶谱水平与炎症指标的相关性;采用二分类Logistic逐步回归分析探讨IE患者预后的影响因素。结果 102例IE患者血培养阳性率为69.61%(71/102)。阳性组肿瘤坏死因子-α(TNF-α)、白介素(IL-2)、白介素-6(IL-6)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)均高于阴性组,差异有统计意义(P<0.05)。Pearson相关分析显示,IE患者血清CK-MB、CK、LDH水平与TNF-α、IL-2、IL-6均呈正相关(P<0.05)。死亡组年龄≥60岁占比、糖尿病史占比、心功能分级Ⅲ~Ⅳ级占比、心脏赘生物大小≥15 mm占比、接受手术治疗占比、TNF-α、IL-2、IL-6、CK-MB、CK、LDH水平高于存活组,低血红蛋白水平于存活组,差异有统计意义(P<0.05)。多因素回归分析显示,心脏赘生物大小≥15 mm、低血红蛋白水平、高CK-MB水平、高CK水平、LDH水平高是IE患者预后的独立危险因素(P<0.05)。结论 IE患者病原菌以革兰阳性菌为主,可通过监测心肌酶谱水平来判断患者病情严重程度;心脏赘生物大小、血红蛋白、心肌酶谱指标均是影响IE患者预后的相关因素。
Objective To investigate the characteristics of pathogenic bacteria,the level of myocar-dial enzymes and the outcome factors of infectious endocarditis(IE).Methods 102 IE patients admitted to Qilu Hospital of Shandong University from March 2021 to December 2023 were selected.Based on the blood culture results,they were divided into two groups:negative group(31 cases),and positive group(71 cases).According to whether the patients died during hospitalization,they were divided into the death group(9 cases)and the sur-vival group(93 cases).The distribution characteristics of pathogenic bacteria in IE patients were analyzed,and the changes of serum inflammatory index and myocardial enzyme spectrum index between the negative group and positive group were compared.The correlation between the level of myocardial enzyme spectrum and inflamma-tion index in IE patients were explored by Pearson correlation analysis.The prognostic factors of IE patients were explored by Binary logistic stepwise regression.Results The positive blood culture rate in 102 IE patients was 69.61%(71/102).Tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6),creatine ki-nase isoenzyme(CK-MB),creatine kinase(CK)and lactate dehydrogenase(LDH)levels in the positive group were higher than those in the negative group,with statistical significance(P<0.05).Pearson correlation analysis showed that the serum levels of CK-MB,CK,and LDH in IE patients were positively correlated with TNF-α,IL-2,and IL-6(P<0.05).The proportion of age≥60 years in death group,the proportion of diabetes history,the proportion of cardiac function gradeⅢtoⅣ,the proportion of cardiac neoplasma size≥15 mm,the proportion receiving surgical treatment,the level of TNF-α,IL-2,IL-6,CK-MB,CK,and LDH were higher than those in the survival group,and the hemoglobin level was lower than that in the survival group,with statistical significance(P<0.05).Multivariate regression analysis showed that the size of cardiac neo-plasms≥15 mm,low hemoglobin levels,high CK-MB l
作者
徐克
王山山
杨慧
宋丽
王刚
赛林涛
XU Ke;WANG Shanshan;YANG Hui;SONG Li;WANG Gang;SAI Lintao(Department of Infectious Disease,Qilu Hospital of Shandong University,Jinan,Shandong,China,250012;Department of Hospital Infection-Control,Yingjisha County People's Hospital,Kashgar,Xinjiang Uygur Autonomous Region,China,844500)
出处
《分子诊断与治疗杂志》
2024年第6期1091-1094,1099,共5页
Journal of Molecular Diagnostics and Therapy
基金
新疆维吾尔自治区课题(WJWY-XCZX202235)。
关键词
感染性心内膜炎
病原菌
心肌酶谱
炎症指标
IE
Pathogenic bacteria
Myocardial enzyme profile
Indicators of inflammation
