Heart:感染性心内膜炎并发的化脓性脊椎炎

2020-06-01 MedSci原创 MedSci原创

PS是IE的常见并发症(占IE的8.5%),在老年高血压合并肠球菌或溶血链球菌IE的患者中观察到,其预后与其他形式的IE相似。

近日,心脏病领域权威杂志Heart上发表了一篇研究文章,该研究主要目的是评估感染性心内膜炎(IE)患者化脓性脊椎炎(PS)的特征和预后。次要目的是评估与PS发生相关的因素。

研究人员对1755例伴有PS(n=150)或不伴有PS(n=1605)的IE患者进行病例对照双中心研究。研究人员记录了受试者临床、微生物和预后变量。

PS患者年龄较大(平均年龄为69.7±18 vs. 66.2±14; p=0.004),并且动脉高血压(48% vs. 34.5%;p<0.001)和自身免疫性疾病(5% vs. 2%; p=0.03)患者更多,相比于不伴有PS的患者。腰椎受累最频繁(84例患者,占66%),尤其是L4–L5。在59%的患者中观察到神经系统症状。PS患者中肠球菌和溶血链球菌的发生率更高(分别为24% vs. 12%和24% vs. 11%;p<0001)。92例患者PS的诊断基于对比增强MRI,88例患者基于骨CT和56例患者基于18F-FDG PET/CT。伴有或不伴有PS的患者的院内死亡率(16% vs. 13.5%,p=0.38)和1年死亡率(21% vs. 22%,p=0.82)没有差异。

由此可见,PS是IE的常见并发症(占IE的8.5%),在老年高血压合并肠球菌或溶血链球菌IE的患者中观察到,其预后与其他形式的IE相似。由于PS与特定的治疗相关,因此应使用包括MRI、CT和PET/CT在内的多模态成像检查对这种心内膜炎并发症进行早期诊断。

原始出处:

Andreina Carbone.et al.Spondylodiscitis complicating infective endocarditis.heart.2020.https://heart.bmj.com/content/early/2020/05/27/heartjnl-2019-316492

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    2020-08-30 丁鹏鹏
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    2020-06-03 zhaojie88
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    2020-06-03 neizongke

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