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Circulation：侵入性牙科治疗后感染性心内膜炎的风险！

2018-04-20 xing.T MedSci原创

IDTIE风险
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在两项研究设计中，在IDT之后短时间内没有观察到IE的临床风险更高。研究人员还发现高危患者中IDT和IE之间无关联。因此，台湾人群不需要抗生素治疗以预防IE。

侵入性牙齿治疗（IDTs）可引起暂时性菌血症，因此被认为是感染性心内膜炎（IE）的潜在危险因素。据推测，通过IDT引起的创伤，细菌进入血液，可能附着于异常心脏瓣膜或心脏组织受损，导致IE。然而，IDT和IE之间的关联仍然存在争议。近日，心血管领域权威杂志Circulation上发表了一篇研究文章，这项研究的目的是评估IDT与IE之间的关联。

该研究的数据来自于台湾健康保险数据库。研究人员选择了两个病例研究设计、病例交叉和自我对照的病例系列以分析数据。这些方法的优点是不会随着时间变化的混杂因素可被隐藏调整。在病例交叉设计中，使用暴露于IDT的条件logistic回归模型分别用于估计IDT后4、8、12和16周后IE的风险。在自我对照的病例系列设计中，研究人员使用条件泊松回归模型估计IDT后1-4周、5-8周、9-12周和13-16周IE风险。

总共有9120例和8181例IE患者被纳入病例交叉设计和自我对照病例系列设计。在病例交叉设计中，277例病例和249例对照者在暴露期间接受了IDT，4周期间比值比为1.12（95％可信区间（CI）为0.94-1.34）。在自我对照的病例系列设计中，研究人员观察到IDT后前四周期间407例患者发生IE，IDT后1-4周期间年龄校正发生率比率为1.14（95％CI为1.02-1.26）。

在两项研究设计中，在IDT之后短时间内没有观察到IE的临床风险更高。研究人员还发现高危患者中IDT和IE之间无关联。因此，台湾人群不需要抗生素治疗以预防IE。

原始出处：

Tzu-Ting Chen,et al. Risk of Infective Endocarditis After Invasive Dental Treatments: A Case-Only Study. Circulation. 2018. https://doi.org/10.1161/CIRCULATIONAHA.117.033131

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    2018-10-03 医者仁心

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    2018-08-23 xiaoyang_ambs

    #侵入性#

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    2018-10-02 charl1234575

    #感染性#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1708451, encodeId=2dbb1e08451f8, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed Oct 03 08:40:00 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2028779, encodeId=a93e2028e79a9, content=<a href='/topic/show?id=b1e1269e5c6' target=_blank style='color:#2F92EE;'>#侵入性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26975, encryptionId=b1e1269e5c6, topicName=侵入性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4736501, createdName=xiaoyang_ambs, createdTime=Thu Aug 23 14:40:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049646, encodeId=7a022049646af, content=<a href='/topic/show?id=4e146e62931' target=_blank style='color:#2F92EE;'>#牙科治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67629, encryptionId=4e146e62931, topicName=牙科治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d275294, createdName=andy2087, createdTime=Sun Aug 19 18:40:00 CST 2018, time=2018-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655420, encodeId=cf9d16554203b, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Tue Oct 02 12:40:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350705, encodeId=83aa1350e052c, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 22 07:40:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461333, encodeId=1be9146133302, content=<a href='/topic/show?id=67356e62003' target=_blank style='color:#2F92EE;'>#牙科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67620, encryptionId=67356e62003, topicName=牙科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2d786418402, createdName=xzw115, createdTime=Sun Apr 22 07:40:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307734, encodeId=8e9030e734c1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Apr 21 00:24:57 CST 2018, time=2018-04-21, status=1, ipAttribution=)]
    2018-04-22 zhaojie88

    #心内膜炎#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1708451, encodeId=2dbb1e08451f8, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed Oct 03 08:40:00 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2028779, encodeId=a93e2028e79a9, content=<a href='/topic/show?id=b1e1269e5c6' target=_blank style='color:#2F92EE;'>#侵入性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26975, encryptionId=b1e1269e5c6, topicName=侵入性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4736501, createdName=xiaoyang_ambs, createdTime=Thu Aug 23 14:40:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049646, encodeId=7a022049646af, content=<a href='/topic/show?id=4e146e62931' target=_blank style='color:#2F92EE;'>#牙科治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67629, encryptionId=4e146e62931, topicName=牙科治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d275294, createdName=andy2087, createdTime=Sun Aug 19 18:40:00 CST 2018, time=2018-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655420, encodeId=cf9d16554203b, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Tue Oct 02 12:40:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350705, encodeId=83aa1350e052c, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 22 07:40:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461333, encodeId=1be9146133302, content=<a href='/topic/show?id=67356e62003' target=_blank style='color:#2F92EE;'>#牙科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67620, encryptionId=67356e62003, topicName=牙科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2d786418402, createdName=xzw115, createdTime=Sun Apr 22 07:40:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307734, encodeId=8e9030e734c1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Apr 21 00:24:57 CST 2018, time=2018-04-21, status=1, ipAttribution=)]
    2018-04-22 xzw115

    #牙科#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1708451, encodeId=2dbb1e08451f8, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Wed Oct 03 08:40:00 CST 2018, time=2018-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2028779, encodeId=a93e2028e79a9, content=<a href='/topic/show?id=b1e1269e5c6' target=_blank style='color:#2F92EE;'>#侵入性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26975, encryptionId=b1e1269e5c6, topicName=侵入性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4736501, createdName=xiaoyang_ambs, createdTime=Thu Aug 23 14:40:00 CST 2018, time=2018-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049646, encodeId=7a022049646af, content=<a href='/topic/show?id=4e146e62931' target=_blank style='color:#2F92EE;'>#牙科治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67629, encryptionId=4e146e62931, topicName=牙科治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d275294, createdName=andy2087, createdTime=Sun Aug 19 18:40:00 CST 2018, time=2018-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655420, encodeId=cf9d16554203b, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Tue Oct 02 12:40:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350705, encodeId=83aa1350e052c, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Apr 22 07:40:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1461333, encodeId=1be9146133302, content=<a href='/topic/show?id=67356e62003' target=_blank style='color:#2F92EE;'>#牙科#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67620, encryptionId=67356e62003, topicName=牙科)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2d786418402, createdName=xzw115, createdTime=Sun Apr 22 07:40:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307734, encodeId=8e9030e734c1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Apr 21 00:24:57 CST 2018, time=2018-04-21, status=1, ipAttribution=)]
    2018-04-21 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0