Analysis of clinical manifestations,ultrasonic characteristics and prognosis in patients with infective endocarditis
OBJECTIVE To observe the clinical manifestations and ultrasonic characteristics in patients with infec-tious endocarditis(IE)and different prognosis,and to analyze the influencing factors of prognosis in IE patients.METHODS A total of 120 patients with IE admitted to Central People's Hospital of Tengzhou between May 2020 and Apr 2023 were retrospectively enrolled.The data of patients were collected,including clinical baseline data,therapeutic regimens,nosocomial complications,results of laboratory tests,cardiac ultrasound characteristics and follow-up situation.According to the prognosis six months after treatment,patients were divided into the good prognosis group(n=95)and poor prognosis group(n=25).The clinical manifestations and cardiac ultrasound characteristics in IE patients with different prognosis were observed.The independent influencing factors of prog-nosis in IE patients were analyzed by multivariate logistic regression analysis.RESULTS The heart rate at admis-sion in the good prognosis group was lower than that in the poor prognosis group,and the interval between symp-tom onset and treatment was shorter than that in the poor prognosis group.Proportions of cardiac function at grade Ⅳ and lower limb edema were lower than those in poor prognosis group(P＜0.05).In good prognosis group,the proportions of surgical treatment,no nosocomial complications,hemoglobin ≥90 g/L and serum albu-min ≥30 g/L were higher than those in the poor prognosis group(P＜0.05),while levels of neutrophils,white blood cell count,procalcitonin,hypersensitive C-reactive protein,D-dimer,brain natriuretic peptide and cardiac troponin Ⅰ at admission were lower than those in the poor prognosis group(P＜0.05).Neoplasm＜15 mm in the good prognosis group was higher than that in the poor prognosis group(P＜0.05),while proportions of valve per-foration,perivalvular leakage and pulmonary hypertension were lower than those in the poor prognosis group(P＜0.05).Multivariate logistic regression analysis showed that high level of cardiac troponin Ⅰ at admission,neo-plasm＞15 mm and perivalvular leakage were risk factors for poor prognosis in IE patients(P＜0.05),while sur-gical treatment,high levels of serum hemoglobin and albumin at admission were protective factors(P＜0.05).CONCLUSION The clinical manifestations are complex in IE patients,and the suspected patients should be screened and intervened in time.High level of cardiac troponin Ⅰ at admission,neoplasm＞15 mm and perivalvular leakage will increase the risk of poor prognosis for IE patients.
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