感染性心内膜炎（Infective endocarditis）.doc

感染性心内膜炎（Infective endocarditis） Seventh unit infective endocarditis Clinical typing Infective endocarditis (IE) is a microbial infection of the intima or adjacent large artery with formation of vegetations. According to the progress of the disease can be divided into acute, subacute, and can be divided into autologous valve, prosthetic valve and intravenous drug addiction endocarditis. The most common site of infection is the heart valve, which can also occur in the chordae chordae and the endocardium of the heart wall. Section 1 infective endocarditis of auto valve (1) common pathogenic microorganisms; Common pathogenic microorganisms include: 1. streptococci and staphylococci accounted for 65% and 25% of pathogenic microorganisms in patients with auto valve endocarditis, respectively. 2. the main pathogens of acute IE are Staphylococcus aureus, and a few of them are caused by pneumococcus, Neisseria gonorrhoeae, Streptococcus A and Haemophilus influenzae. 3. of the patients with subacute IE were most commonly green streptococci, followed by group D streptococci (bovine Streptococcus, Enterococcus), and Staphylococcus epidermidis and other bacteria were less common. 4. fungi, Rickettsia and Chlamydia are uncommon endocarditis in patients with valvular endocarditis. (two) the related factors of subacute infective endocarditis 1. hemodynamic factors Subacute IE occurs mainly in patients with organic heart disease (valvular heart disease and congenital cardiovascular disease). Rheumatic heart disease, especially mitral and aortic valves, is the most susceptible to subacute infective endocarditis. The common sites of vegetations are abnormal blood flow, the endocardium of the lower reaches may decrease with the decrease of these sites and the perfusion of the intima, which is beneficial to the deposition of microorganisms. High velocity jet impingement can cause localized damage to the intima of the large vessels, which can cause infection, such as mitral regurgitation