老年感染性心内膜炎的临床过程及诊断特点

M. Stepchenko, N. S. Meshcherina, E. M. Hardikova, M. Moskalyuk, I. O. Maltseva
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摘要

感染性心内膜炎是一种可怕的疾病,其自然病程预后极差。分析文献资料可以发现,俄罗斯联邦的感染性心内膜炎发病率相对其他国家较高。目前,感染性心内膜炎的早期诊断问题仍然存在。尽管感染性心内膜炎的诊断得到了改善,主要是由于超声心动图和微生物方法的改进,新的抗菌药物和心脏手术技术的引入到临床实践中,但临床图像、实验室参数的变化可能导致免疫炎症、风湿病、肿瘤、血液病的排除,使感染性心内膜炎的诊断复杂化和延迟。感染性心内膜炎的第一个临床症状可能是非特异性的,并且该疾病在数周甚至数月内仍未被发现。血栓性、血栓出血性并发症的高频率表明感染性心内膜炎的止血系统发生了深刻的变化,有必要揭示这些疾病的发病机制。这些因素的结合导致该患者诊断较晚。本研究旨在探讨在临床实践中提高感染性心内膜炎诊治效果的可能性。
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Clinical course and features of the diagnosis of infectious endocarditis in the elderly
Infectious endocarditis is a formidable disease characterized by an extremely unfavorable prognosis in its natural course. Analyzing the literature data, it can be noted that the frequency of infectious endocarditis in the Russian Federation has relatively high prevalence rates in relation to other countries. Currently, the problem of early diagnosis of infectious endocarditis remains relevant. Despite the fact that the diagnosis of infectious endocarditis has improved, mainly as a result of the improvement of echocardiographic and microbiological approaches, the introduction of new antibacterial drugs and cardiac surgery technologies into clinical practice, the clinical picture, changes in laboratory parameters can lead to the exclusion of immuno-inflammatory, rheumatic, oncological, hematological diseases, complicating and delaying the diagnosis of infectious endocarditis. The first clinical signs of infectious endocarditis may be nonspecific, and the disease remains unrecognized for weeks or even months. The high frequency of thrombotic, thrombohemorrhagic complications indicates profound changes in the hemostasis system in infectious endocarditis and the need to disclose the pathogenesis of these disorders. The combination of these factors led to the late diagnosis of this disease in the patient. The aim of the study is to study the possibility of improving the results of diagnosis and therapy of patients with infectious endocarditis in clinical practice.
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