目的：分析儿童感染性心内膜炎的临床特征、治疗和预后。方法回顾性分析1998—2012年收治的83例感染性心内膜炎患儿的临床资料。结果共83例患儿，男53例、女30例，平均年龄(6.8±4.6)岁，临床特征以发热(77.1%)、轻中度贫血(71.1%)、C反应蛋白升高(67.5%)、红细胞沉降率增高(60.2%)、白细胞增高(47.0%)为主；出现栓塞症状20例(24.1%)；血培养阳性56例(67.5%)，以革兰阳性菌为主，链球菌属及葡萄球菌属占89.3%；万古霉素等敏感抗生素治疗有效；超声检查检出赘生物68例(82%）。55例(66.2%)患儿接受心脏手术，最终死亡7例(8.4%)。结论近年来感染性心内膜炎的病原菌变迁，缓症链球菌及金黄色葡萄球菌成为主要病原菌，需万古霉素等敏感抗生素治疗；心脏超声检出赘生物阳性率较高。%Objective To study the clinical characteristics, treatment and prognosis of infective endocarditis in children. Methords Clinical data from 83 patients of infective endocarditis admitted from 1998 to 2012 were retrospectively analyzed. Results In a total of 83 patients, there were 53 males and 30 females, and the average age was 6.8±4.6 years. The main clinical characteristics were fever (77.1%) and mild to moderate anemia (71.1%). The C-reaction protein (67.5%), erythrocyte sedimen-tation rate (60.2%), and white blood cell (47.0%) were elevated. Twenty (24.1%) patients had embolism. Blood culture was pos-itive in 56 (67.5%) cases with bacteria mainly being Gram-positive and Streptococcus and Staphylococcus accounted for 89.3%. Vancomycin and other sensitive antibiotics were effective. Neoplasm was detected in 68 cases (82%) by transthoracic echocar-diograerphy. Fifty-ifve (66.2%) patients underwent cardio surgery. Seven patients (8.4%) died. Conclusion In recent years, the distribution of pathogenic bacteria in infective endocarditis had changed. Streptococcus mitis and Staphylococcus aureus has become a major pathogens and need to be treated by vancomycin and other sensitive antibiotics. The detection rate of neoplasm is higher by echocardiography.
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