雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Kokyu to Junkan Volume 32, Issue 6 （June 1984）

呼吸と循環 32巻6号（1984年6月発行）

Japanese English

研究

置換弁心内膜炎の臨床病理学的検討 Clinicopathological analysis of prthetic valve endocarditis 仁禮隆 ¹ , 登坂正子 ¹ , 寺田一行 ¹ , 大林直子 ¹ , 雨宮邦子 ¹ , 笠貫宏 ¹ , 堀江俊伸 ¹ , 長村好章 ¹ , 近藤瑞香 ¹ , 広沢弘七郎 ¹ , 小柳仁 ² Takashi Nirei ¹ , Masako Tosaka ¹ , Kazuyuki Terada ¹ , Naoko Obayashi ¹ , Kuniko Amamiya ¹ , Hiroshi Kasanuki ¹ , Toshinobu Horie ¹ , Yoshiaki Osamura ¹ , Mizuka Kondo ¹ , Koshichiro Hirosawa ¹ , Hitoshi Koyanagi ² ¹東京女子医科大学附属日本心臓血圧研究所内科 ²東京女子医科大学附属日本心臓血圧研究所外科 ¹Department of Internal Medicine, Heart Institute of Japan, Tokyo Women's Medical College ²Department of Surgery, Heart Institute of Japan, Tokyo Women's Medical College pp.601-607

発行日 1984年6月15日 Published Date 1984/6/15

DOI https://doi.org/10.11477/mf.1404204463

PDF(5474KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　近年人工弁置換術の普及はめざましく，症例数の増加とともに様々な合併症がみられるようになってきた。なかでも置換弁心内膜炎（prosthetic valve endocarditis：以下PVEと略す）は死亡率が高く生命予後に関して非常に重篤な合併症であり，本邦においてもいくつかの施設でその報告がなされ^1〜4），その重要性が認識されつつある。今回我々は当施設において昭和44年より56年までの13年間にみられたPVE 11例について臨床的ならびに病理学的検討を行い，若干の興味ある知見を得たので報告する。

A clinical and pathological study was performed in 11 cases of prosthetic valve endocarditis (PVE) and these cases were compared with 55 cases of non-operated infective endocarditis (NOE) at Heart Institute of Japan during 1969 to 1981. During this period, 1027 cases underwent prosthetic valve re-placement and PVE occurred in 11 (1.1%). In 6 cases of PVE, Hancock porcine valve was affected which amounted 4.3% of 139 cases of Hancock bio-prosthesis.

In PVE, gram negative bacilli (30%) and fungi (27%) were identified more commonly than in NOE, in which incidence was 8% and 0% respec-tively.

Among 11 cases of PVE, 6 (54.5%) were complicated by cerebral infarction, and this inci-dence was significantly higher (p<0.0001) than in NOE (1.1%). Among 5 deceased patients with PVE, the cause of death was cardiac in 3 and cere-bral infarction in 2.

In tissue valve, vegetation was always located on the cusp, as well as in the host tissue over the sew-ing ring in 1 case. On the other hand, infective endocarditis was recognized only surrounding the sewing ring in mechanical prostheses.