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自Osler提出“恶性心内膜炎”至今已有一百余年,但心内膜炎一直是临床和基础各领域中饶有兴趣而又棘手的问题。抗生素的问世降低了它的病死率和发病率。但是,近二十年来,由于心脏外科的发展,各种侵袭性导管的广泛应用以及重危儿存活率的提高,使小儿心内膜炎的发病率又有所上升。目前,将心内膜炎分为感染性心内膜炎(IE)和非感染性心内膜炎(NIE)二大类。前者又分为细菌性心内膜炎(BE)和非细菌性心内膜炎(NBE)。IE中,细菌性约占95%,真菌性约占5%,其它立克次体、病毒及衣原体总计不及1%。本文拟对近年来欧美在小儿IE方面的一些进展作一简要综述。
Since Osler put forward “malignant endocarditis” has been more than a hundred years, but endocarditis has been an interesting and difficult issue in all clinical and basic fields. The advent of antibiotics reduced its mortality and morbidity. However, the incidence of endocarditis in children has risen again in recent 20 years due to the development of cardiac surgery, the widespread use of various invasive catheters and the increased survival rate of critically ill children. Currently, endocarditis is divided into infective endocarditis (IE) and non-infective endocarditis (NIE) two categories. The former is divided into bacterial endocarditis (BE) and non-bacterial endocarditis (NBE). In IE, bacteria account for about 95%, fungi account for about 5%, other rickettsia, viruses and chlamydia total less than 1%. This article is intended to give a brief overview of some progress made by children in Europe and America in recent years.